Inflammatory Response to Acute Myocardial Infarction Complicated by Cardiogenic Shock

Abstract

We report a case of a 60-year-old man with acute myocardial infarction (AMI) treated using thrombolysis, and complicated by cardiogenic shock (CS). Plasma interleukin (IL) 1β, IL 6, IL 8, tumor necrosis factor alpha (TNFα), and soluble adhesion molecule (sICAM 1, sE-selectin) levels were measured at 3-h intervals. This observation showed the effect of AMI and CS on the plasma interleukin levels. Remarkable changes were found in the plasma TNF α level, which reached two significant peaks. The peak of the first elevation caused by AMI (80.11 pg/ml, vs. normal value 4.35 pg/ml, SD 21.3 pg/ml) was seen 6 h after the onset of the symptoms. After the period of significant decrease, TNF α level was increasing until the end of the observation period because of CS (the last TNF α level was 204.1 pg/ml). The plasma IL 1β level was continually increased during the period of observation (maximal IL 1β level 32.1 pg/ml, normal value <10 pg/ml). The plasma IL 6 level reached the first peak caused by AMI nine hours after the onset of the symptoms (362.85 pg/ml, normal value (10 pg/ml). Because of CS, after the short period of decrease, the plasma IL 6 level was increasing until the end of the observation period (the last IL 6 level was 859.61 pg/ml). The plasma IL 8 level was also elevated throughout the time of observation (max. value 1652 pg/ml, vs. normal value <30pg/ml). The soluble adhesion molecule levels (sE-selectin and sICAM 1) were elevated throughout the period of observation without any significant peak.

Keywords

• Acute myocardial infarction
• Cardiogenic shock
• Interleukins
• Soluble adhesion molecules