IL-6, IL-1β, and MDA Correlate with Thrombolysis in Myocardial Infarction (TIMI) Risk Score in Patients with Acute Coronary Syndrome

Abstract

Background: Inflammation plays a significant role in the pathophysiology of Acute Coronary Syndrome (ACS) but is not included in current risk stratification. Objective: This study aimed at determining the association between thrombolysis in Myocardial Infarction (TIMI) risk score and inflammatory biomarkers in the ACS, including unstable angina (UA), non-ST segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI). We hypothesized that inflammatory biomarkers could add prognostic value to the TIMI risk score. Methods: In this cross-sectional study, serum levels of interleukins (IL)-6 and IL-1β and MDA (malondialdehyde) were quantified by ELISA and colorimetry, respectively, of patients with ACS (n = 48; 31.3 % with UA, 33.3 % with NSTEMI, and 35.4 % with STEMI) and healthy controls (n = 43). We assessed the TIMI scores in the first 24 h after symptom onset. Results: The results showed that patients with ACS had significantly higher levels (p<0.05) of the inflammatory biomarkers IL-6, IL-1β, and MDA than the control group. However, we found no significant differences in IL-6, IL-1β, and MDA levels among the patients with ACS according to their classification as UA, NSTEMI, and STEMI. Positive correlations were observed between TIMI and IL-6 (r=0.68), IL-1β (r= 0.53), and MDA (r=0.58) in patients with UA and between TIMI and IL-1β (r= 0.62) in STEMI patients. Conclusion: These data suggested the presence of a pro-inflammatory profile in patients with ACS as well as positive correlations between TIMI scores and the inflammatory biomarkers IL-6, IL-1β, and MDA in patients with UA and between TIMI scores and IL-1β in patients with STEMI. Combining inflammatory biomarkers with the TIMI risk score could provide better insight into the processes involved in ACS.