Serum interleukin 6 and 10 levels in Takotsubo cardiomyopathy: Increased admission levels may predict adverse events at follow-up

• Published in: Atherosclerosis Vol. 254; pp. 28 - 34
• Main Authors: Santoro, Francesco, Tarantino, Nicola, Ferraretti, Armando, Ieva, Riccardo, Musaico, Francesco, Guastafierro, Francesca, Di Martino, Luigi, Di Biase, Matteo, Brunetti, Natale Daniele
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.11.2016
• Subjects: Acute Disease; Aged; Cardiovascular; Coronary Angiography; Echocardiography, Doppler; Female; Follow-Up Studies; Humans; Inflammation; Interleukin-10; Interleukin-10 - blood; Interleukin-6; Interleukin-6 - blood; Male; Middle Aged; Myocardial Infarction - blood; Patient Admission; Prognosis; Proportional Hazards Models; Prospective Studies; Recurrence; Takotsubo cardiomyopathy; Takotsubo Cardiomyopathy - blood; Takotsubo Cardiomyopathy - therapy; Ventricular Function, Left; Takotsubo cardiomyopathy; Prognosis; Interleukin-10; Interleukin-6
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2016.09.012

Systemic inflammation has been hypothesized as a possible mechanism of Takotsubo cardiomyopathy (TTC). Aim of the study was to assess the role of interleukin (IL)-6 and IL-10 in subjects with an episode of TTC. Fifty-six consecutive subjects with TTC were prospectively enrolled in the study and followed for a mean of 178 days. Circulating levels of IL-6, IL-10, clinical condition and left ventricular ejection fraction were evaluated at admission. Incidence of death, re-hospitalization and recurrence of TTC during follow-up was also recorded. 23% of patients experienced in-hospital complications while 20% of patients had adverse events at follow-up. IL-6 and IL-10 serum levels at admission were higher in subjects with adverse events at follow-up (120 ± 294 vs. 22 ± 40 pg/ml, p<0.05; 13 ± 35 vs. 2 ± 3 pg/ml, p=0.05, respectively). Increased serum levels of IL-6 and IL-10 were associated with higher adverse events rates at follow-up (Log-Rank p<0.001, <0.05, hazard ratio 8.6, 5.1, respectively) and mortality rates (Log-Rank p<0.001, p<0.05, hazard ratio 20.8, 7.1, respectively). Subjects with both increased IL-6 and IL-10 levels were characterized by an increased risk of adverse events when compared to subjects with only IL-6 or IL-10 increased levels or with values below cutoff values (Log-Rank p<0.01 for any event, <0.001 for death; hazard ratio 1.20 for any event, 1.31 for death), even after correction for age, LVEF and NTproBNP levels in multivariable Cox analysis. Serum IL-6 and IL-10 admission levels are associated with higher risk of adverse events during follow-up. •There is a lack of data about the pathophysiology of Takotsubo cardiomyopathy (TTC).•Systemic inflammation has been hypothesized as a possible mechanism of TTC.•Interleukin (IL)-6 and IL-10 are well known mediators of inflammation and may modulate the prognosis after AMI.•Progressively increased rates of in-hospital complications were found in subjects with high levels of IL6 and IL10.•Patients with TTC presenting with both increased IL-6 and IL-10 levels have a higher risk of adverse events.