IL-1β level at admission predicts mortality, MACE in MI patients

Interleukin (IL)-1β concentrations measured in patients with acute myocardial infarction (MI) at admission independently correlated with the risk of mortality and recurrent major adverse cardiovascular events (MACEs), according to a study.

The investigators examined the association between IL-1β level and all-cause mortality in 1,398 patients with acute ST-segment elevation MI who underwent primary percutaneous coronary intervention and the interaction between IL-1β and high-sensitivity C-reactive protein (hs-CRP) concentrations on the risk of premature death.

Multivariate Cox proportional regression analysis was used to estimate crude and hazard ratios (HRs) for all-cause and cardiovascular mortality at 90 days and 1 year. MACEs were also analysed.

IL-1β concentration measured at admission was predictive of all-cause mortality at 90 days (adjusted HR, 1.47, 95 percent confidence interval [CI], 1.16–1.87; p<0.002). The association was linear, with the highest tertile of IL-1β correlating with higher mortality rates at 90 days (adjusted HR, 2.78, 95 percent CI, 1.61–4.79; p=0.0002) and at 1 year (adjusted HR, 1.93, 95 percent CI, 1.21–3.06; p=0.005), regardless of the hs-CRP concentration.

There were also significant associations when considering cardiovascular mortality and MACEs at 90 days (adjusted HR, 2.42, 95 percent CI, 1.36–4.28; p=0.002 and adjusted HR, 2.29, 95 percent CI, 1.31–4.01; p=0.004, respectively) and at 1 year (adjusted HR, 2.32, 95 percent CI, 1.36–3.97; p=0.002 and adjusted HR, 2.35, 95 percent CI, 1.39–3.96; p=0.001, respectively).

“Inhibition of IL-1β innate immunity pathway is associated with anti-inflammatory effects and a reduced risk of recurrent cardiovascular events in stable patients with previous MI and elevated hs-CRP,” the investigators said.