Introduction
Cardiovascular diseases (CVDs) are the primary cause of death worldwide:
it is approximated that 17.5 million people die from CVDs every year,
and this makes CVDs accountable for more than one-fourth of the total
global deaths.1 There is a considerable amount of
evidence to show that obesity is one of the strongest risk factors
associated with the development of MI. Obesity is characterized by
inflammation that is related to other disorders, too.2Blood vessel inflammation plays a vital role in the initiation of
plaques, their progression, and fibrous capture, which causes the
formation of local thrombus and leads to hypoxia-related myocardial
damage. In MI patients who have thrombus, the infarction-related
arteries often exhibit endothelial dysfunction. In such vessels,
inflammatory cytokines, such as interleukin-6 (IL-6), and its related
signaling protein C-reactive protein (CRP), are found at high
levels.3 Additionally, epidemiological research, as
well as meta-analytical studies, have reported a linkage between the
IL-6 and CRP levels in heart diseases, even among healthy males and
females. Both markers have been linked with an augmented risk of
mortality, especially in patients with unstable coronary artery disease
(CAD).4, 5 In particular, circulating IL-6 is
considered as an important pro-atherogenic cytokine, and its level is an
independent predictor of cardiovascular mortality.6
High serum levels of IL-6, as well as other cytokines, are associated
with poor clinical outcomes in hospitalized patients who have unstable
angina or ST-elevated myocardial infarction (STEMI).7Moreover, multiple diseases that commonly lead to death among the
elderly might stimulate or sustain a systemic inflammatory state that
can be detected via a rise in IL-6 levels and other pro-inflammatory
cytokines.8 In addition, IL-6 is one of the major
cytokines involved in the production of acute-phase proteins, which show
elevated levels in clinical conditions such as tissue injury caused by
infections, tumors, ischemic disorders, and trauma.9Exploring the correlation of IL-6 with other important clinical
parameters in these pathophysiologic events might shed light on the
underlying inflammatory mechanisms and their association with an
increased risk of mortality.9
High-sensitivity CRP (hs-CRP) has been shown to be a biomarker for
vascular risk in atherothrombosis.10 hs-CRP has also
been shown to be a prognostic marker in acute coronary syndrome
patients, but it has poor specificity. In fact, it may be more useful as
a prognostic marker when used in combination with IL-6, which has been
reported to be a marker of inflammation, localized coronary plaques, and
atherosclerotic plaques,11 and has also been reported
to be significantly associated with inflammatory plaques in acute
coronary syndrome patients.12 A combination of
clinical parameters, such as CRP, IL-1,and IL-6, has shown promise as a
target for anti-inflammatory agents used for
atheroprotection.13 In the context of involvement of
IL6 and CRP in the process of MI, this study was designed to determine
the correlation of different parameters of cardiovascular risk with
serum IL-6 and hsCRP levels in patients with MI.