Interleukin-1β and Risk of Premature Death in Patients With Myocardial Infarction
Silvain J, Kerneis M, Zeitouni M, Lattuca B, Galier S, Brugier D, Mertens E, Procopi N, Suc G, Salloum T, Frisdal E, Le Goff W, Collet JP, Vicaut E, Lesnik P, Montalescot G, Guerin M.
J Am Coll Cardiol. 2020 Oct 13;76(15):1763-1773. doi: 10.1016/j.jacc.2020.08.026. Epub 2020 Aug 27. PMID: 32861811
Background: Inhibition of the interleukin (IL)-1β innate immunity pathway is associated with anti-inflammatory effects and a reduced risk of recurrent cardiovascular events in stable patients with previous myocardial infarction (MI) and elevated high-sensitivity C-reactive protein (hs-CRP).
Objectives: This study assessed the association between IL-1β level with all-cause mortality in patients with acute ST-segment elevation MI who underwent primary percutaneous coronary intervention and the interplay between IL-1β and hs-CRP concentrations on the risk of premature death.
Methods: IL-1β concentration was measured in 1,398 patients with ST-segment elevation MI who enrolled in a prospective cohort. Crude and hazard ratios for all-cause and cardiovascular mortality were analyzed at 90 days and 1 year using multivariate Cox proportional regression analysis. Major adverse cardiovascular events (MACEs) were analyzed.
Results: IL-1β concentration measured at admission was associated with all-cause mortality at 90 days (adjusted hazard ratio [adjHR]: 1.47 per 1 SD increase; 95% confidence interval [CI]: 1.16 to 1.87; p < 0.002). The relation was nonlinear, and the highest tertile of IL-1β was associated with higher mortality rates at 90 days (adjHR: 2.78; 95% CI: 1.61 to 4.79; p = 0.0002) and at 1 year (adjHR: 1.93; 95% CI: 1.21 to 3.06; p = 0.005), regardless of the hs-CRP concentration. Significant relationships were equally observed when considering cardiovascular mortality and MACEs at 90 days (adjHR: 2.42; 95% CI: 1.36 to 4.28; p = 0.002, and adjHR: 2.29; 95% CI: 1.31 to 4.01; p = 0.004, respectively) and at 1 year (adjHR: 2.32; 95% CI: 1.36 to 3.97; p = 0.002, and adjHR: 2.35; 95% CI: 1.39 to 3.96; p = 0.001, respectively). Conclusions: IL-1β measured at admission in patients with acute MI was independently associated with the risk of mortality and recurrent MACEs. Keywords: C-reactive protein; inflammation; interleukin-1β; mortality; myocardial infarction.