Keywords
macrophage-inhibiting factor
left ventricular remodeling
How to Cite
Abstract
We studied the role of macrophage-inhibiting factor in prognostication the development of adverse post-infarction remodeling of the left ventricle in 73 patients with confirmed myocardial infarction with ST segment elevation (STEMI) and successful restoration of blood flow (TIMI-III) at middle age of (58,37±10,34). Clinical, anamnestic and biochemical indicators were determined. The level of macrophage-inhibiting factor in the blood serum was determined by enzyme immunoassay. All patients were divided according to the median level of macrophage-inhibiting factor into two groups: the first – 36 patients with a low or moderate increase in macrophage-inhibiting factor (≤2582,80 ng/ml), the second – 37 patients with a high level of cytokine (>2582,80 ng/ml). The control group consisted of 20 healthy individuals. After 6 months of observation, patients were invited for re-examination. Adverse remodeling of the left ventricle was considered an increase in its end-diastolic volume by more than 10 %. In patients with STEMI, a statistically significant increase in the median cytokine level was observed relative to the control (2582,80 [1308,40–4122,20] and (573,75 [397,80–1016,75] ng/ml, respectively, p<0,001). which indicates the activation of macrophage-inhibiting factor formation due to an index event. A positive correlation was found between the levels of macrophage-inhibiting factor and troponin I (r=0,33; p=0,045) and the number of blood leukocytes (r=0,36; p=0,039). ROC analysis revealed a cut-off level of macrophage-inhibiting factor ≥2644,5 ng/ml (the area under the curve is 0.736, senses specificity is 72,7 % and specificity is 81,8 %; 95 % confidence interval is 0,515–0,956, p=0,0362), according to which patients with possible development of adverse remodeling of the left ventricle after 6 months of observation are identified, which may affect course of the disease and prognosis. A positive correlation between the levels of macrophage-inhibiting factor and troponin I and the number of white blood cells confirms its participation in the processes of inflammation and necrosis. The level of macrophage-inhibiting factor can be used to predict adverse left ventricular remodeling after 6 months of follow-up after STEMI.
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