Borrayo-Sánchez G, Pacheco-Bouthillier A, Mendoza-Valdez L, Isordia-Salas I, Argüero-Sánchez R, Careaga RG

Idioma: Español
Referencias bibliográficas: 34
Paginas: 23-30
Archivo PDF: 200.20 Kb.

RESUMEN

Introducción: La interlucina-6 (IL6) participa en la aterogénesis y en el fenómeno aterotrombótico más catastrófico: el infarto agudo del miocardio con elevación del ST (IAM CEST). El objetivo de esta investigación fue evaluar el pronóstico de los niveles elevados de IL6 para eventos cardiovasculares mayores en pacientes con IAM CEST.
Material y métodos: Estudiamos pacientes consecutivos con diagnóstico de IAM CEST de acuerdo con los criterios convencionales establecidos por la ACC/AHA/ESC. Se determinó IL6 sérica a las 24 horas de iniciado el evento, mediante quimioluminiscencia. Las variables de desenlace fueron arritmias, angina, falla cardiaca, reinfarto no fatal y muerte, o la combinación de ellas durante la hospitalización.
Resultados: Incluimos 97 pacientes; el punto de corte de IL6 para identificar a los pacientes con alto riesgo fue de 20 pg/ml. En el grupo I (‹ 20 pg/ml) fueron 46 pacientes y en el grupo II (› 20 pg/ml), 51 (IL6 11.52 ± 4.83 pg/ml versus 63.19 ± 44.4 pg/ml, p ‹ 0.0001). Fue más frecuente la muerte (2.2 versus 15.7 %, p = 0.023, RR 1.16 IC 95 % = 1.02-1.31) y el punto final combinado durante la hospitalización en el grupo II (21.7 versus 51 %, p = 0.003, RR = 1.59, IC 95 % = 1.16-2.19). La clase de Killip ≥ 2 y los niveles de IL6 ≥ 20 pg/ml fueron factores independientes para el punto final combinado.
Conclusiones: Los niveles de IL6 ≥ 20 pg/ml en IAM CEST se asociaron significativamente a más eventos cardiovasculares durante la hospitalización.

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