eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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SCImago Journal & Country Rank
1/2019
vol. 15
 
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abstract:
Original paper

Chemokine RANTES and IL-1β in mild therapeutic hypothermia-treated patients after out-of-hospital sudden cardiac arrest

Jakub Podolec, Aleksander Trąbka-Zawicki, Rafał Badacz, Mateusz Siedliński, Marek Tomala, Krzysztof Bartuś, Jacek Legutko, Tadeusz Przewłocki, Krzysztof Żmudka, Anna Kabłak-Ziembicka

Adv Interv Cardiol 2019; 15, 1 (55): 98–106
Online publish date: 2019/03/15
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Introduction
CCL5/RANTES and IL-1, which regulate the immune response, may have an impact on survival in patients with acute coronary syndrome (ACS) and sudden cardiac arrest (SCA).

Aim
To evaluate levels of CCL5/RANTES and IL-1 in patients with ACS complicated by SCA, treated with coronary angioplasty (PCI) and mild therapeutic hypothermia (MTH), and these chemokines’ impact on the 30- and 180-day survival.

Material and methods
Thirty-three unconscious patients admitted after SCA with ACS underwent PCI and MTH treatment. CCL5/RANTES and IL-1 were evaluated on admission (T0), at 12–24 h (T1) and at 48–72 h (T2). All-cause mortality was recorded at 30 and 180 days.

Results
We observed a statistically significant decrease in median levels of CCL/RANTES at T0, T1 and T2 (24.69 ng/ml vs. 3.89 ng/ml vs. 2.71 ng/ml; p < 0.001), and significant differences in median levels of IL-1 (0.196 pg/ml vs. 0.171 pg/ml vs. 0.214 pg/ml; p = 0.034). Initial levels of CCL5/RANTES and IL-1 correlated significantly (r = –0.360; p = 0.045). At T2, CCL5/RANTES correlated with the maximum levels of hs-TnT and CK-MB (r = –0.594; p < 0.001 and r = –0.389; p = 0.030), and at T0 with BNP (r = –0.521; p = 0.003). Mortality rate at 30 days and 180 days was 18.2% and 45.5%, respectively. At 30 days, we observed a trend to significance for IL-1 at T0 and T1 (p = 0.078 and p = 0.079), but not for CCL5/RANTES (p = 0.284 and p = 0.351). For 180-day survival curves, only the IL-1 level at T1 was associated with mortality (p = 0.028).

Conclusions
Although CCL5/RANTES levels correlate with cardiac injury and heart failure markers and they decrease during MTH, they failed to predict early and late mortality. In contrast, IL-1 level was associated with 180-day survival.

keywords:

chemokine RANTES, IL-1, mild therapeutic hypothermia, sudden cardiac arrest

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