Inhibition of the interleukin-1β (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).
To assess the association between IL-1β level with all-cause mortality in patients with acute ST segment elevation myocardial infarction (MI) undergoing primary percutaneous coronary intervention and the interplay between IL-1β and hs-CRP concentrations on the risk of premature death.
IL-1β concentration was measured among 1398 ST segment elevation MI patients enrolled in a prospective cohort. Crude and hazard ratios for all-cause and cardiovascular mortality were analyzed at 90-days and one-year using a multivariate-cox proportional regression analysis. Major cardiovascular events (MACE) were analyzed.
IL-1β concentration measured at admission was associated with all-cause mortality at 90 days (adjusted hazard ratio [adjHR], 1.47 per 1SD increase; 95% CI, 1.16 to 1.87; p<0.002). The relation was nonlinear, and highest tertile of IL-1β was associated with higher mortality rates at 90 days (adjHR: 2.78; 95%CI: 1.61-4.79, p=0.0002) and one-year (adjHR: 1.93; 95%CI: 1.21-3.06, p=0.005), regardless of the hs-CRP concentration. Significant relationships were equally observed when considering cardiovascular mortality and MACE at 90 days (adjHR: 2.42; 95% CI: 1.36-4.28, p=0.002 and 2.29; 95% CI: 1.31-4.01, p=0.004, respectively) and at one year (adjHR: 2.32; 95% CI: 1.36-3.97, p=0.002 and 2.35; 95% CI: 1.39-3.96, p=0.001, respectively).
IL-1β measured at admission in acute MI patients is independently associated with the risk of mortality and recurrent MACE.