Increased plasma group II phospholipase A(2) concentrations in patients with acute myocardial infarction: correlation with tumor necrosis factor-alpha.

OBJECTIVE

Group II phospholipase A(2) (PLA(2)) is thought to play an important role in inflammation and tissue injury. It has been suggested that the inflammatory process is important in the setting and progression of myocardial ischemia or reperfusion. We measured plasma PLA(2) as well as inflammatory cytokines in patients in the acute stage of myocardial infarction.

RESULTS

In 48 patients with acute myocardial infarction, blood samples were taken to measure plasma PLA(2), tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 beta (IL-1 beta) 36-48 h after onset. Serial changes in plasma PLA(2) were also examined in 15 consecutive patients in this group. Plasma PLA(2) levels were significantly higher in complicated patients (Killip's class > or = II) than in uncomplicated patients (Killip's class = I) (35.9 +/- 11.9 vs. 5.3 +/- 1.1 ng/ml, p < 0.01). Plasma PLA(2) concentrations increased gradually over time during the first 3 days and at 36-48 h after onset were correlated with left-ventricular ejection fraction on admission (r = -0.42, p < 0.01), and with plasma TNF-alpha (r = 0.39, p < 0.01), but not with IL-1 beta.

CONCLUSIONS

Plasma PLA(2) concentrations rose during the acute stage of myocardial infarction, especially in severe cases mainly with heart failure. TNF-alpha may be associated with PLA(2)activity as a potent stimulator in vivo.