In the setting of AMI, IL-6 was identified
as independent prognostic marker [21]. In the present
study, IL-6 levels differed significantly between the
survivor and nonsurvivor groups at the early points in
time, in which the values at admission showed an
impressive discrepancy. In accordance with that, univariate
analysis confirmed the predictive value of IL-6 for
30-day mortality at the early points in time. IL-6 levels
at admission revealed the highest level of significance
within the ROC analyses. A cut-off level of 307 pg/ml
showed a very clear differentiation between survivors
and nonsurvivors within the Kaplan-Meier curves, associated
with a very high specificity of 98%. Moreover, in
contrast to Nt-proBNP, IL-6 levels at T0 and T1 were
predictive for occurrence of MOF. Our data confirm the
results of a small retrospective study with only initial
measurements of IL-6 that also showed an independent
predictive value of IL-6 for 30-day mortality [11]. It is
hypothesized that next to ischemic myocardium, whole
body ischemia, endotoxin translocation from the gut,
excessive vasopressor therapy, and noncardiac organ
failure are also contributing factors to IL-6 release [22].
Possibly, IL-6 constitutes not only an innocent bystander
of inflammatory activation, but also might be an
aggravating factor because IL-6 determines negative inotropic
effects on the myocardium