Young women post-MI have higher plasma concentrations of interleukin-6 before and after stress testing

Cherie R. Rooks, Ijeoma Ibeanu, Amit Shah, Pratik Pimple, Nancy Murrah, Lucy Shallenberger, Thaddeus Pace, J. Douglas Bremner, Paolo Raggi, Viola Vaccarino

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Objectives Young women have poorer prognosis after myocardial infarction (MI) and a higher rate of mental stress-induced ischemia compared with similarly aged men. A higher inflammatory status may help explain these sex differences. Methods We examined 98 patients (49 women and 49 men) age 18–59 years with recent MI (past 6 months). Women and men were matched for age, type of MI, and time since MI. Interleukin 6 (IL-6) concentrations were measured at baseline, after mental stress using a speech task, and after exercise/pharmacologic stress (60 and 90 min). Depressive symptoms were measured with the Beck Depression Inventory (BDI-II) and angiographic coronary artery disease (CAD) severity was quantified with the Gensini score. Single-photon emission computed tomography (SPECT) was used to obtain a computerized measurement of stress-induced ischemia (summed difference score, or SDS) and determine whether severity of stress-induced ischemia affects the inflammatory response to stress. Analysis was stratified by the median age of 50. Geometric mean concentrations of IL-6 were obtained from general linear regression models. Results In both age groups, women had less angiographic CAD and a similar level of conventional risk factors compared with men. Despite this, baseline IL-6 geometric means before both mental and physical stress were twice as high in women ⩽50 years of age compared to age-matched men (3.8 vs. 1.8 pg/mL, p = 0.001, across both conditions), while they were similar in women and men age >50 years (2.3 vs. 2.2 pg/mL, p = 0.83). After mental stress, IL-6 concentrations increased in both women and men in a similar fashion and remained twice as high in women ⩽50 years than men at both 60 min (5.4 vs. 2.6 pg/mL, p = 0.002) and 90 min (5.9 vs. 3.4 pg/mL, p = 0.01). No significant difference was found between women and men?>50 years of age at any time point after mental stress. Results were similar for physical stress. After accounting for SDS, IL-6 concentrations in young women remained higher after both mental and physical stress. Baseline IL-6 concentrations were not significantly related to inducible ischemia. Conclusions After MI, young women aged 50 years or younger, compared with age-matched men, have remarkably higher concentrations of inflammation at baseline and after both mental and physical stress, with a similar inflammatory response to both stressors. Sustained concentrations of inflammation in young women, not their response to stress, may contribute to their adverse outcomes post-MI.

Original languageEnglish (US)
Pages (from-to)92-98
Number of pages7
JournalBrain, Behavior, and Immunity
StatePublished - Jan 2016


  • Inflammation
  • Interleukin-6
  • Ischemia
  • Sex differences
  • Stress

ASJC Scopus subject areas

  • Immunology
  • Endocrine and Autonomic Systems
  • Behavioral Neuroscience


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