What is the clinical evidence from this study?

Study design: Observational. Population: Patients diagnosed with dilated cardiomyopathy including men, women, and children from Iraq (n=90). Primary outcome: Serum interleukin-12 (IL-12) levels distinguishing DCM patients from healthy controls (ROC AUC 0.730, p=≤0.001).

What question did this study set out to answer?

The research aims to explore the relationship between coxsackievirus infection, interleukin-12 levels, and dilated cardiomyopathy in patients.

March 1, 2026Open Access

Association of Coxsackievirus infection with serum Interleukin-12 levels in Iraqi patients with Dilated Cardiomyopathy

Key Result

Elevated IL-12 levels (median 11.99 pg/mL) differentiated DCM patients from controls with AUC 0.730 and p ≤ 0.001.

Key Points

The research aims to explore the relationship between coxsackievirus infection, interleukin-12 levels, and dilated cardiomyopathy in patients.
60 patients with dilated cardiomyopathy and 30 healthy controls were evaluated.
Lipid profiles and troponin levels were measured using specific kits and analyzers.
ELISA was used to assess IL-12 levels and coxsackievirus antibodies (IgG and IgM).
Data were analyzed using SPSS with a significance threshold of p≤0.05.
Lipid levels differed significantly between dilated cardiomyopathy patients and controls, while HDL levels showed no significant difference.
Troponin levels were significantly elevated in dilated cardiomyopathy patients.
IL-12 levels increased by 1.27-fold in patients, indicating potential diagnostic value.
Both IgG and IgM antibody levels for coxsackievirus were significantly elevated in patients, yet no correlations with IL-12 levels were found.

Study Design

Type

Observational (n=90)

Multicenter

Structured PICO

Are IL-12 levels, lipid profiles, troponin levels, and Coxsackievirus antibodies associated with dilated cardiomyopathy compared to healthy controls?

Population

60 patients (men, women, and children) diagnosed with dilated cardiomyopathy and 30 healthy subjects of a similar age group.

Comparator

Healthy controls (n=30)

Outcome

Differences in lipid levels, interleukin-12 (IL-12) levels, troponin levels, and coxsackievirus antibodies (IgG and IgM) between dilated cardiomyopathy patients and healthy controls.surrogate

Elevated IL-12 levels and Coxsackievirus antibodies in dilated cardiomyopathy patients suggest a potential immune and viral link to the disease pathogenesis, though they are not directly correlated with each other.

Main Result

Effect estimate: ROC AUC 0.730

Absolute Event Rate: 11.99% vs 9.39%

p-value: p=≤0.001

Limitations

Observational cross-sectional design limits causal inference between Coxsackievirus infection and DCM.
Sample size may not represent wider diverse populations.
Lack of viral genotyping limits identification of specific Coxsackievirus strains.
More than half of patients were on statins, potentially confounding lipid profile results.

Abstract

Background Dilated cardiomyopathy (DCM) is a condition characterized by the dilation and dysfunction of the left ventricle, leading to heart failure. This study investigates the relationship between dilated cardiomyopathy and factors such as lipid levels, interleukin-12 (IL-12) levels, troponin levels, and coxsackievirus antibodies. Methods This study involved 60 patients diagnosed with dilated cardiomyopathy and 30 healthy controls. We used a BioSystems kit to measure lipid profiles and a fully automated c111 analyzer (Germany) to quantify troponin levels. We used ELISA to evaluate IL-12 levels and antibodies (IgG and IgM) to Coxsackievirus. We used SPSS for data analysis, with statistically significant defined as p≤0.05 . Results Patients with dilated cardiomyopathy showed a significant difference in lipid levels compared to the control group, while HDL levels showed no statistically significant difference. In addition, troponin levels were significantly elevated in patients with dilated cardiomyopathy. IL-12 levels were elevated by 1.27-fold in individuals with dilated cardiomyopathy suggests a reasonable diagnostic accuracy. Antibody levels for Coxsackievirus (IgG and IgM) were markedly elevated in dilated cardiomyopathy, with a positive test in both IgG t and IgM, while no positive controls were observed for either antibody.in addition This study evaluated the associations between IL-12, IgM, and IgG. The results showing nonsignificant correlation between IL-12 and IgM and IL-12 and IgG. Conclusion Elevated IL-12 levels and coxsackievirus-positive antibodies in dilated cardiomyopathy patients suggest a possible immune link. However, no statistically significant relationship has been found between IL-12 and coxsackie virus antibodies.

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