Inflammatory Activity in Patients with Obstructive and Non-obstructive Coronary Artery Disease

Aim . To study the levels of pro-inflammatory biomarkers in patients with obstructive and non-obstructive coronary artery disease (CAD), to identify possible differences for diagnosing the degree of coronary obstruction. Material and methods . The observational study included two groups of patients: with non-obstructive (main group, coronary artery stenosis <50%; n=30) and obstructive (comparison group, hemodynamically significant coronary artery stenosis according to the results of coronary angiography; n=30) CAD. The levels of interleukin-1β (IL-1β) and interleukin 6 (IL-6) were measured in plasma using enzyme immunoassay. Results . IL-6 levels were significantly higher in patients with obstructive CAD (p=0.006) than in patients with non-obstructive CAD. There were no significant differences in the level of IL-1β in both groups (p=0.482). When constructing the ROC curve, the threshold value of IL-6 was 26.060 pg/ml. At the level of IL-6 less than this value, CAD was diagnosed with hemodynamically insignificant stenoses of the coronary arteries. Conclusion . The results of this study confirm that in patients with different types of coronary artery lesions, there are differences in the activity of the inflammation process in the arterial wall. IL-6 was higher in the obstructive lesion group, and IL-1β levels did not differ between groups. Thus, it can be assumed that hemodynamically significant obstruction of the coronary arteries develops as a result of highly active inflammation of the vascular wall. Given the presence of a proven biological basis and the available data on the effectiveness of monoclonal antibodies to IL-1β, one cannot exclude their possible benefit in a cohort of patients with CAD and hemodynamically insignificant stenoses.