Key result
NSTE-ACS is linked to significantly higher IL-8, TNF-α, and IL-4 levels versus chronic coronary syndrome.
Why the study?
New risk factors contributing to atherogenesis need to be identified due to increasing primary morbidity of ischemic heart disease.
Cross-Sectional (n=192)
p-value: p=<0.001
Elevated levels of both pro- and anti-inflammatory cytokines are associated with acute coronary syndrome and the angiographic severity of coronary atherosclerosis in middle-aged men.
Cytokine-lesion associations in middle-aged men with CCS or NSTE-ACS remain hypothesis-generating; prospective studies needed before biomarker adoption.
It is necessary to search for new risk factors that contribute to atherogenesis in presence of an unfavorable trend of increasing primary morbidity of ischemic heart disease (IHD). Objective. To study the features of cytokine status and its relationship with the severity of atherosclerotic coronary bed lesion in middle-aged men with chronic coronary syndrome and acute coronary syndrome without ST-segment elevation. Material and methods. A number of men equal 192 were examined (mean age 55.1±3.4 years), who were divided into 3 groups: the 1st group — patients with acute coronary syndrome without ST-segment elevation (n=93; mean age 55.37±3.14 years); the 2nd group — patients with chronic coronary syndrome (n=63; mean age 55.12±3.50 years) and the 3rd group — control, which consisted of conditionally healthy subjects without cardiac pathology (n=36; mean age 52.8±4.2 years). Levels of proinflammatory cytokines (interleukin (IL) IL-8, tumor necrosis factor-α — TNF-α), anti-inflammatory cytokine (IL-4) in the blood serum were determined in all participants of the study. Instrumental examination of patients with IHD included electrocardiography, echocardiography and selective coronary angiography. Results. The highest levels of IL-8 (93.62±13.04; 7.34±2.26; 5.86±1.13 pg/ml; F=38.12; p<0.001), TNF-α (12.44±2.04; 4.34±1.21; 3.53±0.96 pg/ml; F=77.73; p<0.001) and IL-4 (289.83±30.61; 3.70±0.16; 1.87±0.11 pg/ml; F=75.12; p<0.001) have been determined in patients with acute coronary syndrome without ST-segment elevation compared to patients with chronic coronary syndrome and subjects of control group. Correlations between the levels of all studied cytokines and the number of hemodynamically significant stenoses (p<0.05), the total number of the coronary bed sections affected by atherosclerosis, degree of stenosing of different sections of the coronary bed according to coronary angiography results (p<0.05) have been established. The most significant positive correlation was between TNF-α and the number of coronary bed lesions detected by coronary angiography (R=0.54; p<0.05). The cytokine TNF-α level >4.41 pg/ml was related to the probability of acute coronary syndrome without ST-segment elevation in middle-aged men with IHD. The value of the IL-4/IL-8 coefficient >3.4 was associated with the probability of IHD exacerbation in middle-aged males. Conclusions. The development of acute coronary syndrome without ST-segment elevation is associated with increase of both proinflammatory (IL-8, TNF-α) and anti-inflammatory cytokines (IL-4) levels. The imbalance between levels of proinflammatory and anti-inflammatory cytokines contributes to the progression of coronary atherosclerosis in patients with ischemic heart disease.
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Gostimsky et al. (2024) conducted a cross-sectional in Ischemic heart disease (n=192). Acute coronary syndrome without ST-segment elevation vs. Chronic coronary syndrome and healthy controls was evaluated on Levels of IL-8, TNF-α, and IL-4 (p=<0.001). Acute coronary syndrome without ST-segment elevation was associated with significantly higher levels of IL-8, TNF-α, and IL-4 compared to chronic coronary syndrome and healthy controls (p<0.001).
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