title: Sites of interleukin-6 release in patients with acute coronary syndromes and in patients with congestive heart failure.
abstract: This study examines the source of elevated interleukin-6 (IL-6) levels in patients with acute coronary syndrome (ACS) and congestive heart failure (CHF). IL-6 is elevated in the peripheral blood of patients with ACS and CHF, but it is not known if this proinflammatory cytokine is from a cardiac or extracardiac source. Blood samples were obtained from the femoral artery, femoral vein, left main coronary artery, and coronary sinus in 57 patients during cardiac catheterization. IL-6 levels from 12 patients with ACS and 12 patients with CHF were compared with the IL-6 levels in 33 patients who had neither of these clinical conditions. Median IL-6 levels in the peripheral and coronary circulation were a minimum fivefold higher in patients with ACS or CHF relative to control patients. An elevated transcardiac IL-6 gradient (coronary sinus-left main level) was present in patients with ACS (median 5.2; 25th and 75th percentiles 3.9 and 29.3 pg/ml, respectively) compared with control patients (median 0, -0.7 and 0.5 pg/ml; p < 0.001), but not in patients with CHF (median 0.4, -0.7 and 3.5 pg/ml; p = NS). Elevated IL-6 levels in patients with ACS derive from a cardiac source, presumably from "inflamed" coronary plaques and areas of myocardial necrosis, whereas elevated levels in patients with CHF are most likely the result of extracardiac production.
authors.affiliation: Cardiac Catheterization Laboraotry at the University of North Carolina Hospitals, Chapel Hill 27514, USA.
authors.forename: E N
authors.initials: EN
authors.lastname: Deliargyris
authors.forename: R J
authors.initials: RJ
authors.lastname: Raymond
authors.forename: T C
authors.initials: TC
authors.lastname: Theoharides
authors.forename: W S
authors.initials: WS
authors.lastname: Boucher
authors.forename: D A
authors.initials: DA
authors.lastname: Tate
authors.forename: G J
authors.initials: GJ
authors.lastname: Dehmer
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000792:Angiography; D006328:Cardiac Catheterization; D016009:Chi-Square Distribution; D003331:Coronary Vessels / Q000737:chemistry*; D005260:Female; D005263:Femoral Artery / Q000737:chemistry*; D006333:Heart Failure / Q000097:blood* / Q000000981:diagnostic imaging; D006801:Humans; D015850:Interleukin-6 / Q000097:blood / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000000981:diagnostic imaging; D011336:Probability; D012680:Sensitivity and Specificity
chemical_list: D015850:Interleukin-6