Inflammatory cytokine imbalance after coronary angioplasty: links with coronary atherosclerosis.
OBJECTIVE
To investigate release of some inflammatory cytokines (Cys) after coronary angioplasty and its links with coronary atherosclerosis.


METHODS
Twenty-seven consecutive subjects with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI) were enrolled in the study: serial blood samples were taken in order to evaluate plasma concentrations of Interleukin (IL)-2, IL-10, IL-18, TNFalpha, and IFNgamma just before PCI at 12 and 24 hours. Patients were then divided, considering balance between each inflammatory Cy and IL-10, an antiinflammatory Cy, into four groups, ranging from a prevalent antiinflammatory response (stable inflammatory Cy-increasing IL-10 values) to a marked inflammatory imbalance (increasing inflammatory Cy-stable IL-10 values).


RESULTS
All Cys showed significant increases in plasma concentrations if compared with baseline values. Release curves were not significantly different when comparing subjects with ST-elevation myocardial infarction (STEMI) versus unstable angina-non-STEMI (UA-NSTEMI), diabetics versus controls. Subjects with marked inflammatory response showed a higher incidence of stenosis on left anterior descending (LAD) coronary artery (IL-2 chi(2) and IFNgamma P < 0.05); Cy release was higher in patients with multivessel coronary disease (IL-2 and IFNgamma, ANOVA P < 0.01). Correlations were also referable between Cys and myocardial enzyme release. Subjects treated with sirolimus-eluting stents (SES) showed significantly lower Cy periprocedure ratio if compared with those treated with bare metal stents.


CONCLUSIONS
A significant Cy release is detectable after PCI: inflammatory response seems to correlate with both PCI due to plaque instabilization and coronary atherosclerosis. A blunted inflammatory response is detectable in subjects treated with SES.
Brunetti
Natale Daniele
ND
Cardiology Department, University of Foggia, Foggia, Italy. dr.natale.daniele.brunetti@hotmail.it
Munno
Irene
I
Pellegrino
Pier Luigi
PL
Ruggiero
Vincenzo
V
Correale
Michele
M
Cuculo
Andrea
A
De Gennaro
Luisa
L
Campanale
Giulio
G
Mavilio
Giovanni
G
Ziccardi
Luigi
L
Di Biase
Matteo
M
D015906:Angioplasty, Balloon, Coronary; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000097:blood* / Q000628:therapy*; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D020382:Interleukin-18 / Q000097:blood; D007376:Interleukin-2 / Q000097:blood; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D016207:Cytokines; D020382:Interleukin-18; D007376:Interleukin-2; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D007371:Interferon-gamma