Interleukin-18: a strong predictor of the extent of coronary artery disease in patients with unstable angina.
The aim of this study was to confirm that plasma interleukin (IL)-18 level is associated with the extent of coronary artery disease in unstable angina patients. Previous studies have shown that patients with unstable angina have significantly higher plasma IL-18 levels than healthy volunteers. However, the association between IL-18 and the extent of coronary artery atherosclerosis in patients with unstable angina remains unclear. Plasma concentrations of IL-18 and high-sensitivity C-reactive protein (hs-CRP) were measured in 166 consecutive patients admitted for coronary arteriography. One hundred and eighteen patients with unstable angina had coronary artery disease (coronary artery disease group; severity score: 2.32 +/- 1.47; Gensini score: 31.3 +/- 25.9), and 48 patients with coronary risk factors and without coronary artery lesions served as the risk control group. Plasma levels of IL-18 were higher in the coronary artery disease group than in the risk control group (P = 0.062). Additionally, plasma levels of IL-18 were significantly higher in 77 coronary artery disease patients with severity score > or =2 than in the risk control group (242.3 +/- 110.6 vs 209.8 +/- 120.3 pg/ml, P = 0.016). By univariate analysis, log-transformed plasma IL-18 concentration was positively correlated with coronary artery disease severity score (r = 0.244, P = 0.009). By multiple regression analyses, the association between coronary artery disease severity score and IL-18 remained significant (beta = 0.733, P = 0.017) when controlling for age, diabetes mellitus and left ventricular ejection fraction. Additionally, coronary artery disease severity score was greater in the highest tertile (>246 pg/ml) of plasma IL-18 levels than in the middle (176-246 pg/ml) and the lowest (<176 pg/ml) tertiles (2.79 +/- 1.52 vs 2.05 +/- 1.08 vs 2.13 +/- 1.66, P = 0.028). Of note, plasma hs-CRP level had no significant correlation with coronary artery severity. Plasma IL-18 level is associated with the extent of coronary artery disease in unstable angina patients, suggesting the link between IL-18 and coronary artery atherosclerosis in these patients.
Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Niao Sung Hsiang, Kaohsiung Hsien, Taiwan. chenmien@ms76.hinet.net
Mien-Cheng
MC
Chen
Chien-Jen
CJ
Chen
Cheng-Hsu
CH
Yang
Chiung-Jen
CJ
Wu
Chih-Yuan
CY
Fang
Yuan-Kai
YK
Hsieh
Hsueh-Wen
HW
Chang
D000368:Aged; D000789:Angina, Unstable / Q000097:blood* / Q000209:etiology; D002097:C-Reactive Protein / Q000032:analysis*; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications; D005260:Female; D006801:Humans; D020382:Interleukin-18 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012720:Severity of Illness Index
D020382:Interleukin-18; D002097:C-Reactive Protein