Inflammatory cytokines imbalance in the very early phase of acute coronary syndrome: correlations with angiographic findings and in-hospital events.
The aim of this study is to investigate the release of some inflammatory cytokines (Cks) during the very early phase (first 24 h) of acute coronary syndrome (ACS). Twenty-six consecutive subjects admitted to coronary care unit with ACS underwent serial blood sampling in order to evaluate concentrations of interleukin (IL)-2, IL-10, IL-18, tumor necrosis factor (TNF)-α, and interferon (IFN)-γ. Blood samples were taken within 6 h after onset of chest pain (T₀), at 12 h (T₁), and at 24 h (T₂). Patients were thus divided into four groups comparing pro-inflammatory Ck release (IL-2, TNF-α, and IFN-γ) and anti-inflammatory activity (IL-10). Clinical features, risk factors, incidence of adverse events, and coronary angiography findings were compared with Ck activation. Ck levels were significantly increased if compared with baseline. Subjects with marked inflammatory response showed a higher incidence of left anterior descending coronary disease (IL-2, p < 0.001; TNF-α and IFN-γ, p < 0.05) and more often incurred early complications (IL-2, p < 0.05; IFN-γ, p < 0.001). A correlation was detectable between IL-18 levels and myocardial enzyme release (creatine kinase, r = 0.47; lactate dehydrogenase, r = 0.54; troponin I, r = 0.58; p < 0.05). TNF-α levels were associated with a worse prognosis at follow-up (Log rank, p < 0.05). A Ck activation characterizes the early phase of ACS. Early inflammatory reaction seems to correlate with coronary disease and adverse events.
Brunetti
Natale Daniele
ND
Cardiology Department, University of Foggia, viale Pinto 1, 71100, Foggia, Italy. nd.brunetti@unifg.it
Munno
Irene
I
Pellegrino
Pier Luigi
PL
Ruggero
Vincenzo
V
Correale
Michele
M
De Gennaro
Luisa
L
Cuculo
Andrea
A
Campanale
Erasmo Giulio
EG
Di Biase
Matteo
M
D054058:Acute Coronary Syndrome / Q000097:blood / Q000000981:diagnostic imaging / Q000276:immunology*; D000368:Aged; D015415:Biomarkers; D017023:Coronary Angiography; D016207:Cytokines / Q000097:blood*; D004452:Echocardiography; D005260:Female; D006801:Humans; D007249:Inflammation / Q000276:immunology*; D016898:Interferon-alpha / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D020382:Interleukin-18 / Q000097:blood; D007376:Interleukin-2 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D015415:Biomarkers; D016207:Cytokines; D016898:Interferon-alpha; D020382:Interleukin-18; D007376:Interleukin-2; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10
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