Early inflammatory cytokine response: a direct comparison between spontaneous coronary plaque destabilization vs angioplasty induced

Atherosclerosis. 2014 Oct;236(2):456-60. doi: 10.1016/j.atherosclerosis.2014.07.037. Epub 2014 Aug 15.

Abstract

Aim: To compare inflammatory response accompanying acute coronary syndrome (ACS) with that following coronary plaque rupture caused by coronary angioplasty (PCI).

Methods: Twenty-seven consecutive subjects with either ACS or treated with PCI in the subacute phase of ACS underwent serial evaluation of circulating interleukin (IL)-2, IL-8, IL-10, interferon (IFN)-γ and tumor-necrosis-factor (TNF)-α levels. Blood samples were drawn immediately before angioplasty (T0) in the PCI group or at admission in the ACS group, 12 h (T1) and 24 h later (T2).

Results: Differences between cytokine levels were substantially not statistically significant when comparing PCI, non-ST-elevation-ACS, and ST-elevation-ACS groups, especially 24 h after plaque rupture (T2, Type-II error 85-94%).

Conclusions: Inflammatory activation during the first 24 h of ACS or after PCI is comparable, regardless of myocardial damage in terms of troponin levels. Coronary plaque rupture may be presumed as being the main responsible for increased circulating cytokine levels in this early phase.

Keywords: Acute coronary syndrome; Atherosclerosis; Coronary angioplasty; Coronary plaque; Cytokine; Inflammation; Interleukin; Myocardial infarction.

Publication types

  • Comparative Study

MeSH terms

  • Acute Coronary Syndrome / blood*
  • Acute Coronary Syndrome / therapy
  • Aged
  • Angioplasty* / adverse effects
  • Biomarkers
  • Female
  • Humans
  • Interferon-gamma / blood*
  • Interleukins / blood*
  • Male
  • Middle Aged
  • Myocardial Infarction / blood
  • Myocardial Infarction / therapy
  • Percutaneous Coronary Intervention* / adverse effects
  • Plaque, Atherosclerotic / blood*
  • Rupture / blood
  • Rupture, Spontaneous
  • Stress, Mechanical
  • Systemic Inflammatory Response Syndrome / blood*
  • Systemic Inflammatory Response Syndrome / etiology
  • Time Factors
  • Troponin / blood
  • Tumor Necrosis Factor-alpha / analysis*

Substances

  • Biomarkers
  • Interleukins
  • Troponin
  • Tumor Necrosis Factor-alpha
  • Interferon-gamma