The Significance Of Plasma Interleukin-18 And HsCRP Variety In Patients With Coronary Heart Disease Pre-and Pro-Coronary Intervention

Background:Coronary heart disease (CHD) has been the first critical disease of human being around the world. Percutaneous coronary intervention(PCI) has established an effective procedure for CHD. However, there were still some complications unsolved after PCI. Since Ross initiatively suggested that atherosclerosis be a chronic inflammatory disease of the vessel wall in 1973[1], there have been progressive reports about the relation between inflammatory reaction and artherosclerosis. Some study[2-5] discovered that the inflammatory reaction may be activated by percutaneous coronary intervention.CRP is an acute phase protein which is a risk factor of artherosclerosis ,and it may predict independently the risk and prognosis of coronary heart disease. Interleukin-18 can also be synthetized and secreted by vascular endothelial cell except macrophage[6].Interleukin-18 is a multifunctional cytokine which may promote the inflammation cascade reaction by other cytokine.Therefore interleukin-18 plays an important role in the development and progression of atherosclerosis[7-11].Objective:To explore the changes of serum levels of IL-18 and hsCRP in coronary artery disease after PCI and to investigate the prognostic value of IL-18 and hsCRP for early complications after PCI.Methods:105 patients with ACS which including 57 patients with UA and 48 patients with AMI were enrolled. All patients were treated by PCI. The pre- and pro- procedural levels of serum IL-18 and hsCRP were tested to investigate the changes of serum levels of IL-18 and hsCRP and the prognostic value for early complications after PCI. Result:1. The levels of serum IL-18 and hsCRP in AMI patients were significant higher than that in UA patients(P<0.05);The peak levels of serum IL-18 and hsCRP on just after PCI,6 hour,24 hour and 1 month after PCI were significant higher than that on the point of 5 minute before PCI(P<0.05);The levels of serum IL-18 and hsCRP were much higher in those patients whose operation is much complicated(P<0.05).2. Incidence of the early complications is 8.6%(9/105) in the whole population,incidence in AMI 14.6%(7/48) is higher than that in UA3.5%(2/57)(P<0.05).The levels of serum IL-18 and hsCRP of patients of early complications before PCI is higher than those without early complications before PCI(P<0.05).The increase of serum IL-18 and hsCRP of patients of early complications after PCI is higher than those without early complications after PCI(P<0.05).Conclusions:1. The earlier inflammation reaction in coronary artery may be triggered and aggravated by PCI.2. The occurrence of early complications after PCI may concerned with inflammatory responses.IL-18 and hsCRP may provide more powerful predictors of early complications after PCI.