Effects Of Valsartan On IFN-γ And IL-2 In Patients With Unstable Angina Pectoris

【Objective】It is well known that inflammation and immune response play an important role in the development of acute coronary syndrome(ACS).The recent studies clarified the T-helper(Th)1/Th2 imbalance in patients with ACS,it mainly displayed that the function of Thl cell was predominant as shown by an increase in the levels of serum IFN-γand IL-2.Meanwhile,some studies demonstrated angiotensinⅡreceptor blocker,(ARB) can modulated the imbalance of Th1/Th2 and suppressed the function of Th1 and its cytokine of IFN-γand IL-2.However,ARB has not become a conventional therapy drug in the treatment guidline with UAP.This study firstly investigate the effects of valsartan on Th1 function and its cytokines in patients with unstable angina pectoris.【Methods】95 UAP patients(63 men,32 women;mean age 61±7.5years;age range 55-68years) in Shandong Provincial Hospital underwent coronary angiography(at least a coronary artery stenosis≥50%).All patients fell into Braunwald classⅡorⅢ,defined as angina at rest or an angina episode lasting＜20 minutes during the preceding 24 h,with diagnostic ST-segment depression and/or T-wave inversion but no evidence of myocardial infarction as determined by serial cardiac muscle enzyme assays.Exclusion criteria included decompensated congestive heart failure(LVEF＜40%),hypertension, renal failure,advanced liver disease,clinically significant valvular heart disease, malignancy,inflammatory or autoimmune disorders.No patient was treated with anti-inflammatory drugs such as non-steroidal anti-inflammatory drugs,steroids,etc. Blood samples(2ml) were obtained from all patients as soon as possible after admission and 6 months later.95 patients with UAP were divided into two groups randomly: Conventional therapy group(n=47) and valsartan therapy group(n=48).The levels of IFN-γ,IL-2 and IL-4 of two groups were measured by ELISA at baseline and 6 months later.Major adverse cardiovascular events(MACE) in two groups were observed after 6 months.【Results】The levels of IFN-γand IL-2 in two groups were all lower than that of baseline level(P＜0.05 ) and more reduced in valsartan group compared with conventional group (P＜0.05).No significant difference could be observed on the level of IL-4 between baseline and 6 months later in two groups(P＞0.05).Major adverse cardiovascular events(MACE) in Valsartan group were significantly improved in 6 months.(P＜0.05).【Conclusion】Valsartan could suppress the function of Th1 and its cytokine of IFN-γand IL-2 in patients with UAP.This may contribute to the stability of atherosclerotic plaque and improvement of myocardial ischemia.