The Changes And Significance Of The Plasma Levels Of Interleukin-18 In Acute Coronary Syndrome

1, BackgroundAt the bases of the atherogenesis there are complex interactions between macrophages, T lymphocytes and smooth muscle cells. Inflammatory mechanisms play a pivotal role in the atherosclerotic process, especially in atherosclerotic plaque growth and in plaque instability. A growing body of experimental evidences suggest that inflammation is involved in the pathogenesis of acute coronarysyndromes (ACS) and influences their clinical evolution. Activatedcirculating inflammatory cells (neutrophil, monocytes and lymphocytes) and increased concentrations of pro-inflammatory cytokines, such as interleukin-1, interleukin-6, TNF-a C-reactive protein (CRP). Recent data demonstrate that CRP is a strong independent predictor of adverse cardiac events and death in patients with ACS, but also in patients with stable ischemic heart disease and in apparently healthy men and women. Blankenberg pointed out that Interleukin (IL-18) played a central role in accelerating atherosclerosis and plaque vulnerability in animal models. He said Serum IL-18 level was identified as a strong independent predictor of death from cardiovascular causes in patients with coronary artery disease regardless of the clinical status at admission. This result strongly supports recent experimental evidence of IL-18-mediated inflammation leading to acceleration and vulnerability of atherosclerotic plaques. But no reports have been found in our country. We would like to detect the changes and significance of the plasma levels of interleukinlS in acute coronary syndrome.2, ObjectiveIn our study , We detected the changes of plasma levels of interleukin 18 in coronary heart disease especially in acute coronary syndrome, then investigated the correlation between interleukin 18 and acute coronary syndrome.3, MethodEach plasma level of interleukin 18 was determined on admission in fifty-three cases with coronary heart disease who were diagnosed by coronary artery radiography . There were thirty-two patients with acute coronary syndrome (ACS), twenty-one patients with stable angina pectoris (SCHD). We detected the changes of plasma levels of interleukin 18 in both groups by enzyme-linked immunosorbent assay (ELISA) and the significance of correlation of them.4, Result1. Interleukin 18 levels was higher (113.73+58.14 pg/ml ) in acute coronary syndrome than in stable angina pectoris (76.13+43.88 ) pg/ml.2. There were statistic significance in the results of independent sample T test of ACS group and SCHD group (P= 0.015<0.05). We demonstrated that interleukin 18 might be a risk factor of acute coronary syndrome, and also might be a strong predictor of clinical events in coronary heart disease.5, ConclusionsOur study suggests that plasma IL-18 level may play a key role in coronary susceptibility of acute coronary syndrome in coronary heart disease, IL-18 level is identified as a strong independent predictor of death from cardiovascular causes in patients with coronary artery disease.