The Concentration Of Serum Soluble P-selectin And Interleukin-18 In Patients With Acute Coronary Syndrome

Background Recent data have implicated that atherosclerosis is an inflammatory disease. The acute coronary syndrome occurs often secondary coronary plaque disruption with consequent platelet aggregation and thrombus formation. A growing body of experimental evidences suggest that inflammation is involved in the pathogenesis of ACS and influences their clinical evolution. Abundant evidence has been observed platelet activation and aggregation to serve as key elements in the pathogenesis of acute coronary syndromes(ACS). Therefore, the level of P-seletin may detect ACS earlier than markers of myocardial injury. IL-18 is a proin-flammatory cytokine which has many biological functions including regulation of the inflammatory reaction. IL-18, originally identified as an IFN-Tinducing factor in Kupfer cells and macorphages, play a central role in the inflammatory cascade. It is believed to play an important role in acute coronary syndrome.Objective To elucidate whether the changes and significances of serum soluble P-selectin and interleukin-18 in patients with acute coronary syndrome (ACS) correlated with severity of the diseases and whether P-selectin and interleukin-18 are reliable biochemical markers correctly indicates the severity of ACS. Methods Eighty-six subjects came from Cardiology Department of the Hospital Affiliated to Nanjing Medical University, from May 2006 to Novermber 2006, In this study the spectrum of ACS only included unstable angina pectoris (UA) and acute myocardial infarction (AMI). Patients with UA were separated into 3 groups by Braunwald classes and those with AMI were separated into 4 groups by Killip classes. The concentration of serum soluble P-selectin and interleukin-18 were measured by enzyme linked immunoabsorbent assay. The coronary artery lesions score was recorded according to single, double and triple-vessel lesions and Gensini scoring system. The relationships between soluble P-selectin, interleukin-18 levels and the coronary artery score (the severity of coronary heart disease) were assessed. Data was estimated by SPSS.Results The concentration of serum soluble P-selectin and interleukin-18 in patients with ACS were dramatically correlative with the severity of the diseases.The level of plasma soluble P-selectin and interleukin-18 were obviously higher in the coronary heart disease group than in the control group. The two markers were significantly higher in the acute coronary syndrome group than in the control group and the stable angina pectoris group. The level of soluble P-selectin and interleukin-18 were higher in multi-vessel coronary artery lesions group than in single-vessel group. The two markers were positively correlated with the numbers of vessels lesions and the Gensini score.Conclusion The concentration of soluble P-selectin and interleukin-18 in patients with ACS might be reliable biochemical markers which can objectively indicate the degree of this diseases. The positive correlation between the two markers and the coronary artery score may indicate that those levels might reflect the severity of coronary heart disease.