Cytokine Profile and Endothelial Status in Patients with Coronary Artery Disease and Different Outcomes of Coronary Artery Bypass Grafting

Abstract

Aim. To assess the cytokine profile and the level of endothelial dysfunction in patients with coronary artery disease (CAD) and different outcomes of coronary artery bypass grafting (CABG).Materials and methods. The study included 95 people, with 22 of them being practically healthy (without CAD). The CAD patients (73) were retrospectively divided into 2 subgroups according to the presence of complications within the first month after the CABG. The first subgroup consisted of 25 patients suffering from complications after CABG, with 48 people making up the second subgroup (no complications after CABG). CABG was performed on a beating heart; bypass grafts were attached during revascularisation. The serum levels of IL-4 and IFN-γ were determined through the enzyme-linked immunosorbent assay (ELISA) using appropriate test systems manufactured by BCM Diagnostics and a Zenyth 340 microplate photometer (Biochrom Ltd). In order to determine the content of endothelin-1 in blood serum, ELISA test systems manufactured by Biomedica were used. The statistical analysis of study results was performed employing the descriptive statistics module of Statistica 12.0 (StatSoft, USA). The mean (M), its error (m), median (Me) and the interquartile range [Q25; Q75] were calculated. In cases when p ≤ 0.05, the results were considered statistically significant.Results. It was revealed that, in the preoperative period, CAD patients from both subgroups exhibited increased levels of endothelin-1 (p = 0.0001) and IFN-γ (p = 0.0001), whereas an increase in IL-4 production was noted only in the first subgroup (p = 0.0001), as compared to the control group. The follow-up revealed that CAD patients with complications after CABG exhibited stable high levels of IL-4 (p > 0.05) and IFN-γ (p > 0.05) during the entire observation period, as compared to the initial values. The content of endothelin-1 in both subgroups increased significantly on the 4th day of observation (p > 0.05) and returned to its initial high values after 1 month.Conclusion. Immune response in CAD patients suffering from complications after CABG develops mainly along the pro-inflammatory pathway and is accompanied by endothelial dysfunction.