Elevated levels of sIL-2R, TNF-α and hs-CRP are independent risk factors for post percutaneous coronary intervention coronary slow flow in patients with non-ST segment elevation acute coronary syndrome

Abstract

To evaluate the association between circulating levels of inflammatory cytokines and the occurrence of post-percutaneous coronary intervention (PCI) coronary slow flow (CSF) in patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS). CSF after PCI commonly occurs and implies poor outcomes, while the determinants of post-PCI CSF in patients with NSTE-ACS remain controversial. In this multicenter case control study, 176 patients diagnosed with NSTE-ACS and with post-PCI CSF occurred composed of CSF group, while 352 matched NSTE-ACS patients composed control group. Corrected thrombolysis in myocardial infarction frame count (cTFC), circulating levels of inflammatory cytokines and PCI related parameters were analyzed using Logistic regression models. Among 528 patients with median age of 67 (59–76) and male proportion of 65.5%, 176 (35.0%) patients had occurrence of post-PCI CSF defined as cTFC ≥ 24. Patients with CSF presented more intense inflammatory activity revealed by higher levels of white blood cell, high-sensitivity C-reactive protein (hs-CRP), interleukin-1ß (IL-1ß), soluble IL-2 receptor (sIL-2R), IL-6, IL-8, IL-10 and tumor necrosis factor-α (TNF-α), while PCI related parameters were comparable. Correlation analysis showed cTFC was positively correlated with those inflammatory cytokines. Logistic regression model indicates that hs-CRP (odds ratio (OR) = 3.038, 95% confidence interval (CI) 1.545–5.975), sIL-2R (OR = 2.103, 95% CI 1.959–4.026) and TNF-α (OR = 3.708, 95% CI 1.426–9.641) were valuable predictors for CSF occurrence. Elevated circulating levels of inflammatory cytokine including hs-CRP, sIL-2R and TNF-α rather than PCI related parameters could predict post-PCI CSF in patients with NSTE-ACS.

Determining the association of inflammatory markers, cell-adhesion molecules, and endothelial dysfunction biomarkers with ACS in Indian population

“…1 A). Previous studies 6 , 10 have observed elevated circulating levels of inflammatory markers such as IL-6 and TNF-α in ACS patients and a direct correlation with an increase in the severity of ACS and in-hospital mortality.…”

“…Studies have indicated that circulating levels of proinflammatory cytokines, Interleukin 6 (IL-6), Tumour Necrosis Factor α (TNF-α) and chemokines might trigger ACS. 6 Serum vascular CAM (VCAM-1, ICAM-1 and E-Selectin) were found to be associated with the severity of atherosclerosis and cardiovascular risk factors. 7 Increased levels of Matrix metalloproteinases (MMPs) and Monocyte Chemoattractant Proteins-1 (MCP-1) in patients with advanced cardiovascular disease (CAD) and ACS were associated with future risk of cardiovascular events.…”

Advances in cardiovascular-related biomarkers to predict diabetic peripheral neuropathy

“…In addition, CRP is a marker of early myocardial injury that can be elevated within hours of the onset of myocardial damage. High-sensitivity CRP (hs-CRP) predicts the risk of cardiac events in asymptomatic populations and can assess the outcome of patients with acute coronary syndromes[ 36 , 37 ]. Chronic hyperglycaemia can induce vascular endothelial cell injury and an inflammatory response leading to DPN, while the inflammatory cytokines tumor necrosis factor-alpha and interleukin-6 can stimulate CRP synthesis in vivo [ 38 ].…”