Inflammatory Cytokine Release in Patients with Unstable Angina after Coronary Angioplasty.

Abstract

The aim of the present study was to investigate inflammatory cytokine release and the interaction with platelets in patients with unstable angina (UA) after coronary angioplasty. In 50 patients with stable angina (SA) and 58 patients with UA, serial venous blood samples were obtained immediately before, and 30 minutes, 4, 12, 24, 48 and 72 hours, and 7 days after coronary angioplasty. Plasma concentrations of IL-8 and vWF were determined by immunoassay, while the expression of CD11 b/CD18 on monocytes and the expression of CD41 on platelets were assessed by flow cytometry. Differences in the baseline plasma concentrations of IL-8, vWF and CD11b/CD18, CD41 were found in the UA and SA groups before angioplasty (101.1 +/- 31.28 pg/mL to 55.8 +/- 17.24 pg/mL, 137.67 +/- 38.14% to 107.40 +/- 28.67% and 318.67 +/- 36.85 MFI to 240.72 +/- 28.43 MFI, 147.5 +/- 23.18 MFI to 104.43 +/- 26.68 MFI all p < 0.05). The peak plasma levels of IL-8 (172.24 +/- 37.82 pg/mL at 12 hours) and vWF (256 +/- 42.32% at 4 hours) significantly increased after coronary angioplasty (both p < 0.01), and were associated with significant time course increases in surface expression of CD11b/CD18 (p < 0.01) and CD41 (p < 0.01). The levels of plasma IL-8 and vWF were significantly higher pre- and post-procedure in UA patients with lesion type C compared to types A or B (p < 0.05), but there were no differences for pre-procedure in the SA group patients with different lesion types (p > 0.05). There were significant correlations between plasma IL-8 and monocyte CD11b/CD18, vWF and CD41 in the UA group (r = 0.5248, r = 0.6240 both p < 0.01, respectively). The findings demonstrate increases in plasma IL-8 and CD11b/CD18 as inflammatory mediators, vWF and CD41 as the abnormal coagulation activity may therefore yield a rationale for pharmacological anticytokines in patients with UA after coronary angioplasty.

The Prognostic Value of IL-8 for Cardiac Events and Restenosis in Patients with Coronary Heart Diseases After Percutaneous Coronary Intervention

“…However, as discussed above, we and others have demonstrated the importance of these values for evaluating the contribution of inflammatory changes in patients following PCI. 3,4,14) Conclusions: Our study shows that preprocedure plasma levels and peak levels of IL-8 provide a more powerful predictor of cardiac events and restenosis than other factors considered thus far in patients with PCI. Low preprocedural IL-8 levels may help identify patients with a good outcome who did not require additional treatment after PCI.…”

“…One of our previous studies 3) revealed that IL-8 concentrations showed a remarkable increase in the unstable angina group pre-and post-PCI. A sizable cardiac release of IL-8, however, occurs after recanalization of the stenosis vessel even in patients with stable angina who had a normal level of IL-8 before PCI.…”

“…Blood sampling: Peripheral blood samples were taken immediately before and 30 minutes, 4, 12, 24, 48, and 72 hours, and 7 days after balloon angioplasty. 3) Coded samples were stored at −80°C and analyzed in a single batch at the end of the study. Thus, patient management was independent of these results.…”

“…3,4) These observations suggested that inflammatory responses play an important role in the prognosis in patients with PCI. Therefore, we prospectively investigated the predictive value of periprocedural levels of IL-8 on the one-year angiographic and clinical outcomes of cardiovascular events and restenosis in consecutive patients undergoing coronary stent implantation.…”

“…1) Angioi, et al reported that the increased plasma level of C-reactive protein (CRP) before PCI has a predictive value for early complications and reverse cardiac events. 2,3) The increase in preprocedural CRP levels appears to be a powerful predictor of restenosis.…”