Relation of interleukin-6 level with coronary  artery disease severity in patients undergoing  coronary angiography: Koroner anjiyografi yapılan hastalarda interlökin-6 düzeyi ile  koroner arter hastalığının ciddiyeti arasındaki ilişki

Fethullah  Gerin; Erdal  Durmuş; Ali  Yaman; Murat  Sünbül; Ceyhun Mammadov; Mehmet  Bozbay; İbrahim  Sarı; Tarık Kıvrak

doi:10.5152/EurJTher.2017.01007

Authors

Fethullah Gerin Department of Clinical Biochemistry, Central Laboratory of Public Health
Erdal Durmuş Department of Cardiology, Silifke State Hospital
Ali Yaman Department of Biochemistry, Marmara University School of Medicine
Murat Sünbül Department of Cardiology, Marmara University School of Medicine
Ceyhun Mammadov Department of Cardiology, Marmara University School of Medicine,
Mehmet Bozbay Department of Cardiology, Marmara University School of Medicine
İbrahim Sarı Department of Cardiology, Marmara University School of Medicine
Tarık Kıvrak Department of Cardiology, Sivas Numune Hospital

DOI:

https://doi.org/10.5152/EurJTher.2017.01007

Keywords:

Coronary artery disease, Inflammation, IL-6, GENSINI score, SYNTAX score

Abstract

Objective: Atherosclerosis plays an important role in the pathogenesis of coronary artery disease (CAD). There is a closer relationship between atherosclerosis and inflammatory cytokines. Commonly used scoring systems for risk stratification in clinical practice are GENSINI and SYNergy between PCI with TAXUS and Cardiac Surgery (SYNTAX) scores for determining disease severity and method of revascularization. The aim of this study was to investigate the relationship between interleukin (IL)-6 levels and both GENSINI and SYNTAX scores in patients with CAD.
Methods: In total, 118 patients who underwent coronary angiography were enrolled in the study. GENSINI and SYNTAX were calculated for determining disease severity. IL-6 level was measured using immunometric assay method.
Results: There were no significant differences between the groups with respect to mean age, blood pressure, heart rate, and use of alcohol. Gender and smoking status were significantly different between the groups. GENSINI and SYNTAX scores of patients were significantly higher in the CAD group than in the controls. IL-6 level was significantly higher in the CAD group than in the controls. In the correlation analysis, IL-6 level significantly correlated with GENSINI and SYNTAX scores and was an independent predictor of abnormal coronary angiography. Optimal cut-off level of IL-6 was 7.81 pg/mL to assess the ability of IL-6 to differentiate the presence of CAD (area under curve, 0.78; sensitivity, 78.3%; and specificity, 70.7%).
Conclusion: Patients with CAD have higher IL-6 levels compared with the controls. IL-6 level correlated with both GENSINI and SYNTAX scores. Moreover, IL-6 was an independent predictor of abnormal coronary angiography. An IL-6 value of ≥7.81 pg/mL predicted the presence of CAD with a sensitivity of 78.3% and a specificity of 70.7%.

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References

Hansson GK, Robertson AK, Söderberg-Nauclér C. Inflammation and atherosclerosis. Annu Rev Pathol 2006; 1: 297-329.

Yan ZQ, Hansson GK. Innate immunity, macrophage activation and atherosclerosis. Immune Rev 2007; 219: 187-203.

Saadeddin SM, Habbab MA, Ferns GA. Markers of inflammation and coronary artery disease. Med Sci Monit 2002; 8: 5-12.

Papanicolaou DA, Wilder RL, Manolagas SC, Chrousos GP. The pathophysiologic roles of interleukin-6 in human disease. Ann Intern Med 1998; 128: 127-37.

Gotsman I, Stabholz A, Planer D, Pugatsch T, Lapidus L, Novikov Y, et al. serum cytokine tumor necrosis factor-alpha and ınterleukin-6 associated with the severity of coronary artery disease: ındicators of an active ınflammatory burden? Isr Med Assoc J 2008; 10: 494-8.

SYNTAX Working Group. SYNTAX score calculator. (accessed January 15): Avaible from: http://www.SYNTAXscore.com.

Gensini GG. A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardiol 1983; 51: 606.

Libby P, Ridker PM, Hansson GK; Leducq Transatlantic Network on Atherothrombosis. Inflammation in atherosclerosis: from pathophysiology to practice. J Am Coll Cardiol 2009; 54: 2129-38.

Horne BD, Anderson JL, John JM, Weaver A, Bair TL, Jensen KR, et al; Intermountain Heart Collaborative Study Group. Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol 2005; 45: 1638-43.

Tanindi A, Sahinarslan A, Elbeg S, Cemri M. Relationship Between MMP-1, MMP-9, TIMP-1, IL-6 and Risk Factors, Clinical Presentation, Extent and Severity of Atherosclerotic Coronary Artery Disease. Open Cardiovasc Med J 2011; 5: 110-6.

Su D, Li Z, Li X, Chen Y, Zhang Y, Ding D, et al. Association between serum interleukin-6 concentration and mortality in patients with coronary artery disease. Mediators Inflamm 2013; 2013: 726178.

Tuomisto K, Jousilahti P, Sundvall J, Pajunen P, Salomaa V. C-reactive protein, interleukin-6 and tumor necrosis factor alpha as predictors of incident coronary and cardiovascular events and total mortality A population-based, prospective study. Thromb Haemost 2006; 95: 511-8.

Volpato S, Guralnik JM, Ferrucci L, Balfour J, Chaves P, Fried LP, et al. Cardiovascular disease, interleukin-6, and risk of mortality in olderwomen: the women’s health and aging study. Circulation 2001; 103: 947-53.

Rajpal S, Rana MA, Peter E, Shah S, Pardue S, Gebregziabher H, et al. Relationship of syntax score with markers of vascular inflammation. J Am Coll Cardiol 2014; 63: A2066.

Provan SA, Berg IJ, Hammer HB, Mathiessen A, Kvien TK, Semb AG. The impact of newer biological disease modifying anti-rheumatic drugs on cardiovascular risk factors: a 12-month longitudinal study in rheumatoid arthritis patients treated with rituximab, abatacept and tociliziumab. PLoS One 2015; 26: e0130709.

Lazzerini PE, Acampa M, Capecchi PL, Fineschi I, Selvi E, Moscadelli V, et al. Antiarrhythmic potential of anticytokine therapy in rheumatoid arthritis: tocilizumab reduces corrected QT interval by controlling systemic inflammation. Arthritis Care Res (Hoboken) 2015; 67: 332-9.

Yoshida S, Takeuchi T, Sawaki H, Imai T, Makino S, Hanafusa T. Successful treatment with tocilizumab of pericarditis associated with rheumatoid arthritis. Mod Rheumatol 2014; 24: 677-80.

Jernberg T, Lindahl B, Siegbahn A, Andren B, Frostfeldt G, Lagerqvist B, et al. N-terminal pro-brain natriuretic peptide in relation to inflammation, myocardial necrosis, and the effect of an invasive strategy in unstable coronary artery disease. J Am Coll Cardiol 2003; 42: 1909-16.