Background: Increased plasma levels of acute phase reactants are correlated with acute coronary syndromes and increased risk of in-hospital events. Interleukin-1 receptor antagonist (IL-1Ra) modulates the activity of IL-1, a cytokine associated with inflammatory response; we have prospectively investigated whether detection of increased levels of IL-1Ra in patients may be useful in the characterization of coronary syndromes. Methods: Plasma levels of IL-1Ra were measured in 118 consecutive patients undergoing coronary angiography with a clinical diagnosis of recent unstable angina (N=57), chronic stable angina (N=49) or atypical chest pain (N=12). Results: Angiography showed significant coronary disease in the first two groups and was normal in the latter group. Patients with unstable angina had significantly higher levels of IL-1Ra than stable patients [ 158 (110-224) vs 108 (95-154) pg/ml, P = 0.002] and individuals with chest pain and normal coronary angiogram [ 110 (97-123) pg/ml, P = 0.038]. In contrast, while C-reactive protein levels were significantly higher in patients with stable and unstable angina vs those without coronary disease (0.29 vs 0.06 mg/dl, P = 0.022), they did not discriminate between stable and unstable angina patients (0.22 vs 0.32 mg/dl, P = 0.66). Conclusions: These results indicate that IL-1Ra may be a sensitive marker of clinical instability in patients with coronary artery disease. Abbreviated abstract. Increased plasma levels of acute phase reactants are correlated with acute coronary syndromes and increased risk of in-hospital events. Interleukin-1 receptor antagonist (IL-1Ra) modulates the activity of IL-1, a cytokine associated with inflammatory response; we have prospectively investigated whether detection of increased levels of IL-1Ra in patients may be useful in the characterization of coronary syndromes. Plasma levels of IL-1Ra were measured in 118 consecutive patients undergoing coronary angiography. Patients with recent unstable angina had significantly higher levels of IL-1Ra than stable patients [158 (110 -224) vs 108 (95-154) pg/ml, P = 0.002] and individuals with chest pain and normal coronary angiogram [110 (97-123) pg/ml, P = 0.038]. IL-1Ra may therefore represent a sensitive marker of clinical instability in patients with coronary artery disease.
Interleukin-1 receptor antagonist: A sensitive marker of instability in patients with coronary artery disease
Patti G;
2002-01-01
Abstract
Background: Increased plasma levels of acute phase reactants are correlated with acute coronary syndromes and increased risk of in-hospital events. Interleukin-1 receptor antagonist (IL-1Ra) modulates the activity of IL-1, a cytokine associated with inflammatory response; we have prospectively investigated whether detection of increased levels of IL-1Ra in patients may be useful in the characterization of coronary syndromes. Methods: Plasma levels of IL-1Ra were measured in 118 consecutive patients undergoing coronary angiography with a clinical diagnosis of recent unstable angina (N=57), chronic stable angina (N=49) or atypical chest pain (N=12). Results: Angiography showed significant coronary disease in the first two groups and was normal in the latter group. Patients with unstable angina had significantly higher levels of IL-1Ra than stable patients [ 158 (110-224) vs 108 (95-154) pg/ml, P = 0.002] and individuals with chest pain and normal coronary angiogram [ 110 (97-123) pg/ml, P = 0.038]. In contrast, while C-reactive protein levels were significantly higher in patients with stable and unstable angina vs those without coronary disease (0.29 vs 0.06 mg/dl, P = 0.022), they did not discriminate between stable and unstable angina patients (0.22 vs 0.32 mg/dl, P = 0.66). Conclusions: These results indicate that IL-1Ra may be a sensitive marker of clinical instability in patients with coronary artery disease. Abbreviated abstract. Increased plasma levels of acute phase reactants are correlated with acute coronary syndromes and increased risk of in-hospital events. Interleukin-1 receptor antagonist (IL-1Ra) modulates the activity of IL-1, a cytokine associated with inflammatory response; we have prospectively investigated whether detection of increased levels of IL-1Ra in patients may be useful in the characterization of coronary syndromes. Plasma levels of IL-1Ra were measured in 118 consecutive patients undergoing coronary angiography. Patients with recent unstable angina had significantly higher levels of IL-1Ra than stable patients [158 (110 -224) vs 108 (95-154) pg/ml, P = 0.002] and individuals with chest pain and normal coronary angiogram [110 (97-123) pg/ml, P = 0.038]. IL-1Ra may therefore represent a sensitive marker of clinical instability in patients with coronary artery disease.Pubblicazioni consigliate
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