Reaserch Of The Relationship Of Interleukin-18 And High Senscitive CRP And Coronary Heart Disease

Background Coronary heart disease was a muli-course disease.Inflammation played an important role in the pathogenesis in it. Local and systemic inflammation is the important pathological basis of plaque instability. However, the relationship between cytokines IL-18, high sensitive CRP (hsCRP)and coronary disease has been little reported for domestic study.Objective To study the role of IL-18, high sensitive CRP (hsCRP) in the pathogenesis of coronary disease and to evaluate the relationship between IL-18, high sensitive CRP (hsCRP)with the range of coronary lesions, heart function prognosis of patients with coronary heart disease.Methods To measure the levels of IL-18, high sensitive CRP (hsCRP) in 40 patients with ACS, 20 patients with SAP and 10 controls(patients without coronary heart disease). All patients were performed coronary angiography .Patients with coronary heart disease were divided into groups of single vessel disease, two vessel disease, multiple vessel disease. At the same time,all patients were performed doppler echocardiography and calculated left ventricular ejection fraction.Patients with coronary heart disease were divided into two groups based on left vebtricular ejection fraction:one group was LVEF≤50%, the other was LVEF>50%.Results (1)Comparison of general data: The age and gender were comparableamong the 3 groups. The occurrences of risk factors of coronary artery disease were similar between the ACS and SAP patients.(2)Comparison of the coronary artery lesions: patients with ACS and SAP have no significant difference in single vessel disease, two vessel disease, but multiple vessel disease were much higher in SAP patients than in ACS patients (70% vs 60%, P<0.05 ). (3)Compared with the controls, the ACS and SAP patients had significantly higher IL-18 concentrations (545.14±92.57pg/ml vs 471.52±49.65pg/ml, 528.81±88.47pg/ml vs 471.52±49.65 pg/ml, P<0.05), while no differences existed between ACS and SAP patients (P>0.05). The levels of hsCRP in ACS patients were much higher than those in the SAP(5.63±1.41mg/L vs 2.96±1.04mg/L, P<0.05)and the controls (5.63±1.41mg/L vs 2.28±0.82mg/L, P<0.01), while the latter 2 groups did not differ from each other(P>0.05). (4)The levels of IL-18 were much higher in multiple vessel disease (648.15 ±178.82pg/mlvs544.90±150.61pg/ml, 648.15± 178.82pg/ml vs 591.48 ± 196.38 pg/ml, P 均)<0.01) , and the levels of hsCRP were no differences existed in single vessel disease, two vessel disease, multiple vessel disease. (5)Association of hsCRP, IL-18 with cardiac function in patients with coronary artery disease: Patients with LVEF<50% had higher IL-18 concentrations than those with LVEF>50% (576.66±94.12pg/ml vs 504.36±66.67 pg/ml, P<0.05), while the rest parameters did not show significant differences between the 2 groups.Conclusion Inflammation may invole in growth and ruptur in atherosclerotic plaque and thrombosis, and serum levels of IL-18, hsCRP may be markers of diagnosis of coronary heart disease and evaluate the stability of plaque and prognosis of patients with coronary heart disease .