| Objectives: (1) To investigate the changes of serum concentration of high-sensitive C reactive protein (hs-CRP), monocyte chemoattractant protein 1 (MCP-1), interleukin 18 (IL-18) and interleukin 10 (IL-10) in elderly patients with acute coronary syndrome (ACS). (2) To analyse the association of hs-CRP, MCP-1, IL-18, IL-10 with stenosis of coronary arteries. (3) To observe the effects of ramipril on cytokines of hs-CRP, MCP-1, IL-18 and IL-10 in elderly patients with ACS.Methods: Serum levels of hs-CRP, MCP-1, IL-18 and IL-10 were detected by ELISA in 32 elderly patients with ACS, 26 elderly patients with SAP before and after treated with low doses of ramipril (2.5~5mg/d). Compared these results with that of 18 healthy elderly subjects. Wrote down the results of coronary arteriography according to Gensini standard in these patients.Results: (1) The serum levels of hs-CRP, MCP-1 and IL-18 were much higher in patients with ACS than that of SAP and control (P<0.05, P<0.01) , but serum levels of interleukin 10 was much lower than above patients (P<0.05) . (2) The Gensini grades of stenosis of coronary arteries in ACS group and SAP group had no statistic difference (P>0.05) . The correlation analysis results showed that Gensini grades of stenosis of coronary arteries had no association with serum levels of hs-CRP, MCP-1,IL-18 and IL-10 (P>0.05) . (3) The serum levels of hs-CRP, MCP-1 and IL-18 decreased significantly after ramipril treatment, however, that of interleukin 10 increased notably. It is easy to see that ramipril can inhibit the inflammation of unstable plaque of acute coronary syndrome in elderly patients.Conclusions: The findings show that hs-CRP, MCP-1, IL-18 and IL-10 play an important role in the occurrence of ACS in elderly patients. Stenosis of coronary arteriograph can't reflect the activity of unstable plaque in coronary arteries of ACS. Ramipril can inhibit the inflammation of unstable plaque of ACS in elderly patients.
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