| Objective:Through testing and comparing the expression levels of cytomegalovirus IgG and IgM antibodies,interleukin-6(IL-6)and interleukin-8(IL-8)in serum both in control arm and acute coronary syndrome(ACS)patients using the enzyme-linked immunosorbent assay(ELISA)and chemiluminescence methods,the study was aiming to investigate the relationship between cytomegalovirus infection,IL-6,IL-8 expression and acute coronary syndrome.Methods :(1)Participants: the eligible participants were selected from the Department of Cardiology of The second affiliated hospital of Dalian Medical University who were admitted to the hospital because of “chest pain” from September2018 to February 2019.According to the electrocardiogram test,myocardial marker test results and typical clinical symptoms,the participants were classified as the following:32 patients was classified in the unstable angina pectoris(UA)group while 22 patients fell in the acute myocardial infarction(AMI)group;thus there were 54 patients in all were in the acute coronary syndrome group.51 patients who were also admitted to the hospital due to "chest pain" but confirmed as normal by coronary angiography later were selected as the control group.Of the 105 patients enrolled,57 were male and 48 were female.The age was ranged from 37 to 89 years old.All patients who were admitted to the hospital denied a previous history of coronary heart disease.Coronary angiography was performed after admission in all participates.The enrolled patients were quantitatively assessed and grouped by the Gensini score for each coronary artery stenosis.In the ACS group,according to the Gensini score of coronary angiography,the patients were divided into mild lesion group(1-19 points,10 cases),moderate disease group(20-39 points,14 cases),and severe disease group(≥40 points,30 cases).TheACS group can be also classified as HCMV-IgG positive and HCMV-IgG negative sub-groups including 49 and 5 cases respectively.(2)Exclusion criteria: cases with incomplete clinical or angiographic data,severe heart failure(LVEF <35%),liver or kidney dysfunction,thyroid disease,acute inflammatory disease,coagulopathy,rheumatic immune disease,malignant tumor and hematological disease,heart valve disease,cardiomyopathy and other types of organic heart disease,major surgery recently.(3)Biochemical examination: The data of all participants were collected as follows:hemagglutination routine data,creatine kinase isoenzyme(CK-MB),troponin(CTNI),proBNP,cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),High-density lipoprotein cholesterol(HDL-C),human cytomegalovirus antibodies(HCMV-IgG and HCMV-IgM),IL-6 expression and IL-8 expression data.Results:1.The HCMV-IgG positive rate 90.74% in the ACS group was much higher than the control group with HCMV-IgG positive rate as 58.82% and the difference was statistically significant(P<0.01);the HCMV-IgG titer level(3.46±1.57)was significantly increased in the ACS group comparing the HCMV-IgG titer level(2.00±1.64)in the control group,and the difference was also statistically significant(P<0.01).When sub-classifying the ACS component as AMI group and UA group,the HCMV-IgG titer levels in both of the UA group(3.12±1.33)and AMI group(3.95±1.77)were significantly increased comparing the control group with HCMV-IgG titer level as(2.00±1.64);the difference was statistically significant(P<0.05).However,there was no significant difference in HCMV-IgG titer level between UA group and AMI group(P>0.05).There was no significant difference in HCMV-IgM level between the control group and the ACS group,both of which were 0%.2.While the TC and LDL-C data was(3.91±0.72)and(1.81±0.65)respectively in the control group,the ACS group showed TC as(4.79±1.20)and LDL-C as(2.36±0.76)which were significantly increased(P<0.05);in contrast,the HDL-C level was(1.23±0.36)in ACS group comparing(1.51±0.50)in the control group,which was significantly decreased(P<0.05).When sub-classifying ACS component as AMI group and UA group,the IL-6(4.18±2.17)and IL-8(74.84±35.95)level in the UA group were both significantly increased comparing with the control group with IL-6 as(2.89±1.15)and IL-8 as(54.66±74.66).Moreover,the IL-6(7.65±4.20)level in the AMI group was significantly increased than the UA group IL-6(4.18±2.17)and the difference wasstatistically significant(P<0.01),however the IL-8(74.84±35.95)in the UA group showed no significant difference with AMI group as IL-8(110.79±76.36)(P>0.05).3.When including HCMV-IgG titer,IL-6,IL-8,TC,LDL-C,HDL-C,gender,smoking,age,body mass index,hypertension,diabetes in the binary logistic regression model,IL-8,cholesterol,hypertension,diabetes,and age were found as the independent risk factors for the occurrence and development of ACS(P<0.05)with the risk factors as 1.015,3.135,5.794,13.05,and 1.091 respectively.Furthermore,the ROC curve of cytomegalovirus IgG titer,IL-6 and IL-8 was plotted.The area of cytomegalovirus IgG titer,IL-6 and IL-8 under the ROC curve was 0.714,0.773 and 0.738 respectively,suggesting that HCMV-IgG titers,IL-6,and IL-8 may have moderate diagnostic value for acute coronary syndrome.The diagnostic value of IL-6 is the most significant,followed by IL-8 and HCMV-IgG as the last.4.The ACS group was further divided into HCMV-IgG positive group and HCMV-IgG negative group.In the HCMV-IgG positive group,IL-6(5.94±3.56),IL-8(95.71±57.27),TC(4.92±1.17)and LDL-C(2.46±0.71)were significantly increased comparing to the HCMV-IgG negative group with IL-6(2.20±0.45),IL-8(28.54±19.08),TC(3.46±0.53)and LDL-C(1.33±0.26).The difference was significant(P<0.05).In contrast,the HDL-C level in the IgG positive group(1.19±0.33)was decreased comparing with the IgG negative group(1.70±0.34),and the difference was statistically significant(P<0.05).Conclusion:1.Serum HCMV-IgG titer level,IL-6 and IL-8 levels in the ACS group were higher than those in the control group and were positively correlated with Gensini score.2.Serum IL-8,cholesterol,high blood pressure,diabetes,and age were independent risk factors for ACS.3.The serum level of IL-6 and IL-8 may have diagnostic value for acute coronary syndrome. |
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