Volume 4 No. 2, April 2009

The Pro-And Anti-Inflammatory Mediators Balance As A Predictor of Short-Term Clinical Outcome Following Percutaneous Coronary Stenting

Elsokkary H⁽¹⁾, Attia M⁽²⁾, Ismail Gh M⁽³⁾

Departments of Cardiology⁽¹⁾, Clinical Pathology⁽²⁾ and Physiology⁽³⁾, Faculty of Medicine, Tanta University, Egypt
Tanta Med. Sc. J 2009; 4(2):38-47

Abstract provided by Publisher

Background/Aim: Elevated pre-procedural hs-CRP levels are predictive of a worse outcome after elective or urgent coronary artery stenting which itself can elicit an inflammatory response. Interleukin-10 (IL-10) is a major inhibitor cytokine synthesis i.e. anti-inflammatory cytokine. The aim of this work is to find out if we could use the balance between pro-inflammatory mediator (hs-CRP) and anti-inflammatory cytokine (IL-10) as a predictor of short-term outcome after coronary stenting. Patients & Methods: We assessed independent predictors of short-term clinical outcome after successful percutaneous coronary bare metal stenting in 65 patients including hs-CRP and IL-10 serum levels using multiple logistic regression analysis. The study end-point was the development of any major adverse cardiac events (MACEs) during 6-months post-stenting follows up. Results: During the 6-month follow-up, only 58 patients completed the study. 18 (31%) patients had recurrent cardiac events and 40 (69%) were event-free. IL-10 was significantly lower and hs-CRP was significantly higher in patients who developed MACEs. Multiple regression analysis showed that post-procedural IL-10 independently predicted the occurrence of adverse cardiac events among other biochemical and clinical risk markers. Conclusion: Serum IL-10 level is an independent predictor of recurrent coronary events during short-term follow-up in patients underwent successful percutaneous coronary stenting. Our study supported the hypothesis that the balance between pro-inflammatory and anti-inflammatory cytokines may be an important determinant of patient outcome. Further studies should clarify if therapeutic interventions that increase circulating IL-10 levels may improve outcome in CAD patients after PCI with stenting and ongoing elevated inflammatory activity.

ICID 889517