Association of inflammatory cytokines/biomarkers with acute coronary syndrome and its correlation with severity and hospital outcome

Objective: Coronary atherosclerosis is one of the major causes of coronary artery disease. Atherosclerosis is an inflammatory process involving vascular wall cells, monocytes, T-lymphocytes, pro-inflammatory cytokines, chemoattractant cytokines (chemokines), and growth factors. The presence of inflammatory cells in the atherosclerotic lesion and elevated levels of the inflammatory markers in peripheral circulation correspond to an active inflammatory process in the body. In view of this background, this study was undertaken to evaluate the association between activation of inflammatory cytokines and acute coronary syndrome (ACS). Furthermore, the correlation of these factors with severity of ACS and in-hospital mortality outcomes was studied. Study Design: It is a prospective case–control study, including forty cases of ACS (as per the inclusion criteria listed below) and twenty controls. The levels of inflammatory markers interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and troponin I were estimated in cases and controls. The levels of these markers in the peripheral circulation were also stratified on the basis of the presenting ACS type (unstable angina, non-ST-elevation myocardial infarction, and ST-elevation myocardial infarction). All statistical data were analyzed using SPSS software version 19 Statistical package for windows (Chicago, Inc., IL, USA). Results: The levels of inflammatory markers such as IL-6, TNF-α, and troponin I were higher in the ACS group than the control, and difference was statistically significant. Furthermore, there was a statistically significant difference in the levels of these markers between the various ACS groups. Conclusions: The circulating levels of inflammatory markers such as IL-6 and TNF-α are significantly elevated in patients with ACS, supporting the view that inflammatory cytokines are associated with ACS. There is a direct correlation of the levels of IL-6 and TNF-α with the severity of ACS and in-hospital mortality in these cases