Clinical usefulness of cytokines as diagnostic and follow up markers in patients with stable angina pectoris
Keywords:
stable angina, inflammatory cytokines, biomarkers, ischemic heart diseaseAbstract
Background and aims: Angina pectoris is the discomfort felt when the heart muscle does not receive enough oxygen. The definition of stable angina is the presence of symptoms only with exertion. Chest pain, or its angina equivillant, is a defining feature, and it is relieved by rest or nitroglycerin when exercise is ceased. Often, this is one of the first symptoms or warning indications of underlying coronary disease. The proinflammatory state is believed to aggravate endothelial dysfunction by activating endothelial cells, releases cytokines and chemokines, which may be crucial in the atherosclerotic plaque formation which is the primary cause of angina pectoris. We studied the value of some cytokines and cardiac markers as a diagnostic and follow up markers in patients with stable angina. Methodology: The study was carried out on 50 patients diagnosed with stable angina pectoris, who visited Nasiriya Heart Center throughout the period from December 2021 to April 2022, and 20 age matched healthy person. IL-1β, IL-5, IL-6, IL-8 were assayed at baseline (hospital admission), 1 day and 1 week post-PCI by an enzyme-linked immunosorbent assay (ELISA). In addition, Troponin I (cTnl) was determined by using monoclonal cTnI-specific antibody.
Downloads
References
Ait-Oufella, H., Herbin, O., Bouaziz, J.-D., Binder, C. J., Uyttenhove, C., Laurans, L., Taleb, S., Van Vré, E., Esposito, B., & Vilar, J. (2010). B cell depletion reduces the development of atherosclerosis in mice. Journal of Experimental Medicine, 207(8), 1579–1587.
Alhadi, H. A., & Fox, K. A. A. (2010). Validity of cardiac markers as diagnostic and prognostic indicators of complications in patients undergoing percutaneous coronary intervention. Sultan Qaboos University Medical Journal, 10(1), 31–40.
Al-Lamee, R., Thompson, D., Dehbi, H. M., Sen, S., Tang, K., Davies, J., Keeble, T., Mielewczik, M., Kaprielian, R., Malik, I. S., Nijjer, S. S., Petraco, R., Cook, C., Ahmad, Y., Howard, J., Baker, C., Sharp, A., Gerber, R., Talwar, S., … Swallow, R. (2018). Percutaneous coronary intervention in stable angina (ORBITA): a double-blind, randomised controlled trial. The Lancet, 391(10115), 31–40. https://doi.org/10.1016/S0140-6736(17)32714-9
An, Z., Li, J., Yu, J., Wang, X., Gao, H., Zhang, W., Wei, Z., Zhang, J., Zhang, Y., Zhao, J., & Liang, X. (2019). Neutrophil extracellular traps induced by IL-8 aggravate atherosclerosis via activation NF-κB signaling in macrophages. Cell Cycle (Georgetown, Tex.), 18(21), 2928–2938. https://doi.org/10.1080/15384101.2019.1662678
Arslan, F., De Kleijn, D. P., & Pasterkamp, G. (2011). Innate immune signaling in cardiac ischemia. Nature Reviews Cardiology, 8(5), 292–300.
Aydin, S., Ugur, K., Aydin, S., Sahin, İ., & Yardim, M. (2019). Biomarkers in acute myocardial infarction: Current perspectives. Vascular Health and Risk Management, 15, 1–10. https://doi.org/10.2147/VHRM.S166157
B., H.-C. U., W., M. M., Sruti, S., Joel, S., Stefanie, B., P., K. J., Heinz-Jürgen, S., Axel, G., Jürgen, S., T., G. M., Malte, K., & Tienush, R. (2008). Nitrite reductase activity of myoglobin regulates respiration and cellular viability in myocardial ischemia-reperfusion injury. Proceedings of the National Academy of Sciences, 105(29), 10256–10261. https://doi.org/10.1073/pnas.0801336105
Bai, Y. J., Li, Z. G., Liu, W. H., Gao, D., Zhang, P. Y., & Liu, M. (2019). Effects of IL-1β and IL-18 induced by NLRP3 inflammasome activation on myocardial reperfusion injury after PCI. European Review for Medical and Pharmacological Sciences, 23(22), 10101–10106. https://doi.org/10.26355/eurrev_201911_19579
Balla, C., Pavasini, R., & Ferrari, R. (2018). Treatment of Angina: Where Are We? Cardiology, 140(1), 52–67. https://doi.org/10.1159/000487936
Baumgarth, N. (2016). B-1 cell heterogeneity and the regulation of natural and antigen-induced IgM production. Frontiers in Immunology, 7, 324.
Boros, P., & Bromberg, J. S. (2006). New cellular and molecular immune pathways in ischemia/reperfusion injury. American Journal of Transplantation, 6(4), 652–658.
Buturak, A., Degirmencioglu, A., Surgit, O., Demir, A. R., Karakurt, H., Erturk, M., Yazici, S., Serteser, M., Norgaz, T., & Gorgulu, S. (2016). Rise of serum troponin levels following uncomplicated elective percutaneous coronary interventions in patients without clinical and procedural signs suggestive of myocardial necrosis. Postepy w Kardiologii Interwencyjnej, 12(1), 41–48. https://doi.org/10.5114/pwki.2016.56948
Cappuzzello, C., Di Vito, L., Melchionna, R., Melillo, G., Silvestri, L., Cesareo, E., Crea, F., Liuzzo, G., Facchiano, A., Capogrossi, M. C., & Napolitano, M. (2011). Increase of plasma IL-9 and decrease of plasma IL-5, IL-7, and IFN-γ in patients with chronic heart failure. Journal of Translational Medicine, 9(1), 28. https://doi.org/10.1186/1479-5876-9-28
Chen, R., Liu, C., Zhou, P., Tan, Y., Sheng, Z., Li, J., Zhou, J., Chen, Y., Song, L., Zhao, H., & Yan, H. (2021). Prognostic Value of D-dimer in patients with acute coronary syndrome treated by percutaneous coronary intervention: a retrospective cohort study. Thrombosis Journal, 19(1), 30. https://doi.org/10.1186/s12959-021-00281-y
Correia, L. C. L., Andrade, B. B., Borges, V. M., Clarêncio, J., Bittencourt, A. P., Freitas, R., Souza, A. C., Almeida, M. C., Leal, J., Esteves, J. P., & Barral-Netto, M. (2010). Prognostic value of cytokines and chemokines in addition to the GRACE Score in non-ST-elevation acute coronary syndromes. Clinica Chimica Acta, 411(7–8), 540–545. https://doi.org/10.1016/j.cca.2010.01.011
Diakos, C. I., Charles, K. A., McMillan, D. C., & Clarke, S. J. (2014). Cancer-related inflammation and treatment effectiveness. The Lancet Oncology, 15(11), e493–e503.
Ferrari, R., Camici, P. G., Crea, F., Danchin, N., Fox, K., Maggioni, A. P., Manolis, A. J., Marzilli, M., Rosano, G. M. C., & Lopez-Sendon, J. L. (2018). Expert consensus document: A “diamond” approach to personalized treatment of angina. Nature Reviews. Cardiology, 15(2), 120–132. https://doi.org/10.1038/nrcardio.2017.131
Gong, P., Yang, S. H., Li, S., Luo, S. H., Zeng, R. X., Zhang, Y., Guo, Y. L., Zhu, C. G., Xu, R. X., & Li, J. J. (2016). Plasma D-Dimer as a Useful Marker Predicts Severity of Atherosclerotic Lesion and Short-Term Outcome in Patients with Coronary Artery Disease. Clinical and Applied Thrombosis/Hemostasis, 22(7), 633–640. https://doi.org/10.1177/1076029616634885
Groot, H. E., Al Ali, L., van der Horst, I. C. C., Schurer, R. A. J., van der Werf, H. W., Lipsic, E., van Veldhuisen, D. J., Karper, J. C., & van der Harst, P. (2019). Plasma interleukin 6 levels are associated with cardiac function after ST-elevation myocardial infarction. Clinical Research in Cardiology, 108(6), 612–621. https://doi.org/10.1007/s00392-018-1387-z
Ishigami, T., Abe, K., Aoki, I., Minegishi, S., Ryo, A., Matsunaga, S., Matsuoka, K., Takeda, H., Sawasaki, T., & Umemura, S. (2013). Anti‐interleukin‐5 and multiple autoantibodies are associated with human atherosclerotic diseases and serum interleukin‐5 levels. The FASEB Journal, 27(9), 3437–3445.
Jaffery, Z., Nowak, R., Khoury, N., Tokarski, G., Lanfear, D. E., Jacobsen, G., & McCord, J. (2008). Myoglobin and troponin I elevation predict 5-year mortality in patients with undifferentiated chest pain in the emergency department. American Heart Journal, 156(5), 939–945.
Jang, J. S., Jin, H. Y., Seo, J. S., Yang, T. H., Kim, D. K., Kim, D. S., Cho, K. I., Kim, B. H., Je, H. G., & Park, Y. H. (2013). Prognostic value of creatine kinase-myocardial band isoenzyme elevation following percutaneous coronary intervention: A meta-analysis. Catheterization and Cardiovascular Interventions, 81(6), 959–967. https://doi.org/10.1002/ccd.24542
Jong, W., Ten Cate, H., Linnenbank, A. C., de Boer, O. J., Reitsma, P. H., de Winter, R. J., & Zuurbier, C. J. (2016). Reduced acute myocardial ischemia–reperfusion injury in IL-6-deficient mice employing a closed-chest model. Inflammation Research, 65(6), 489–499.
Kumar Mahesh, N., Sharma, P., Gupta, A., Bhat, K. G., & Verma, N. (2018). Markers of inflammation following percutaneous coronary intervention (PCI) and its effect on adverse events. International Journal of Advances in Medicine, 5(2), 312. https://doi.org/10.18203/2349-3933.ijam20180944
Kyaw, T., Tay, C., Krishnamurthi, S., Kanellakis, P., Agrotis, A., Tipping, P., Bobik, A., & Toh, B.-H. (2011). B1a B lymphocytes are atheroprotective by secreting natural IgM that increases IgM deposits and reduces necrotic cores in atherosclerotic lesions. Circulation Research, 109(8), 830–840.
Macdonald, S. P. J., & Nagree, Y. (2008). Rapid risk stratification in suspected acute coronary syndrome using serial multiple cardiac biomarkers: a pilot study. Emergency Medicine Australasia, 20(5), 403–409.
Mehran, R., Dangas, G., Mintz, G. S., Lansky, A. J., Pichard, A. D., Satler, L. F., Kent, K. M., Stone, G. W., & Leon, M. B. (2000). Intravascular Ultrasound Study of 2256 Patients. Circulation, 101, 604–610.
Montaser, S., Abd El-Aziz, W., Ghanayem, N., Soliman, M., & Amin El-Lakwah, E. (2016). Diagnostic impact of serum myoglobin and human heart-type fatty acid binding protein in patients with acute myocardial infarction. Menoufia Medical Journal, 29(2), 423. https://doi.org/10.4103/1110-2098.192446
Moreno Velásquez, I., Gajulapuri, A., Leander, K., Berglund, A., de Faire, U., & Gigante, B. (2019). Serum IL8 is not associated with cardiovascular events but with all-cause mortality. BMC Cardiovascular Disorders, 19(1), 34. https://doi.org/10.1186/s12872-019-1014-6
Mozaffarian, D., Benjamin, E. J., Go, A. S., Arnett, D. K., Blaha, M. J., Cushman, M., De Ferranti, S., Després, J.-P., Fullerton, H. J., & Howard, V. J. (2015). Heart disease and stroke statistics—2015 update: a report from the American Heart Association. Circulation, 131(4), e29–e322.
Nageh, T., Sherwood, R. A., Harris, B. M., & Thomas, M. R. (2005). Prognostic role of cardiac troponin I after percutaneous coronary intervention in stable coronary disease. Heart, 91(9), 1181–1185. https://doi.org/10.1136/hrt.2004.042911
Ørn, S., Ueland, T., Manhenke, C., Sandanger, Godang, K., Yndestad, A., Mollnes, T. E., Dickstein, K., & Aukrust, P. (2012). Increased interleukin-1β levels are associated with left ventricular hypertrophy and remodelling following acute ST segment elevation myocardial infarction treated by primary percutaneous coronary intervention. Journal of Internal Medicine, 272(3), 267–276. https://doi.org/10.1111/j.1365-2796.2012.02517.x
Qi, X., Li, J., Gu, J., Li, S., Dang, Y., & Wang, T. (2003). Plasma levels of IL-8 predict early complications in patients with coronary heart disease after percutaneous coronary intervention. Japanese Heart Journal, 44(4), 451–461. https://doi.org/10.1536/jhj.44.451
Roth, G. A., Johnson, C., Abajobir, A., Abd-Allah, F., Abera, S. F., Abyu, G., Ahmed, M., Aksut, B., Alam, T., & Alam, K. (2017). Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. Journal of the American College of Cardiology, 70(1), 1–25.
Sampasa-Kanyinga, H., & Lewis, R. F. (2015). Frequent Use of Social Networking Sites Is Associated with Poor Psychological Functioning Among Children and Adolescents. Cyberpsychology, Behavior and Social Networking, 18(7), 380–385. https://doi.org/10.1089/cyber.2015.0055
Santoso, P., Adrianta, K. A., & Wiranatha, I. G. (2021). Phytochemical screening and in vivo test of dewandaru (Eugenia uniflora L) fruit extract on mice exposed to cigarette smoke. International Journal of Health & Medical Sciences, 4(2), 246-252. https://doi.org/10.31295/ijhms.v4n2.1722
Shetelig, C., Limalanathan, S., Hoffmann, P., Seljeflot, I., Gran, J. M., Eritsland, J., & Andersen, G. (2018). Association of IL-8 With Infarct Size and Clinical Outcomes in Patients With STEMI. Journal of the American College of Cardiology, 72(2), 187–198. https://doi.org/10.1016/j.jacc.2018.04.053
Spitz, C., Winkels, H., Bürger, C., Weber, C., Lutgens, E., Hansson, G. K., & Gerdes, N. (2016). Regulatory T cells in atherosclerosis: critical immune regulatory function and therapeutic potential. Cellular and Molecular Life Sciences : CMLS, 73(5), 901–922. https://doi.org/10.1007/s00018-015-2080-2
Sun, J., Yu, H., Liu, H., Pu, D., Gao, J., Jin, X., Liu, X., & Yan, A. (2020). Correlation of pre‐operative circulating inflammatory cytokines with restenosis and rapid angiographic stenotic progression risk in coronary artery disease patients underwent percutaneous coronary intervention with drug‐eluting stents. Journal of Clinical Laboratory Analysis, 34(3). https://doi.org/10.1002/jcla.23108
Sun, T., Hu, J., Yin, Z., Xu, Z., Zhang, L., Fan, L., Zhuo, Y., & Wang, C. (2017). Low serum paraoxonase1 activity levels predict coronary artery disease severity. Oncotarget, 8(12), 19443–19454. https://doi.org/10.18632/oncotarget.14305
Suryasa, I. W., Rodríguez-Gámez, M., & Koldoris, T. (2022). Post-pandemic health and its sustainability: Educational situation. International Journal of Health Sciences, 6(1), i-v. https://doi.org/10.53730/ijhs.v6n1.5949
Tian, R., Hou, G., Li, D., & Yuan, T.-F. (2014). A possible change process of inflammatory cytokines in the prolonged chronic stress and its ultimate implications for health. The Scientific World Journal, 2014.
Toldo, S., Mauro, A. G., Cutter, Z., & Abbate, A. (2018). Inflammasome, pyroptosis, and cytokines in myocardial ischemia-reperfusion injury. American Journal of Physiology-Heart and Circulatory Physiology, 315(6), H1553–H1568. https://doi.org/10.1152/ajpheart.00158.2018
Tøllefsen, I. M., Shetelig, C., Seljeflot, I., Eritsland, J., Hoffmann, P., & Andersen, G. Ø. (2021). High levels of interleukin- ¬ 6 are associated with final infarct size and adverse clinical events in patients with STEMI. 1–9. https://doi.org/10.1136/openhrt-2021-001869
Tricoci, P., Leonardi, S., White, J., White, H. D., Armstrong, P. W., Montalescot, G., Giugliano, R. P., Gibson, C. M., Van De Werf, F., Califf, R. M., Harrington, R. A., Braunwald, E., Mahaffey, K. W., & Newby, L. K. (2013). Cardiac troponin after percutaneous coronary intervention and 1-year mortality in Non-ST-segment elevation acute coronary syndrome using systematic evaluation of biomarker trends. Journal of the American College of Cardiology, 62(3), 242–251. https://doi.org/10.1016/j.jacc.2013.04.043
Türkoğlu, C., Harbalıoğlu, H., Şeker, T., Baykan, A. O., & Uysal, O. K. (2020). D-dimers are associated with coronary artery disease severity assessed using Syntax and Syntax II scores in patients with ST elevation myocardial infarction. Revista Portuguesa de Cardiologia (English Edition), 39(12), 687–693. https://doi.org/https://doi.org/10.1016/j.repce.2020.08.002
van Hout, G. P. J., & Bosch, L. (2018). The inflammasomes in cardiovascular disease. Inflammasomes: Clinical and Therapeutic Implications, 9–40.
Witting, P. K., Liao, W.-Q., Harris, M. J., & Neuzil, J. (2006). Expression of human myoglobin in H9c2 cells enhances toxicity to added hydrogen peroxide. Biochemical and Biophysical Research Communications, 348(2), 485–493.
Wu, Y.-W., Ho, S. K., Tseng, W.-K., Yeh, H.-I., Leu, H.-B., Yin, W.-H., Lin, T.-H., Chang, K.-C., Wang, J.-H., Wu, C.-C., & Chen, J.-W. (2020). Potential impacts of high-sensitivity creatine kinase-MB on long-term clinical outcomes in patients with stable coronary heart disease. Scientific Reports, 10(1), 5638. https://doi.org/10.1038/s41598-020-61894-3
Ye, D., Wang, Z., Ye, J., Wang, M., Liu, J., Xu, Y., Jiang, H., Chen, J., & Wan, J. (2020). Interleukin-5 levels are decreased in the plasma of coronary artery disease patients and inhibit Th1 and Th17 differentiation in vitro. Revista Española de Cardiología (English Edition), 73(5), 393–402. https://doi.org/10.1016/j.rec.2019.07.005
Published
How to Cite
Issue
Section
Copyright (c) 2022 International journal of health sciences

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.








