Level of systemic inflammation markers and clinical course in patients with stable ischemic heart disease with and without coronary atherosclerosis

V.I. Tseluyko ¹, T.V. Pylova ²

¹ V.N. Karazin Kharkiv National University, Kharkiv, Ukraine
² Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine

The aim – to investigate the relation between levels of inflammatory factors and clinical course of the ischemic heart disease with and without coronary atherosclerosis.

Materials and methods. We examined 105 patients with stable ischemic heart disease (IHD), age 36 to 84 years (mean age 58.5 ± 9.47 years). There were 48.6 % (n = 51) men and 51.4 % (n = 54) women. Based on angiography data, patients were divided into two groups: group I – 53 patients with IHD and non-obstructive coronary arteries (INOCA), group II – 52 patients diagnosed with stable IHD with more than 50 % stenosis. In addition to general clinical methods of examination, the levels of interleukin-6 (IL-6) and highly sensitive C-reactive protein (hsCRP) were determined in all patients. The control group consisted of 20 healthy individuals compared by age and sex.

Results. According to the results, it was found that in patients with IHD the level of IL-6 was significantly higher compared to the control, in group I: 4.40 [2.12–9.56] pg/ml and 2.46 [2.29–3.47] pg/ml, respectively (p = 0.027), and in group II – 4.15 [2.80–6.68] pg/ml, which also differed from the control group (p = 0.006). There was no significant difference in the level of IL-6 between groups of patients with IHD depending on the lesion of the coronary arteries (p = 0.99). Among patients with IHD, the level of IL-6 was increased in 40.7 % (n = 22) of patients with INOCA and 34.6 % (n = 18) in patients with stenotic atherosclerosis (group II) (p = 0.22). However, the proportion of women with elevated levels of IL-6 was higher in the INOCA (66.7 %) compared to women with stenotic atherosclerosis (26.7 %) (p = 0.033). Positive correlations were found between the level of IL-6 and the incidence of ventricular arrhythmias in patients of group I (r = 0.44, p = 0.025), as well as between IL-6 and positive cycling stress-test (r = 0.39, p = 0.01), IL-6 and hsCRP (r = 0.43, p = 0.004). According to the results of multivariate regression logistic analysis, an association was established in patients with INOCA between elevated levels of IL-6 and age, hsCRP, history of myocardial infarction and the number of affected vessels (p = 0.04, p = 0.01, p = 0.04, p = 0.037 respectively).

Conclusions. Significant differences in the level of IL-6 were found in patients with IHD compared to the control group. It was found that in patients with elevated levels of IL-6, there was higher proportion of women in the INOCA group, compared to the patients with stenotic atherosclerosis. An association was established in patients with INOCA between elevated levels of IL-6 and age, history of myocardial infarction and the number of affected vessels.

Key words: ischemic heart disease, INOCA, іnterleukin-6, highly sensitive C-reactive protein.

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