This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ikeda, U. Articles by Shimada, K. Search for Related Content PubMed PubMed Citation Articles by Ikeda, U. Articles by Shimada, K. Related Collections Growth factors/cytokines Catheter-based coronary interventions: stents

(Circulation. 1999;100:e96.)
© 1999 American Heart Association, Inc.

Circulation Electronic Pages

Enhanced Inflammatory Response to Coronary Angioplasty in Patients With Severe Unstable Angina

Uichi Ikeda, MD; Yukihiro Hojo, MD; Takaaki Katsuki, MD; Kazuyuki Shimada, MD

From Department of Cardiology, Jichi Medical School, Tochigi, Japan

	To the Editor:

 
We read with interest the recent article by Liuzzo et al¹ concerning the enhanced inflammatory response to PTCA in patients with severe unstable angina. They found that PTCA induced an increase in plasma interleukin-6 (IL-6) levels in patients with severe unstable angina, but IL-6 levels did not change after PTCA in stable patients.

We previously reported that plasma IL-6 levels become elevated in patients with acute myocardial infarction² and that IL-6 mRNA is expressed in human atherosclerotic lesions.³ Therefore, we propose that the main source of plasma IL-6 in coronary artery diseases is the vascular tissue. Recently, we measured the levels of IL-6 and von Willebrand factor (vWF), a marker of endothelial injury, in the coronary sinus blood of patients with stable angina. Blood samples were taken from the coronary sinus immediately before and after and 4 and 24 hours after either PTCA (group A; n=52) or diagnostic coronary angiography (group B; n=7). Levels of IL-6 and vWF in the coronary sinus blood did not change in group B after coronary angiography. Conversely, in group A, the levels of IL-6 and vWF increased significantly 4 hours after the procedure from the baseline value of 3.34±0.56 to 8.20±0.63 pg/mL (P<0.01) and from 113±6.2% to 130±7.3% (P<0.01), respectively, and reached peak values at 24 hours (13.2±1.20 pg/mL and 139±7.4%, both P<0.01 versus baseline). Furthermore, there was a significant positive correlation between IL-6 and vWF levels in the coronary sinus blood at both 4 hours (r=0.38, . . . [Full Text of this Article]