Cytokine profile in patients with obstructive coronary artery disease

Background. Studies of the role of cytokines in the pathogenesis of coronary artery disease (CAD) are quite relevant. Significant cytokine imbalance is mostly observed in patients with acute coronary syndrome. However, there are limited reports of serum cytokine levels in patients with chronic stable CAD. The problem of relationship between cytokines to the severity of coronary atherosclerosis is still urgent.Aim: To investigate the relationship between serum levels of cytokines and the severity of CAD.Material and Methods. Serum levels of IL-2, IL-4, IL-6, IL-10, TNF-a was analyzed in 24 healthy control patients and 70 patients with stable CAD who underwent coronary angiography. Coronary atherosclerosis was assessed with Gensini scoring system. Depending on the median of GS (38.0), the patients were divided into moderate CAD group (GS = 8-37) and severe CAD group (GS ≥ 38). The data were analyzed using Statistical Package for the Social Sciences (SPSS) software 26.0.Results. Patients with obstructive CAD presented higher TNF-α levels and lower IL-4. Patients with severe CAD increased IL-6 and reduced IL-2 levels. Logistic regression analysis showed that the IL-6 was independently related to the presence of obstructive CAD (OR = 3.836; 95% CI= 1.8-8.177). ROC analysis of the IL-6 logistic regression model showed that a cut-off of 5.19 pg/mL had 75.0 % sensitivity and 70.0 % specificity to predict severe atherosclerosis.Conclusion. Pro-inflammatory TNF-α and IL-6 cytokines increased, while regulatory IL-2 and anti-inflammatory IL-4 decreased in patients with stable CAD. Cytokine imbalance contributes to CAD progression. Elevated IL-6 levels and the pro-inflammatory potential of the blood increases in case of severe coronary atherosclerosis. It has been shown that with an increase in IL-6 levels, the odds of detecting severe CAD increases 3.5-folds.