IL‐6 and IL‐1 receptor antagonist in stable angina pectoris and relation of IL‐6 to clinical findings in acute myocardial infarction

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Abstract
Gabriel AS, Ahnve S, Wretlind B, Martinsson A (Karolinska Institute and Huddinge University Hospital, Stockholm, Sweden). J Intern Med 2000; 248: 61–66. Objectives. To determine if increased inflammatory activity, as reflected by interleukin‐6 (IL‐6) and interleukin‐1 receptor antagonist (IL‐1ra) levels, is present in patients with stable angina pectoris and if IL‐6 levels on admission to the coronary care unit in patients with acute myocardial infarction (AMI) are related to heart failure and fever response. Subjects and methods. We studied 28 patients with stable angina pectoris enrolled for coronary angiography, and compared them with sex‐ and age‐matched controls. Thirty‐four patients with AMI were studied and samples for determination of IL‐6 levels were taken on admission within 36 h of onset of symptoms. IL‐6 and IL‐1ra were determined in serum by enzyme immunoassay. Results. Levels of IL‐6 and IL‐1ra were higher in patients with stable angina pectoris than in controls (mean 4.6 ± 3.6 vs. 3.0 ± 2.9 ng L–1, P < 0.03, and 774 ± 509 vs. 490 ± 511 ng L–1, P < 0.01, respectively). IL‐6 and IL‐1ra levels were not related to angiographic findings. IL‐6 levels were high in patients with AMI (38.9 ± 75.6 ng L–1). Patients with prolonged fever (duration > 4 days) had higher IL‐6 levels (94.7 ± 138.2 vs. 21.7 ± 29.7 ng L–1, P < 0.05). IL‐6 levels were not related to heart failure. Conclusions. Our results indicate that increased inflammatory activity is present not only in acute coronary syndromes, but also in a chronic form of ischaemic heart disease, giving further evidence for a central role of inflammatory processes in coronary artery disease. With regard to AMI, we found increased inflammatory activity in patients with prolonged fever.