de Paula da Silva Marcus V, Villar-Delfino Pedro Henrique, Nogueira-Machado José A, Volpe Caroline M O
Faculdade Santa Casa BH, Programa de Pós-Graduação em Medicina-Biomedicina, Hospital Santa Casa de Belo Horizonte, Minas Gerais, Brazil.
Recent Adv Inflamm Allergy Drug Discov. 2022;15(2):71-79. doi: 10.2174/2772270816666220211091231.
Inflammation plays a significant role in the pathophysiology of Acute Coronary Syndrome (ACS) but is not included in current risk stratification.
This study aimed at determining the association between Thrombolysis in Myocardial Infarction (TIMI) risk score and inflammatory biomarkers in the ACS, including unstable angina (UA), Non-ST Segment Elevation Myocardial Infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI). We hypothesized that inflammatory biomarkers could add prognostic value to the TIMI risk score.
In this cross-sectional study, serum levels of interleukins (IL)-6 and IL-1β and MDA (malondialdehyde) were quantified by ELISA and colorimetry, respectively, of patients with ACS (n = 48; 31.3 % with UA, 33.3 % with NSTEMI, and 35.4 % with STEMI) and healthy controls (n = 43). We assessed the TIMI scores in the first 24 h after symptom onset.
The results showed that patients with ACS had significantly higher levels (p<0.05) of the inflammatory biomarkers IL-6, IL-1β, and MDA than the control group. However, we found no significant differences in IL-6, IL-1β, and MDA levels among the patients with ACS according to their classification as UA, NSTEMI, and STEMI. Positive correlations were observed between TIMI and IL-6 (r=0.68), IL-1β (r= 0.53), and MDA (r=0.58) in patients with UA and between TIMI and IL-1β (r= 0.62) in STEMI patients.
These data suggested the presence of a pro-inflammatory profile in patients with ACS as well as positive correlations between TIMI scores and the inflammatory biomarkers IL-6, IL-1β, and MDA in patients with UA and between TIMI scores and IL-1β in patients with STEMI. Combining inflammatory biomarkers with the TIMI risk score could provide better insight into the processes involved in ACS.
炎症在急性冠状动脉综合征（ACS）的病理生理学中起重要作用，但未纳入当前的风险分层。
本研究旨在确定心肌梗死溶栓（TIMI）风险评分与ACS（包括不稳定型心绞痛（UA）、非ST段抬高型心肌梗死（NSTEMI）和ST段抬高型心肌梗死（STEMI））中炎症生物标志物之间的关联。我们假设炎症生物标志物可为TIMI风险评分增加预后价值。
在这项横断面研究中，通过酶联免疫吸附测定（ELISA）和比色法分别对ACS患者（n = 48；31.3%为UA，33.3%为NSTEMI，35.4%为STEMI）和健康对照者（n = 43）的血清白细胞介素（IL）-6、IL-1β和丙二醛（MDA）水平进行定量。我们在症状发作后的头24小时内评估TIMI评分。
结果显示，ACS患者的炎症生物标志物IL-6、IL-1β和MDA水平显著高于对照组（p<0.05）。然而，根据ACS患者的UA、NSTEMI和STEMI分类，我们发现IL-6、IL-1β和MDA水平无显著差异。在UA患者中，TIMI与IL-6（r = 0.68）、IL-1β（r = 0.53）和MDA（r = 0.58）之间以及在STEMI患者中TIMI与IL-1β（r = 0.62）之间观察到正相关。
这些数据表明ACS患者存在促炎状态，以及UA患者中TIMI评分与炎症生物标志物IL-6、IL-1β和MDA之间以及STEMI患者中TIMI评分与IL-1β之间存在正相关。将炎症生物标志物与TIMI风险评分相结合可以更好地洞察ACS所涉及的过程。
