CORRELATION BETWEEN BLOOD LEVELS OF CRP, TNF-α (AS INFLAMMATORY FACTORS), AND IL-10 (AS ANTI-INFLAMMATORY FACTOR) AND CORONARY ARTERY DISEASE

Background- The results of a great amount of research done the world over in recent years have indicated that atherosclerosis is an inflammatory disease. Most of these investigations were conducted on the correlation between inflammatory factors such as CRP, IL-2, and IL-1 and atherosclerosis. In this study, we evaluated inflammatory factors such as CRP and TNF-a as well as anti-inflammatory factor IL-10 and analyzed the correlation between the balance of these factors with atherosclerosis.
Methods- In total, 135 patients between the ages of 45 and 70 years who were admitted for coronary angiography were selected. All of the selected patients met the inclusion criteria for the research. After recording personal information, medical history, and any previous treatment in the questionnaire, blood samples were collected and levels of CRP (high-sensitive quantitative test), TNF-a, and IL-10 were measured in all the samples. We entered the acquired results, the routine blood examination, and the angiography results in the patients’ charts and analyzed the results using statistical methods.
Results- The angiography results in the 135 patients were as follows: 19 (14.1%) cases had normal coronary arteries, 6 (4.4%) had minimal CAD, 43 (31.8%) had single-vessel disease, 29 (21.5%) two-vessel, and 38 (28.1%) had three-vessel disease. In the laboratory tests, the mean CRP level in patients with normal coronary arteries was 6±4 mg/l; however in patients with CAD it was 17±9 mg/l. Also, the mean IL-10 level in cases with normal coronary arteries was 4.4 pgr/mL, while in patients with CAD it was 2.6 pgr/mL; and serum level of TNF-a in patients with CAD was 6.3±3.8 pgr/mL, whereas in cases with normal coronary arteries, the average serum level of TNF-a was 4.5 ± 2.2 pgr/mL.
Conclusion- The obtained results in this research showed a direct correlation between the blood levels of CRP and TNF-a with the existence and intensity of coronary artery disease. In addition, we found a reverse significant correlation between blood levels of IL-10 and existence of coronary artery disease. Although we found a correlation between reduced levels of IL-10 and intensity of coronary artery disease, it was not statistically significant. Furthermore, in patients with elevated blood levels of inflammatory and anti-inflammatory factors, the intensity of the coronary artery disease was far less than that in patients with high levels of inflammatory factors and reduced levels of anti-inflammatory factors. Therefore, we concluded that high levels of CRP and TNF-a and low levels of IL-10 had a significant correlation with the intensity of coronary artery disease and also the balance between these factors had a significant correlation with the intensity of the coronary artery disease.