[Intracoronary inflammatory markers after percutaneous coronary interventions]

Cardiac release and kinetics of cytokines after elective bare metal coronary stenting

The study was designed to assess the cardiac release kinetics of the cytokines interleukin-1ß (IL-1ß), interleukin-6 (IL-6) and tumor-necrosis-factor-α (TNF-α) in patients with significant stenosis of the ramus interventricularis anterior. Ten patients were treated by bare metal stent implantation, 11 patients who underwent a diagnostic coronary angiography without intervention served as a control group. Cytokines paired blood samples were withdrawn from the coronary sinus and a peripheral vein immediately before and 1, 2, 6 h after the intervention. Myocardial ischemia was monitored by means of cardiac lactate metabolism and 12-lead electrocardiogram. After coronary intervention IL-6 gradually increased from a common baseline level of 1.34 ± 1.56 pg/ml to a maximum of 10.58 ± 5.7 pg/ml in the peripheral vein and 15.81 ± 6.98 pg/ml in the coronary sinus within 6 h with persistent higher levels in the coronary sinus indicating coronary IL-6 release. After 12 h the peripheral venous concentration of IL-6 returned to baseline levels. Neither in the study group for IL-1ß and TNF-α nor in the control group for any cytokine level significant changes were found. Myocardial ischemia was excluded in all patients. Uncomplicated percutaneous coronary intervention (PCI) was followed by a significant cardiac IL-6 release due to endothelial injury and not to myocardial ischemia.