Endothelial Function and Pro-Inflammatory Cytokines as Prognostic Markers in Acute Coronary Syndromes

Area of Science:

• Cardiovascular Medicine
• Immunology
• Biomarkers

Background:

• Endothelial dysfunction and inflammation are key factors in coronary artery disease (CAD) progression and acute coronary syndrome (ACS) pathophysiology.
• Assessing endothelial function and inflammatory markers may offer prognostic insights in ACS patients.

Purpose of the Study:

• To investigate the prognostic value of endothelial function and pro-inflammatory cytokines in patients admitted with ACS.
• To correlate markers of endothelial function and inflammation with ACS diagnosis and major adverse cardiovascular events (MACE).

Main Methods:

• Flow-mediated dilatation (FMD) assessed endothelial function.
• Tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) levels measured via ELISA.
• Follow-up for MACE in ACS patients, including cardiovascular death, myocardial infarction, stroke, and hospitalizations.

Main Results:

• Impaired FMD and elevated TNF-α and IL-6 levels were observed in patients with ACS compared to stable CAD.
• Increased levels of TNF-α, IL-6, and impaired FMD correlated with higher odds of ACS.
• In ACS patients, TNF-α levels > 5.19 pg/mL independently predicted a 2.5-fold increased risk of MACE.

Conclusions:

• Patients presenting with ACS exhibit impaired endothelial function and elevated IL-6 and TNF-α levels.
• TNF-α is a significant independent predictor of MACE in ACS patients.
• Endothelial dysfunction and specific inflammatory markers are crucial in ACS prognosis.