Study of serum levels of interleukine-18 (IL-18) and leptin in Iraqi patients with acute coronary syndromes

Background: Acute Coronary Syndromes (ACS) represents a pathological, diagnostic, and risk continuum from unstable angina through myocardial infarction (MI) with or without ST-segment elevation. These three conditions share a very similar pathology, although treatment differs. Interleukin -18 (IL-18) is a recently evaluated cytokine synthesized by Kupffer cells. It has been shown to activate macrophages and has direct pro-inflammatory activities of many cells including inflammatory and vascular cells. Adipose tissue also serves as an important endocrine organ by producing hormones such as leptin, resistin, and cytokine. Several traditional cardiovascular risk factors track with inflammatory biomarkers, in particular central obesity and body mass index. Objective: The aim of this study was to investigate the predictive value of IL-18 and leptin in acute coronary syndromes. And to assess the relation of serum IL-18 & leptin levels with various cardiovascular risk factors. Patients and Methods: 85 cardiac patients were admitted to the coronary care unit, Ibn-Alnafees Hospital and Al Kindy Hospital over the period July 2012 and March 2013 with the clinical diagnosis of acute coronary syndrome their ages range was (32-78) years, the number of male was (50), (58. 82 %) and female was (35), (41.18 %). 30 healthy control (age, sex-matched) were enrolled in this study. All cardiac patients have routine ECG, cardiac biomarkers measurements especially (Troponin), lipid profile test, cytokine profile (IL-18), and Leptin. 8 ml of blood needed for assessment of the above makers. Results: The current study reported that the patients with ACS had significantly higher level of IL-18 & leptin levels than the healthy controls ,a significant positive correlation was found in mean serum IL-18 level with BMI in ACS (AMI & UA) while a significant positive correlation was observed between leptin with BMI in AMI but non-significant in UA patients. on the other hand a positive correlation was observed between IL-18 and Leptin in AMI, while a negative correlation was observed in unstable angina patients. Conclusion: this study shows a significantly increase in IL-18 and leptin in the circulation of patients with ACS as compared with healthy control. These finding suggest these biomarkers may be useful in diagnosis of patients with ACS. Also Serum IL-18 may play an important role in the instability of atherosclerotic plaque.