الفهرس 
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Abstract
nstable angina is a critical phase of coronary
heart disease with widely variable symptoms and
prognosis. The acute coronary syndromes of UA, NQMI,and Q-wave MI share a common pathogenic substrate:
atherosclerotic lesions of the coronary arteries. Some inflammatory or homeostatic markers constitute cardiovascular risk factors. The aim of the present work was planned to assess the levels of IL-6 and IL-10 with consequent calculation of IL-6/IL-10 ratio in a group of patients with unstable angina and to compare these levels
to those in a group of healthy subjects as a control group.
All participants were selected from the patients
attending the emergency room of the National Heart Institute, in Giza, Egypt. All cases were subjected to clinical examination to exclude the presence of previous or recent hepatic, renal disorders or Diabetes mellitus,which might affect the parameters to be investigated.
The present study involved twenty nine patients
with unstable angina and twenty healthy subjects who constituted the material of the study. proper serum protein markers and enzyme activities were measured for the biochemical rule out the diagnosis of acute myocardial infarction.
For patients with suspected unstable angina, their
serum cardiac protein markers and enzyme activities were drawn as early as possible from admitting to the emergency room or the coronary care unit, and after 48 hours respectively.
patients with unstable angina were subjected to
through other clinical investigations, which included history for their chest pain, ECG for primary diagnosis of their angina, body mass index, and historical background for any previous cardiac disorders. The clinical investigations were assessed by serum estimation of alanine aminotransferase activity, levels of plasma urea
and blood sugar. Cardiac markers as CK, CK-MB, LDH and AST were measured. High activities patients were excluded since they indicate AMI.
Determination of IL-6 and IL-10 levels with
consequent calculation of IL-6/IL-10 ratio for patients with unstable angina was compared with that of healthy subjects, as well as serum levels of hsCRp.
The mean plasma CRp levels after 48 hours were
elevated significantly compared to the first samples levels (on admission). These findings suggest that inflammatory immune activation in coronary arteries initiates acute
coronary syndromes, with circulating levels of
inflammatory markers reflecting the clinical course of the condition.
IL-6, levels were found to be elevated significantly
in the first samples (on admission) over the upper limit (3 ng/ml.) in the all five groups included in this study.
Results of this study revealed lower levels of IL-10, with higher proinflammatory to anti-inflammatory cytokine ratios, were observed on admission in patients with unstable angina who subsequently had cardiovascular events. Higher levels of the anti-inflammatory cytokine
IL-10 may be needed to provide protection in unstable angina. The mean plasma IL-6/IL10 ratio after 48 hours were found to be highly increased in groups who developed AMI only (either died or not).
The present study showed that in unstable angina
patients baseline plasma concentrations of CRp, IL-6 and IL10 are predictive of the risk of a post coronary heart ischemic event. However, these three risk markers are strongly correlated with each other, and IL-6/IL10 ratio appears as the most discriminating marker.