Correlation between subclinical hypothyroidism and coronary artery stenosis in patients with coronary heart disease / 中华老年医学杂志

Objective:To investigate the correlation between subclinical hypothyroidism(SCH)and the degree of coronary artery stenosis in patients with coronary heart disease.Methods:From March 2018 to September 2019, 138 patients undergoing coronary angiography in our hospital were randomly selected and their serum thyroxine(FT4)and high-sensitivity thyroid stimulating hormone(sTSH)levels were measured.Based on the levels of FT4 and sTSH, patients were divided into the SCH group and the normal group.Combined with coronary angiography results, the correlation between the SCH and the number of coronary lesions were analyzed.Results:Patients in the SCH group were associated with significantly higher levels of cholesterol(TC)[(5.83±1.27)mmol/L vs.(5.02±1.22)mmol/L, t=3.746, P=0.000], triglyceride(TG)[(3.29±1.74)mmol/L vs.(2.17±1.68)mmol/L, t=3.769, P=0.000], low-density lipoprotein cholesterol(LDL-C)[(3.81±1.02)mmol/L vs.(3.24±1.08)mmol/L, t=3.092, P=0.001], and high-density lipoprotein cholesterol(HDL-C)[(1.13±0.27)mmol/L vs.(1.02±0.25)mmol/L, t=2.4459, P=0.008]than those in the normal group.There were significant differences in sTSH levels between patients with multivessel, double vessel or single vessel disease when grouped by the number of coronary lesions, and between those with severe, moderate or mild coronary artery stenosis when grouped by disease severity(all P<0.05). Multiple regression analysis showed that SCH, TC, and LDL-C were factors affecting the number of coronary lesions( P<0.05). Conclusions:SCH is an important factor that causes the occurrence and progression of coronary artery stenosis in patients with coronary heart disease, mainly by affecting lipid metabolism.

Prognosis of patients with vulnerable plaques indicated by coronary CT angiography / 浙江大学学报·医学版

OBJECTIVE@#To investigate the prognosis of patients with vulnerable plaque indicated by coronary CT angiography (CCTA).@*METHODS@#Totally 1963 patients underwent CCTA from February 2nd 2015 to September 13th 2015, and 2728 coronary borderline lesions (stenosis of 50%-70%) were detected. Among them 804 patients had vulnerable plaques and 1159 patients had stable plaques. The primary endpoint was major cardiac adverse events (MACE), including cardiac death, acute myocardial infarction and target lesion revascularization.@*RESULTS@#Patients were followed up for a mean follow-up of 27.4±2.3 months. The incidence of MACE in the vulnerable plaque group was significantly higher than that in the stable plaque group (10.8%vs 2.3%, < 0.01). After adjusting for age, gender, smoking, hypertension, diabetes, hyperlipidemia, the MACE hazard ratio () in the vulnerable plaque group was 5.022 (95% :3.254-7.751, < 0.01).Subgroup analysis showed that in the vulnerable plaque group, the incidence of MACE in patients taking antiplatelet and statin ≤3 months and those taking antiplatelet and statin > 3 months was 17.0%and 5.8%, respectively (=3.149, 95% :1.987-4.992, < 0.01); but the difference did not seen in stable plaque group (=1.721, 95% :0.798-3.712, >0.05).@*CONCLUSIONS@#This study confirmed the risk of MACE in patients with vulnerable plaque detected by CCTA and the drug treatment may reduce the risk for patients with vulnerable plaque.

Resveratrol attenuates apoptosis of endothelial progenitor cells induced by tert-butyl hydroperoxide / 中国病理生理杂志

AIM:To investigate the effect of resveratrol on the apoptosis of endothelial progenitor cells (EPC) induced by tert-butyl hydroperoxide (tBHP) and the underlying mechanisms.METHODS:Total mononuclear cells were isolated from peripheral blood by density gradient centrifugation, and the cells were cultured on fibronectin-coated culture dishes.After 4 d of culture, attached cells were divided into control group, tBHP group, and resveratrol plus tBHP group (pretreated with resveratrol for 24 h and then cultured with 100 μmol/L tBHP for 6 h).The proliferation and migration abilities of the EPC were assessed by MTT assay, BrdU incorporation assay and modified Boyden chamber assay.The proportion of apoptotic EPC was determined by flow cytometry after staining with fluorescein isothiocyanate-conjugated Annexin V and propodium iodide.The level of reactive oxygen species (ROS) was determined by H2DCF-DA method.Caspase-3 activity was assay using a caspase-3 colorimetric assay kit.The protein levels of cleaved caspase-3, Bcl-2 and Bax were determined by Western blot.RESULTS:Resveratrol decreased EPC apoptosis induced by tBHP in a dose-dependent manner.Moreover, resveratrol increased the proliferation and migration abilities of the EPC.Resveratrol decreased intracellular ROS level, caspase-3 activity and the protein level of cleaved caspase-3.Resveratrol also decreased protein expression of Bax and increased protein expression of Bcl-2.CONCLUSION:Resveratrol attenuates EPC apoptosis induced by oxidative stress, and its mechanisms may be related to protecting the mitochondrial function.

Clinical implication of real-time three-dimensional transesophageal echocardiography in percutaneous transcatheter left atrial appendage closure with Amplatzer Cardiac Plug(ACP) device for non-valvular atrial fibrillation patients / 中华超声影像学杂志

Objective To evaluate the application value of real-time three-dimensional echocardiography (RT-3D TEE) in nonvalvular atrial fibrillation patients after transcatheter left atrial appendage closure (LAAC) with the Amplatzer Cardiac Plug (ACP).Methods The two-dimensional transesophageal echocardiography (2D TEE) and RT-3D TEE were performed in selected patients to measure the diameter of left atrial appendage ostium and landing zone,to observe left atrial appendage morphology and lobular distribution.These were also performed to guide the whole process of transcatheter LAAC with ACP,which included the atrial septal puncture,sheathing canal cruise,occluder device implantation,and verifying the stability of occluder device and releasing the device.It involved observing ACP occluder morphology,location,stability,surrounding residual shunt,whether influencing the mitral valve and left superior pulmonary vein flow,and pericardial effusion.Results A total of 15 patients (100％) successfully underwent LAAC with the ACP.The maximum diameter of left atrial appendage ostium by 2D-TEE measurement during operation was (20.5 ± 2.9)mm,located at 135°.The diameter of left atrial appendage landing zone was (17.1 ± 2.8) mm,located at 45°;(18.0 ± 4.0) mm,located at 90°;(22.1 ± 4.7)mm,located at 135°,respectively.The left atrial appendage morphology:2 had one leaf and 13 had two leaves or more,including 2 cases of bifoliate short neck shape.In 15 patients,6 cases of cauliflower type,2 cases of wind sock type,3 cases of chicken wing type,2 cases of cactus type and 2 cases of complex type.The proximal left atrial appendage morphology:3 cases of boot type,2 cases of wide mouth type,6 cases of narrow mouth type,2 cases of straight tube type,and 2 cases of bifoliate short neck type.There was no obvious residual shunt in all the patients at immediately post-operation.Conclusions In the transcatheter LAAC with the ACP,RT-3D TEE has important application value in the preoperative selection of patients,the choice of appropriate occluder,guidance of full-process monitoring during operation,the postoperative effect evaluation and so on.

Assessment of left atrial function in patients with hypertrophic obstructive cardiomyopathy before and one year after alcohol septal ablation by two dimensional speckle tracking echocardiography / 中华医学超声杂志（电子版）

Objective To assess left atrial (LA) function by two dimensional speckle tracking echocardiography (2DSTE) in patients with hypertrophic obstructive cardiomyopathy (HOCM) before and one year after percutaneous transluminal septal myocardial ablation (PTSMA).Methods The study included 31 patients with HOCM who underwent PTSMA performed between November 2012 and December 2014 in Sir Run Run Shaw Hospital.Mean age was 51 ± 13 years,and 13 patients were men,18 patients were women.New York Heart Association class was 2.6± 0.7 at baseline.If the target region was correctly marked by the injection of the echo contrast agent,ethanol was slowly (0.5 ml/min) injected to a maximum of 3 ml.Ten minutes after the injection of ethanol,the balloon was deflated.A successful procedure was defined as a ≥ 50％ reduction in the LV outflow tract peak systolic gradient compared to baseline level.Each patient with HOCM had a complete two-dimensional transthoracic echocardiography assessment before and one year after the PTSMA.The measurements included basal septal thickness,left ventricular outflow tract (LVOT) gradient,mitral regurgitation (MR) grade,left atrial dimensions,left ventricular (LV) ejection fraction and tissue Doppler parameters of lateral mitral annular e'and septal mitral annular e'.The LA wall was tracked on a frame-by-frame basis using 2D-STE,and LA volume waveforms were generated.The maximum LA volume (LAVmax),minimal LA volume (LAVmin),and the LA volume before atrial contraction (LAVpre-a) were measured.The LA reservoir function was calculated as left atrial expansion index (LAEI) and left atrial diastolic emptying index (LADEI).The LA conduit function was calculated as the passive emptying percentage of total emptying (PE) and the passive emptying index (PEI).The LA booster function was calculated as the active emptying percentage of total emptying (AE) and the active emptying index (AEI).The comparisons between patient New York Heart Association class,echocardiography and LA function parameter before and after PTSMA were conducted by paired t test.Results Compared with pre-operative values,LVOTG,MR grade,LA end-diastolic size,E/lateral e'ratio,septal mitral annular e'decreased in patients one year after the PTSMA [(35±26) mmHg vs (74135) mmHg,0.9310.35 vs 2.27±0.73,(40±6) mm vs (45±6) mm,12.6±3.8 vs 14.6±4.6,(4.3± 1.1) cm/s vs (5.0± 1.3) cm/s],whereas New York Heart Association class,Lateral mitral annular e',E/septal e'ratio [1.4±0.5 vs 2.6±0.7,(6.9±2.3) cm/s vs (5.8± 1.7) cm/s,20.2±7.1 vs 17.0±5.2] increased (t=6.55,4.78,2.60,2.84,2.59,-3.32,-2.67,-2.93,all P ＜ 0.05).Compared with pre-operative values,LAVImax,LAVImin,LAVIpre-a,AE,AEI(％) decreased in patients one year after the PTSMA [(32.7±7.1) ml/m2 vs (38.9±9.3) ml/m2,(16.3±4.4) ml/m2 vs (20.7±5.5) ml/m2,(23.1±5.7) ml/m2 vs (30.5±7.0) ml/m2,(41.5±8.7)％ vs (53.8± 10.4)％,(29.4±3.9)％ vs (32.1±4.6)％],(t=3.65,3.11,3.38,3.92,2.17,all P ＜ 0.05);whereas the LAEI(％),LADEI(％),PE(％),PEI(％) [(100.1 ± 19.3)％ vs (87.9± 14.7)％,(50.2±9.8)％ vs (46.7±9.1) ％,(58.5± 11.8) ％ vs (46.1 ±9.1) ％,(26.9±5.2)％ vs (21.6±4.8)％] increased (t=-2.82,-2.33,-3.89,-2.74,all P ＜ 0.05).Conclusions The study showed the improvement in LA reservoir and conduit function,while the reduction in LA booster pump function in patients one year after PTSMA.

Effects of fibroblast growth factor inducible 14 (Fn14) on high glucose induced-cardiomyocyte hypertrophy / 中华内分泌代谢杂志

Objective To investigate the effect and mechanisms of factor fibroblast growth factor inducible 14(Fn14)in the high glucose induced-cardiomyocyte hypertrophy. Method To observe the expression of collagenⅠ, connective tissue growth factor ( CTGF ) , transforming growth factor-β1 ( TGF-β1 ) , and Fn14 in high glucose induced-cardiomyocyte hypertrophy. Fn14 expressions was down-regulated by siRNA interference technique, and then the expressions of collagen Ⅰ, CTGF, and TGF-β1 were observed, and the mechanism was also explored. Results The expression of collagen I, CTGF and TGF-β1 was significantly up-regulated after high glucose induced-cardiomyocyte hypertrophy for 72 h. At the same time, the expression of Fn14 was increased after 72 h-treatment, and reached the peak at concentration of 30 mmol/L high glucose. High glucose could not up-regulated the expression of collagenⅠ, CTGF, and TGF-β1 after siFn14 interference, while the same result was observed in the expression of p-JNK. Conclusion The expressions of collagenⅠ, CTGF, TGF-β1, and Fn14 in cardiomyocyte of neonatal rats were induced by high glucose. While Fn14 expression was inhibited, the expressions of collagenⅠ, CTGF, and TGF-β1 were down-regulated, which seems to be involved with p-JNK signaling pathway.

Nine-month angiographic and two-year clinical follow-up of polymer-free sirolimus-eluting stent versus durable-polymer sirolimus-eluting stent for coronary artery disease: the Nano randomized trial / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>First generation drug-eluting stents (DES) were associated with a high incidence of late stent thrombosis (ST), mainly due to delayed healing and re-endothelization by the durable polymer coating. This study sought to assess the safety and efficacy of the Nano polymer-free sirolimus-eluting stent (SES) in the treatment of patients with de novo coronary artery lesions.</p><p><b>METHODS</b>The Nano trial is the first randomized trial designed to compare the safety and efficacy of the Nano polymer-free SES and Partner durable-polymer SES (Lepu Medical Technology, Beijing, China) in the treatment of patients with de novo native coronary lesions. The primary endpoint was in-stent late lumen loss (LLL) at 9-month follow-up. The secondary endpoint was major adverse cardiac events (MACE), a composite of cardiac death, myocardial infarction or target lesion revascularization.</p><p><b>RESULTS</b>A total of 291 patients (Nano group: n = 143, Partner group: n = 148) were enrolled in this trial from 19 Chinese centers. The Nano polymer-free SES was non-inferior to the Partner durable-polymer DES at the primary endpoint of 9 months (P < 0.001). The 9-month in-segment LLL of the polymer-free Nano SES was comparable to the Partner SES (0.34 ± 0.42) mm vs. (0.30 ± 0.48) mm, P = 0.21). The incidence of MACE in the Nano group were 7.6% compared to the Partner group of 5.9% (P = 0.75) at 2 years follow-up. The frequency of cardiac death and stent thrombosis was low for both Nano and Partner SES (0.8% vs. 0.7%, 0.8% vs. 1.5%, both P = 1.00).</p><p><b>CONCLUSIONS</b>In this multicenter randomized Nano trial, the Nano polymer-free SES showed similar safety and efficacy compared with the Partner SES in the treatment of patients with de novo coronary artery lesions. Trials in patients with complex lesions and longer term follow-up are necessary to confirm the clinical performance of this novel Nano polymer-free SES.</p>

Analysis of causes of inappropriate discharge of an implantable cardioverter defibrillator in elderly patients / 中华老年医学杂志

Objective To analyze the causes of inappropriate discharge of implantable cardioverter defibrillator (ICD) in elderly patients and to discuss the corresponding solutions.Methods Totally 95 elderly patients with ICD were collected.They were followed up and the inappropriate ICD discharges were recorded and analyzed.Results All patients were followed up for 235 times/year totally.There were 16 patients with inappropriate ICD discharges.The causes of inappropriate ICD discharges included ventricular oversensing in 7 patients (43.7％),supraventricular tachycardia misclassified into ventricular tachycardia in 4 patients (25.0％),electrode fracture in 2 patients (12.5％),and electromyogram (EMG) interference,electromagnetic interference and electrode fracture with EMG interference in 1 patients respectively (6.3％ each).11 inappropriate ICD discharges were reduced and avoided by reprogrammed and noninvasive treatment in 16 patients.1 patient with the underdetected ventricular fibrillation after reprogramming and the problem was solved by external defibrillation.The other 5 patients got better by the invasive treatment.Conclusions Different causes account for inappropriate discharges in patients with ICD.Reprogramming the corresponding parameters in different ICD can reduce or avoid inappropriate discharges without affecting the sensitivity of ICD.

Assessment of left ventricular systolic synchrony before and after percutaneous transluminal septal myocardial ablation of hypertrophic obstructive cardiomyopathy by two dimensional speckle tracking imaging / 中华超声影像学杂志

ObjectiveTo assess the characteristics of left ventrlcular ( LV) systolic syncnrony before and 6 days after percutaneous transluminal septal myocardial ablation(PTSMA)in patients with hypertrophic obstructive cardiomyopathy (HOCM) using two dimensional speckle tracking imaging(2DSTI),and to investigate correlation between the LV systolic synchrony and LV outflow-trace gradient (LVOTG).MethodsLVOTG were measured before and 6 days after PTSMA in 21 patients with HOCM.The two dimensional loop-cinec were obtained in three levels of the short axis views of LV (mitral valve,papillary muscle and cardiac apex).The time from the onset of QRS complexes to systolic peak strain from the radial vectors (TRs) was recorded using 2D-STI.The standard deviation of the TRS of 18 segments (TRsSD) were calculated as indicator of LV systolic synchrony.Results Six days after PTSMA,LVOTG decreased significantly from (84.3 ± 19.1)mm Hg to (40.6 ± 8.3)mm Hg( P ＜0.01).TRS of the base and middle segments of anteroseptal were prolonged dramatically( P ＜0.05) 6 days after PTSMA compared with that before.There were no significantly differences in TRs-SD of LV between before and 6 days after PTSMA ( t =1.03,P ＞ 0.05).Decreased LVOTG correlated moderately to prolonged TRS of the base segments of anteroseptal ( r =0.657,P ＜0.05).Conclusions2D-STI can detect exactly the characteristics of LV systolic synchrony before and 6 days after PTSMA in patients with HOCM.

Effects of stromal cell-derived factor-1α on senescence of endothelial stem cells from peripheral blood / 中国药理学与毒理学杂志

OBJECTIVE To investigate whether stromal cell-derived factor-1α (SDF-1α) might be able to prevent senescence of endothelial stem cell (ESC) and also study its effects on the telomerase activity. METHODS Total mononuclear cells (MNCs) were isolated from peripheral blood by density gradient centrifugation, and then the cells were plated on fibronectin-coated culture dishes. After cultured for 4 d, attached cells were divided into control and SDF-1α 1, 10, 50 and 100 μg·L~(-1) groups. ESC became senescent as determined by acidic β-galactosidase staining. The proliferation of ESC was assessed by MTT assay and colony-forming capacity. Telomerase activity was measured by telomerase-PCR ELISA and the phosphorylation of Akt was determined by using Western blotting. RESULTS Ex vivo prolonged cultivation of ESC led to rapid onset of ESC senescence. Compared with control group, SDF-1α concentration-dependently inhibited the onset of ESC senescence, maximum at 100 μg·L~(-1) (40.8±7.1 vs 17.5±3.0; P<0.01). Moreover, SDF-1α 100 μg·L~(-1) increased ESC proliferation (0.22±0.02 vs 0.39±0.04; P<0.01) and ESC colony-forming activity (7.8±2.2 vs 22.4±3.4). Compared with control group, SDF-1α 100 μg·L~(-1) also increased telomerase activity (0.34±0.05 vs 0.57±0.09; P<0.01). In addition, SDF-1α treatment of ESC stimulated a concentration- and time-dependent Akt phosphorylation. CONCLUSION SDF-1α-induced prevention of ESC senescence leads to the potentiation of proliferative activity, and clonal expansion, which may be related to the activation of telomerase and Akt phosphorylation.

The effect of vaslartan and fluvastatin on the connective tissue growth factor expression in experimental diabetic cardiomyopathy / 中华内科杂志

the two drugs than using one alone.

Clinical and angiographic results of pullback atherectomy: effects of cutter size and characteristic of the lesion / 中国介入心脏病学杂志

0.05) during follow-up angiography. Conclusion Pullback atherectomy is an effective method of plaque removal for coronary artery disease with optimal short-term angiographic results, and large cutter and eccentric lesion seem to come with good immediate and follow-up angiographic results.

Polymorphisms in the coagulation factor VII gene and the risk of myocardial infarction in patients undergoing coronary angiography / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate whether coagulation factor VII (FVII) polymorphisms play a role in the pathogenesis of coronary artery disease (CAD) and/or myocardial infarction (MI) in a series of Hans.</p><p><b>METHODS</b>The Arg(353)Gln and HVR4 polymorphisms of FVII gene were determined in 374 patients undergoing selective coronary angiography by PCR and restriction fragment length polymorphism assay.</p><p><b>RESULTS</b>The FVII genotype distribution was in accordance with Hardy-Weinberg equilibrium. The frequencies of FVII genotypes or alleles did not show significant differences between the CAD group and the controls or between the males and the females. The frequencies of carriers of the Gln(353) allele and (Arg/Gln + Gln/Gln) genotypes were significantly higher in the CAD patients without MI than in those with MI (P = 0.031, odds ratio 0.37, 95% CI: 0.15 - 0.94). However, HVR4 polymorphisms were not significantly different between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>Carrying the F VII Gln(353) gene may be a protective factor against MI in the Chinese Hans.</p>

Expression of NADPH oxidase subunit p22phox in myocardial infarction rats / 中国病理生理杂志

AIM: To determine the relevance of NADPH oxidase subunit p22hox and the expression of superoxide anion on ventricular remodeling in myocardial infarction (MI) rats. METHODS: MI of Sprague-Dawley rats were established by left anterior descenting coronary artery ligation. 8 weeks after MI, Doppler echocardiography, hemodynamic study and histomorphometry were performed to analyze the ventricular remodeling. The level of thiobarbituric acid reactive substance in plasma and myocardium were measured, and the distribution of superoxide anion was observed with laser scanning confocal microscope. The expression of p22phox mRNA and protein level was detected by RT-PCR and immunohistochemistry. RESULTS: The left ventricular remodeling was significant in MI rats, also the level of thiobarbituric acid reactive substance increased in the plasma and non-infarcted myocardium. The expressions of p22-phox mRNA and protein levels, and superoxide anion increased in infarcted and non-infarcted myocardium in MI rats. CONCLUSION: Our results suggest that the expression of NADPH oxidase and its derived superoxide anion may take part in left ventricular remodeling through oxidative stresss after MI.

Association of F ⅩⅢ Val34Leu with coronary heart disease / 中国病理生理杂志

0.05)). The Val/Leu genotype and Leu allele frequencies in subjects without MI were significantly higher than that in subjects with MI (P

Effect of fluvastatin on left ventricular remodeling after myocardial infarction in rats / 中国病理生理杂志

AIM: To clarify the protective effect of long-term administration of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor fluvastatin on ventricular remodeling after myocardial infarction (MI) in rats and its mechanisms. METHODS: Myocardial infarction were established by ligated left coronary anterior artery in SD rats, 24 hours after the operation, the survival rats were treated by gavage fluvastatin (20 mg?kg~(-1)?d~(-1)) or distilled water for 8 weeks. Doppler echocardiography, homodynamic and cardiac histomorphometry were used to assess the ventricular remodeling and cardiac function. The plasma levels of total cholesterol (Tch), creatinine (Cr), glutamic-oxal (o) acetic transaminase (AST), lipid peroxidation (LPO), glutathione perioxidase (GSH-PX), nitrogen monoxide (NO_2~-/NO_3~-) were detected. RESULTS: The Tch, Cr and AST were not significant difference in groups. Left ventricular end-diastole pressure, right relative weight, left ventricular posterior wall thickness, collagen volume fraction and the lung weight were decreased in AMI+fluvastatin group compared to AMI group (P

Relationship of secretory type Ⅱ phospholipase A2,coronary artery score and atherogenic index in patients with coronary artery disease / 中国介入心脏病学杂志

Objective To study the relationship of secretory type Ⅱ phospholipase A2(sPLA2),coronary artery score and atherogenic index in patients with coronary artery disease.Methods One hundred and seventy nine patients confirmed by angiography were enrolled in the coronary heart disease(CHD)group and another 89 non-CHD patients were enrolled in the control group.Serum levels of sPLA2 were measured by ELISA in all subjects.The severity of coronary artery lesions was analysed in terms of coronary artery score by quantitive computer system(QCA).The atherogenic index(AI)was also evaluated in the 2 groups.Results Compared with the control group,serum level of sPLA2 was higher in the CHD group(55.18?11.75 u/mL vs 68.15?16.70 u/mL,P

Relationship between serum concentrations of IL-18, IL-10, IL-6 and acute coronary syndrome / 中国病理生理杂志

AIM: To examine the relation between serum concentrations of interleukin-18, interleukin-10, interleukin-6 and acute coronary syndrome (ACS). METHODS: Serum concentrations of IL-18, IL-10, IL-6 were measured in 17 patients with acute myocardial infarction (AMI), 30 patients with unstable angina pectoris (UAP), 15 patients with stable angina pectoris (SAP) and 20 controls by enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay (RIA).The relation between IL-18, IL-6 and IL-10 was compared. RESULTS: Serum concentrations of IL-18, IL-6 were significantly increased in the AMI and UAP groups in comparison with the SAP and control groups. Conversely, serum concentrations of IL-10 were significantly decreased in the AMI and UAP groups in comparison with the SAP and control groups. The correlation of concentrations of IL-18 and IL-6 had no significance; but the levels of IL-18 and IL-6 were negatively correlated with IL-10. CONCLUSION: Serum IL-18, IL-6 concentrations increase while serum IL-10 concentration decreases in patients with acute coronary syndromes. The inflammatory imbalance between IL-18, IL-6 and IL-10 may play an important role in the instability of atherosclerotic plaque.