Interleukin-10 serum level in acute coronary syndrome patients.

Aim To compare plasma IL-10 concentrations in patients with Acute Coronary Syndrome (ACS) with those in Coronary Artery Disease (CAD). Methods ACS patients hospitalized in intensive coronary care unit (ICCU) of Cipto Mangunkusumo Hospital/Faculty of Medicine University of Indonesia (CMH/FMUI), Persahabatan Hospital, MMC Hospital, and Medistra Hospital, Jakarta, between May 2005 and May 2006, were included in this study. The ambulatory CAD patients were taken as comparator. The serum IL-10 level was measured by immunoassay method, and compared by using Independent Student’s t-test. To investigate whether IL-10 serum level could predict ACS, the sensitivity and specifi city of this parameter towards SKA in various IL-10 serum levels were calculated as well. Results In this observational study, as many as 146 subjects were analyzed, consisting of 84 ACS patients, and 62 coronary artery disease (CAD). The IL-10 level was higher in the group of ACS patients (7.37 pg/mL + 7.81, CI 95% 5.68-9.07) than that in CAD patients (1.59 pg/mL + 1.55, CI 95% 1.2-1.98). The optimal cut-off point for serum IL-10 level is >1.95 pg/mL, with 79.76 % sensitivity and 77.42 % specifi city. Conclusion The IL-10 level was higher in the ACS patients compared to that in CAD patients. Serum IL-10 measurement is a quite superior method to distinguish acute and stable condition, eventhough it is not as good as hsCRP for the same purpose.

The effect of curcumin on lipid level in patients with acute coronary syndrome.

Aim: to evaluate the effects of curcumin on total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride in acute coronary syndrome patients. Methods: this study were conducted at Dr. Cipto Mangunkusumo General Hospital (RSUPN-CM), Persahabatan Hospital, MMC Hospital and Medistra Hospital, Jakarta. The study started from 1 May 2005 to 5 May 2006. Study Design was an interventional study which was a randomized double blind controlled trial to evaluate the effects of curcumin administration at escalating doses (low dose 3 times 15 mg/day, moderate dose 3 times 30 mg/day, and high dose 3 times 60 mg/day) on total cholesterol level, LDL cholesterol level, HDL cholesterol level, and triglyceride level in ACS patients. Results: a 75 ACS patients undergoing randomization participated in randomized controlled trial (RCT). Of the 75 ACS patients participating in that RCT, 67 received care at RSCM, 6 at Persahabatan Hospital, and 2 at MMC Hospital. As many as 63 patients were able to participate in the RCT up to its conclusion. There was no significant difference in age, sex, risk factor of dyslipidemia, DM, smoking, hypertension, CHD history in family, height, body weight and body mass index, waist circumference, systolic blood pressure, diastolic blood pressure in the four groups of patients. This showed that the randomization performed was reasonably good. There was no significant difference in laboratory parameters, such as total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride, fasting blood glucose, blood glucose 2 hours PP, glyco Hb, triglyceride, Hb, Ht, leukocyte, thrombocyte, ureum, creatinine, SGOT, SGPT, in the four groups. There was no significant difference in types of ACS and locations of ACS in the four groups as well. There was no significant difference in statin medicatios (simvastatin), aspirin ACE inhibitor, and DM medications in the four groups. No patient used tiazolidindion. No significant difference was found in the percentage of compliance in the four groups of patients. The effects of curcumin on total cholesterol level and LDL cholesterol level, there was a trend that the lower the dose of curcumin, the higher the effect of reduction. For HDL cholesterol level, there was also a trend that the lower the dose of curcumin, the higher the effect of increase in HDL cholesterol level. However, for triglyceride the pattern was not the same, and the group of moderate-dose curcumin shoed the minimal effect of increase, followed by the low-dose curcumin and finally the high-dose curcumin that showed the highest effect of increase. Conclusion: the administration of low-dose curcumin showed a trend of reduction in total cholesterol level and LDL cholesterol level in ACS patients.

The traditional plant, Andrographis paniculata (Sambiloto), exhibits insulin-releasing actions in vitro.

AIM: to examine the effect of A.paniculata on pancreatic b-cells. METHODS: sixty minutes incubation of BRIN-BD11 in Modified Kreb-Ringer Solution containing 16.7 mM glucose (KRB-3) + 0.625 - 2.5 mg/mL A.paniculata evoked 1.7 - 3.73 fold of insulin secretion compared to 16.7 mM glucose only (p = 0.003 - p < 0.001). RESULTS: compared to the effect of 100 mM glibenclamide, 60 minutes incubation of BRIN-BD11 in KRB-3 containing 1.25 and 2.5 mg/mL A. paniculata evoked 1.5 fold (p=0.034) and 2.3 fold (p=0.001) insulin secretion. Twenty minutes incubation of BRIN-BD11 in KRB-3 + 0.625-5 mg/mL A.paniculata, evoked 1.4 - 4.7 fold (p = 0.002 - p < 0.001) of insulin secretion compared to 16.7 mM glucose only. Twenty minutes incubation of BRIN-BD11 in KRB-1 containing 1.11 mM glucose + 0.625 - 10 mg/mL A.paniculata, evoked 1.3 - 3.7 fold (p = 0.019 - p < 0.001) of insulin secretion compared to 16.7 mM glucose only. CONCLUSION: this study conclude that A.paniculata was a very strong, dose dependent insulinotropic agent, glucose dependent and independent insulin secreting agent. This study also conclude that A.paniculata affected one of the membrane receptors, mostly ATP-dependent potassium channels (K+ATP).

The cut-off point of interleukin-6 level in acute coronary syndrome.

AIM: this study aimed to observe whether the interleukin-6 level in acute coronary syndrome (ACS) patients were higher than those in coronary heart disease (CHD) patients. In addition, we would like to observe the cut off point of interleukin-6 level in ACS. METHODS: this cross sectional study were conducted at Dr. Cipto Mangunkusumo General Hospital (RSUPN-CM), Persahabatan Hospital, MMC Hospital and Medistra Hospital, Jakarta. The study started from 1 May 2005 to 5 May 2006. RESULTS: in this observational study, as many as 62 CHD patients were collected and 84 ACS that met the study criteria. Demographic analysis showed that there was no difference in ages among the two groups (ACS and CHD). The risk factors of dyslipidemia, hypertension and lipid profile in the two groups did not differ significantly. Waist circumference and IMT, systolic and diastolic blood pressures in the two groups did not also differ significantly. Smoking was more prevalent in the groups of ACS than in the groups of CHD. In this study the IL-6 level in ACS (mean 40.85 pg/mL, SD 41.71, CI 95% 25.63-42.08 was higher than that in CHD (mean 4.58 pg/mL, SD 9.61, CI 95% 2.14-7.02). To identify the IL-6 level as the predictor for the occurrence of ACS, sensitivity and specificity were calculated at various cut-off points of IL-6 level. At cut-off point of IL-6 4.43 pg/mL the highest sensitivity (89.95%) and highest specificity (77.42%) were found with ROC of 0.87. CONCLUSION: it could be concluded that the IL-6 level in ACS were higher that those in CHD. The IL-6 level 4,43 pg/mL could differentiate the acute condition (ACS) and stable condition (non-ACS) with sensitivity of 89.95% and specificity of 77.42%, and ROC of 0.87.