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.

Prevention of cardiovascular disease in diabetes mellitus: by stressing the CARDS study.

Recently, diabetes mellitus has become a global epidemic disease. There is a study indicating that type 2 diabetes mellitus (DM) is frequently found in children and teenager. Furthermore, in some countries, it is more frequent than type 1 diabetes mellitus.1 WHO stated that in the year of 2000, there were 177 million diabetes mellitus patient in the world and it is predicted that in the year of 2030, it will be increased to 366 million.2 This is very problematical for some countries such as India, People's Republic of China and Indonesia where the prevention and treatment facilities are still inadequate. To date, Indonesia has occupied the 4th rank, with predicted number of diabetes mellitus patient about 8.4 million and this number will be increased to 21.3 million in the year of 2030. There is no data about the number of patient with metabolic syndrome (MS) and insulin resistance syndrome (IR), but it should be higher than the number of diabetic patient. As we all have known, these conditions are the high-risk condition of diabetes mellitus development.2 One of reasons concerning why prevalence and pre-diabetic condition are increased (including the increased MS) is rising obesity frequency. In the United States, over 60% of recent adult population are overweight, which is defined as "body mass index" (BMI) 25; and about 30% of them have obesity, which is defined as BMI 30%.3 If diabetes mellitus occurred, cardiovascular disease (CVD) including coronary heart disease (CHD) also may occur. It is important to prevent the diabetes mellitus as well as to prevent the complication risk of CVD in diabetic patient.