Increased coronary arterial release of interleukin-1 receptor antagonist and soluble CD40 ligand indicative of inflammation associated with culprit coronary plaques.

Blood taken from the coronary artery ostium reflects biochemical changes indicative of thrombosis in the culprit vessel. We sought to determine whether inflammation is manifested by increased concentrations of selected markers in ostial blood sampled from a culprit coronary artery proximal to an atherosclerotic plaque. The concentrations of C-reactive protein (CRP), interleukin (IL)-6, IL-1 receptor antagonist, and soluble CD40 ligand (sCD40L) were measured in blood drawn from 75 patients before percutaneous coronary intervention from the femoral artery and from a guide catheter after engagement of the culprit coronary artery. Results were compared using Student's t tests. An acute coronary syndrome was present in 88% of patients. The concentrations of CRP and IL-6 were similar in coronary ostial and peripheral blood. Concentrations of IL-1 receptor antagonist were consistently greater in coronary arterial compared with peripheral arterial blood (peripheral 545 +/- 378 vs coronary 595 +/- 388 pg/ml, p = 0.003). Concentrations of sCD40L were also greater in the coronary compared with peripheral blood (peripheral 0.80 +/- 0.46 vs coronary 2.12 +/- 2.77 ng/ml, p <0.0001). The increased concentration of IL-1 receptor antagonist and sCD40L in blood drawn from the culprit coronary artery compared with that taken from the peripheral artery suggests that these cytokines contribute directly to inflammation in response to coronary intervention and may potentiate a systemic inflammatory state.