Original Article

Association of Severity of Coronary Lesion with Markers of Acute Infection and Inflammation in Patients with Acute Coronary Syndrome


  • Sedat Koçak
  • Atıf Harmankaya
  • Esma Erdemir
  • Zerrin Defne Dündar
  • Recep Keşli
  • Hayrudin Alibasic

Received Date: 21.06.2016 Accepted Date: 06.12.2016 Eurasian J Emerg Med 2016;15(4):157-162


Inflammation and some infectious agents play a key role in acute coronary syndrome (ACS) caused by atherosclerosis. The purpose of this study was to assess the effects of inflammatory markers and the positivity of Chlamydia pneumoniae (CP), Helicobacter pylori (HP), and Cytomegalovirus (CMV) on the level of atherosclerosis in patients with ACS.

Materials and Methods:

Patients (57) that were referred to the emergency unit with classic angina symptoms or angina equivalent symptoms and were determined to have critical lesions in the coronary angiography (>70% stenosis, coronary artery disease (CAD) severity assessed by the Gensini score) were compared with 27 ACS patients who had no critical lesions in terms of procalcitonin (PCT), tumor necrosis factor-alpha (TNF-α), interleukin-2 receptor (IL- 2r), interleukin-6 (IL-6), and interleukin-10 (IL-10) levels and positivity of CP, HP, and CMV. Also, the two groups of ACS patients were compared in terms of cytokine levels measured at hours 0 and 48.


No significant association was found between the degree of the coronary lesion and the inflammatory and infectious agents. However, in patients with critical coronary lesions, as markers of inflammatory agents, the levels of IL-6 were significantly lower and levels of IL-10 were significantly higher (p<0.001 and p=0.030, respectively) at hour 48 than originally found at hour 0.


There is no association between the severity of coronary lesions and cytokine levels and positivity of infectious agents in ACS since the levels of proinflammatory cytokines in ACS are higher than those in atherosclerosis. The changes in cytokine levels at hour 48 were found to be significant.

Keywords: Coronary lesion, biomarkers, infection, inflammation, acute coronary syndrome