ABC | Volume 114, Nº4, April 2020

Original Article Role of Interleukin-18 and the Thrombus Precursor Protein in Coronary Artery Disease Carlos Scherr, 1,2, 5 Denilson Campos de Albuquerque, 2 R oberto Pozzan, 3 Kezia Ataide, 4 Talita Ludmila, 5 Fernanda Blanco, 5 Claudio Martins Mangia 5 Ministério da Saúde – Cardiologia, 1 Brasília, DF - Brazil Universidade do Estado do Rio de Janeiro – Cardiologia, 2 Rio de Janeiro, RJ - Brazil Universidade do Estado do Rio de Janeiro – Cardiologia/Hipertensão, 3 Rio de Janeiro, RJ - Brazil Hospital Universitário Pedro Ernesto – Cardiologia, 4 Rio de Janeiro, RJ - Brazil Fundação Pró Coração – Cardiologia, 5 Rio de Janeiro, RJ – Brazil Mailing Address: Carlos Scherr • Ministério da Saúde – Cardiologia - Rua Visconde de Pirajá, 595 / 1204. Postal Code 22410-003, Ipanema, RJ – Brazil E-mail: carlos.scherr@all.com.br Manuscript received March 14, 2019, revised mansucript June 11, 2019, accepted June 23, 2019 DOI: https://doi.org/10.36660/abc.20190176 Abstract Background: Coronary failure is the leading cause of death worldwide and identifying patients at higher risk for coronary artery disease (CAD) is a challenge. Objectives: To test the biomarkers interleukin 18 (IL-18) and thrombus precursor protein (TpP), involved in atherogenesis, to aid in the early assessment of CAD. Methods : This was a cross-sectional cohort of 119 patients, stratified into three groups: Group I - acute coronary syndrome (39); Group II - chronic CAD (40) and Group III - control, without coronary lesion, but who might have risk factors for CAD (40). Statistical analysis was performed using the statistical program SPSS (Statistical Package for the Social Sciences) for Windows ,version 17.0 of 2008. The significance level was set at 0.05 or 5% (p <0.05), with a 95% confidence interval. Chi- square test ( χ 2), Analysis of variance (ANOVA), and Tukey’s test were used. Results: The mean age was 60.36 ± 9.64 years; there was a prevalence of females in Group III (65.0% p = 0.002), but without statistical significance for the means of IL-18 and TpP. The means of IL-18 and TpP were increased in Group I when compared to the other groups; IL-18 = 1325.44 ± 1860.13 ng/dL, p = 0.002; TpP = 35.86 ± 28.36 µg / mL, p <0.001). When compared two-by-two, it was observed that Group I had higher mean IL-18 and TpP values than Group II (IL-18 = 353.81 ± 273.65 ng / dL; TpP = 25.66 ± 12, 17 µg / mL) and Group III (IL-18 = 633.25 ± 993.93 ng / dL; TpP = 18.00 ± 8.45 µg / mL). Conclusion: There was an increase in these biomarkers in acute CAD, suggesting a relationship with the atherosclerotic plaque instability process, but not with the chronic phase. (Arq Bras Cardiol. 2020; 114(4):692-698) Keywords: Cardiovascular Diseases/mortality; Coronary Artery Diseases; Interleukin 18; Biomarkers; Acute Coronary Syndrome/prevention and control of the most challenging tasks for doctors and researchers worldwide. Several biomarkers have been studied in recent years in the diagnosis, prognosis, prediction of adverse events and therapeutic monitoring. 2 However, the first initiative towards prevention is to apply strategies to identify the individual likely to have atherosclerotic events. In this sense, in addition to the widely known risk factors contributing to the process of identifying vulnerable individuals, the use of biomarkers involved in atherogenesis can be a key factor in the risk assessment of coronary artery disease (CAD).³ ,4 Atherosclerosis is a chronic, multifactorial, slow and progressive inflammatory disease, resulting from several specific cell and molecular responses that lead to endothelial aggression, affecting mainly the intima layer of medium and large-caliber arteries. Generally, the rupture of the fibrous capsule of the atherosclerotic plaque leads to thrombosis, which to a lesser extent can result from superficial endothelial erosion. Ruptured plaques are usually associated with inflammation Introduction Coronary artery disease is one of the main manifestations of cardiovascular disease in the 21 st century, and its importance lies in its high morbidity and mortality. The identification of patients at higher risk becomes necessary to contribute to the improvement of this condition and rationalize costs.¹ Modern medicine has developed rapidly in the field of prevention, early detection and screening of diseases, not being restricted to treatment. Therefore, early detection associated with the immediate treatment of cardiovascular disease (CVD) has become one 692