Cytokines are known to play a critical role in the atherosclerotic process.¹ The cytokine interleukin-6 (IL-6) is involved in a variety of physiological functions ultimately leading to macrophage activation, platelet aggregation, and stimulation of matrix degrading enzymes. An increase in circulating concentrations of IL-6 and of its hepatic byproduct C reactive protein (CRP) has been reported in unstable angina² and after percutaneous coronary intervention (PCI); high concentrations of IL-6 and CRP are considered to be markers of poor prognosis, probably related to the intensity of plaque inflammation. The present study was designed specifically to evaluate whether transmyocardial production of IL-6 could be measured immediately and within two hours of a successful elective PCI and stent implantation in stable patients.

METHODS

The study involved 11 patients with stable angina, admitted for an elective PCI of the proximal segment of the left anterior descending coronary artery. All patients received standard medical treatment consisting of intravenous heparin (70 U/kg body weight), acetylsalicylic acid, and nitrates. No glycoprotein IIb/IIIa inhibitors were given. A six French Cournand catheter was introduced through the right femoral vein in the coronary sinus and the left coronary ostium was catheterised through the right femoral artery. Coronary sinus and arterial blood samples were taken simultaneously …