Circulating cytokines in relation to the extent and composition of coronary atherosclerosis: results from the ATHEROREMO-IVUS study

Atherosclerosis. 2014 Sep;236(1):18-24. doi: 10.1016/j.atherosclerosis.2014.06.010. Epub 2014 Jun 26.


Objective: We investigated whether concentrations of TNF-α, TNF-β, TNF-receptor 2, interferon-γ, IL-6, IL-8, IL-10 and IL-18 are associated with extent and composition of coronary atherosclerosis determined by grayscale and virtual histology (VH)- intravascular ultrasound (IVUS).

Methods: Between 2008 and 2011, IVUS(-VH) imaging of a non-culprit coronary artery was performed in 581 patients (stable angina pectoris (SAP), n = 261; acute coronary syndrome (ACS), n = 309) undergoing coronary angiography from the ATHEROREMO-IVUS study. Plaque burden, presence of VH-IVUS-derived thin-cap fibroatheroma (TCFA) lesions, and presence of VH-TCFA lesions with plaque burden ≥70% were assessed. Blood samples for cytokine measurement were drawn from the arterial sheath prior to the angiography procedure. We applied linear and logistic regression.

Results: TNF-α levels were positively associated with plaque burden (beta (β) [95%CI]: 4.45 [0.99-7.91], for highest vs lowest TNF-α tertile) and presence of VH-TCFA lesions (odds ratio (OR) [95%CI] 2.30 (1.17-4.52), highest vs lowest TNF-α tertile) in SAP patients. Overall, an inverse association was found between IL-10 concentration and plaque burden (β [95%CI]: -1.52 [-2.49 to -0.55], per Ln (pg/mL) IL-10) as well as IL-10 and VH-TCFA lesions with plaque burden ≥70% (OR: 0.31 [0.12-0.80],highest vs lowest IL-10 tertile). These effects did not reach statistical significance in the separate SAP and ACS groups.

Conclusion: Higher circulating TNF-α was associated with higher plaque burden and VH-TCFA lesions in SAP patients. Lower circulating IL-10 was associated with higher plaque burden and large VH-TCFA lesions. These in-vivo findings suggest a role for these cytokines in extent and vulnerability of atherosclerosis.

Keywords: Atherosclerosis; Biomarker; Cytokine; Intravascular ultrasound.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Acute Coronary Syndrome / blood
  • Acute Coronary Syndrome / diagnostic imaging
  • Acute Coronary Syndrome / pathology
  • Aged
  • Angina Pectoris / blood
  • Angina Pectoris / diagnostic imaging
  • Angina Pectoris / pathology
  • Biomarkers
  • Comorbidity
  • Coronary Angiography
  • Coronary Artery Disease / blood*
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / pathology
  • Cytokines / blood*
  • Disease Susceptibility
  • Female
  • Humans
  • Inflammation / blood
  • Male
  • Middle Aged
  • Netherlands
  • Plaque, Atherosclerotic / blood
  • Plaque, Atherosclerotic / diagnostic imaging
  • Plaque, Atherosclerotic / pathology
  • Risk Factors
  • Ultrasonography, Interventional


  • Biomarkers
  • Cytokines