P6375Correlation between cytokine profile and ultrasonic characteristics of atherosclerotic plaques in patients with essential hypertension

Objective To study the association of serum cytokine concentrations (tumor necrosis factor-alpha (TNF-a) and interleukin-10 (IL-10)) with ultrasonic characteristics of atherosclerotic plaque and signs of its instability. Materials and methods We examined 166 patients (mean age 56.3±6.1 years). We used the generally accepted classification of Gray-Weale AC et al.(1988) to describe the structural characteristics of atherosclerotic plaque (ASP) and to determine local hemodynamic defects. There were 3 groups of patients. The 1st group included 48 patients with homogeneous hyperechoic plaques, the 2nd group included 56 patients with predominantly hyperechoic ASP (more than 50% of sites), the 3rd group included 13 patients with anechoic, low ultrasound density of ASP or with predominantly hypoechoic average density ASP (more than 50% of sites with average density). The control group consisted of 39 patients with essential hypertension (EH) without atherosclerotic lesions of the carotid arteries. All patients were subjected to general clinical examinations (measuring height, weight, waist, systolic and diastolic blood pressure, calculating body mass index), laboratory tests (lipid profile, fasting glucose, creatinine with glomerular filtration rate (eGFR), fibrinogen, TNF-a and IL-10). Mass determination of TNF-a and IL-10 was carried out by the method of enzyme-linked immunosorbent assay and ultrasound doppler sonography of the carotid arteries, common carotid artery scanned in longitudinal section using a wideband linear sensor with a frequency of 3–11 MHz, the image was synchronized with the R wave on the ECG). Results Patients of the 1st (7,26±0,64 pg/ml) and 2nd groups (8,93±0,98 pg/ml) who do not have ultrasonic signs of ASP instability TNF-a was significantly lower than in patients of the 3rd group (10,51±2,23 pg/ml, p<0,001) with ultrasound signs of ASP instability. Similar results were obtained in terms of the level of IL-10. The level of IL-10 in patients of the 1st and 2nd groups, having reached 14,7±3,5 pg/ml and 14,4±2,7 pg/ml, was significantly lower in comparison with patients of the 3rd group (17,1±5,3 pg/ml, p<0,025 and p<0,017, respectively). The logistic regression analysis showed that the independent factors associated with the presence of ultrasonic signs of ASP instability in patients with EH are: age (HR-1,20; 95% CI 1,03–1,38; p<0,02), concentration of triglycerides (HR-4,05; 95% CI 1,90–8,64; p<0,001) and TNF-a (HR-2,72; 95% CI 1,44–5,15; p<0,02). The influence of other factors, including IL-10, on the instability of ASP was less significant (p>0,05). Further statistical analysis showed that in patients with level of TNF-a more than 10 pg/ml, the risk of detecting an unstable ASP increased almost in 7 times (HR 6,81; 95% CI 2,17–21,6). Conclusions Increasing the concentration of tumor necrosis factor-alpha above 10 pg/ml is an independent risk factor for unstable atherosclerotic plaques in patients with essential hypertension