Plasma concentrations of interleukin-6, C-reactive protein, tumor necrosis factor-α and matrix metalloproteinase-9 in aortic dissection

Background: The role of inflammation in aortic dissection (AD) has not fully been investigated. We evaluated the potential relationships between interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-alpha), and matrix metalloproteinase-9 (MMP-9) and AD. Methods: Plasma concentrations of IL-6. TNF-alpha. MMP-9 and CRP were determined in 64 acute AD patients. 42 patients with chronic AD, 98 patients with hypertension alone, and 96 healthy subjects. Results: IL-6 concentrations were higher in acute AD than that in hypertension and healthy controls (10.98 +/- 2.38 vs. 3.79 +/- 1.56 and 3.32 +/- 1.60 pg/ml, P<0.05, respectively). Increased CRP concentrations were found in acute AD compared with chronic AD and hypertension as well as healthy subjects (13.48 +/- 3.74 vs. 4.12 -/+ 2.99, 1.62 +/- 0.65 and 1.12 +/- 0.35 mg/l, P<0.001, respectively). Higher MMP-9 concentrations were detected in acute AD. chronic AD and hypertension compared with healthy controls (37.75 +/- 9.38, 55.78 +/- 6.41 and 31.03 +/- 7.94 vs. 21.24 +/- 7.28 ng/ml, P<0.05. P<0.001 and P<0.05, respectively), and in the dead compared to the survived (107.29 +/- 9.38 vs. 86.80 +/- 7.93 ng/ml, P<0.001) among acute AD patients. In acute AD, the time after onset had positive correlation with TNF-alpha (r=0.497, P=0.000), and negative correlation with CRP (r=-0.424, P=0.000). Plasma CRP levels decreased significantly when the onset time increased (P=0.013). Moreover, in the patients with acute AD who underwent surgery and stenting, plasma MMP-9 concentrations increased immediately after surgical treatment and stenting, and reached the peak values at 24 h, then decreased at 1 week (P<0.001). Conclusions: Our findings confirmed and extended previous studies that increased plasma inflammatory markers were significantly associated with AD. (C) 2011 Elsevier B.V. All rights reserved.