Platelet-Leukocyte Aggregate and Interleukin-6: An Emerging Perspective on a New Diagnostic and Therapeutic Clue for Acute Coronary Syndrome, A Case-Control Study

Mohammad Ghorbani; Davood Bashash; Mohamad Esmail Gheydari; Mohammad Hossein Mohammadi; Hojat Shahraki; Somayeh Yazdanparast; Keyvan Olazadeh; Nazli Atashzar; Mohsen Hamidpour

doi:10.1002/hsr2.70209

Platelet-Leukocyte Aggregate and Interleukin-6: An Emerging Perspective on a New Diagnostic and Therapeutic Clue for Acute Coronary Syndrome, A Case-Control Study

Health Sci Rep. 2024 Dec 11;7(12):e70209. doi: 10.1002/hsr2.70209. eCollection 2024 Dec.

Authors

Affiliations

¹ Department of Hematology and Blood Banking School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences Tehran Iran.
² Laboratory Hematology and Transfusion Medicine, Department of Medical Laboratory Sciences Faculty of Allied Medicine, Gonabad University of Medical Sciences Gonabad Iran.
³ Department of Cardiology Taleqani Hospital, Shahid Beheshti University of Medical Sciences Tehran Iran.
⁴ HSC Research Center - Department of Hematology and Blood Banking School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences Tehran Iran.
⁵ Department of Heamatology, Faculty of Medical Sciences Tarbiat Modares University Teharn Iran.
⁶ Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences Shahid Beheshti University of Medical Sciences Tehran Iran.
⁷ Department of Biostatistics School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences Tehran Iran.

Abstract

Background and aims: Acute coronary syndrome (ACS) is one of the most important cardiovascular diseases. The rupture of atherosclerotic plaques in coronary arteries is considered the underlying pathophysiology of ACS. The interaction between cytokines and leukocytes in the presence of platelets results in platelet-leukocyte aggregate (PLA). Monocytes, neutrophils, and cytokines are prime factors that promote PLA formation, which leads to atherosclerotic plaque progression and subsequent ACS development. This study aimed to investigate PLA (PMA and PNA) formation and cytokine (IL-6 and TNF-α) levels as well as the correlation between them in ACS patient samples to identify diagnostic markers.

Methods: A total of 30 patients with ACS and 24 healthy controls participated in this study. Flow cytometry analysis was performed to evaluate PLA formation, and the serum levels of cytokines were assessed by ELISA. The Pearson's correlation coefficient and ROC curve were calculated to investigate the correlation between the parameters and their diagnostic value, respectively.

Results: The results showed that PMA, PNA, and IL-6 levels were significantly higher in ACS patients than in healthy controls. Additionally, TNF-α levels were not significantly increased in the patient group. In addition, the Pearson's correlation coefficient results revealed a direct linear and statistically significant relationship between PMA-IL-6 and PNA-IL-6 as well as a direct linear but statistically nonsignificant relationship between IL-6-TNF-α and PMA-PNA, whereas a convers linear but nonsignificant correlation was shown between PMA and TNF-α and no correlation was detected between PNA and TNF-α. Finally, ROC curve analysis revealed that the PMA, PNA, and IL-6 can have diagnostic value.

Conclusion: In conclusion, the PMA, PNA, and IL-6 can be used as powerful diagnostic markers in ACS patients. Therefore, disrupting PMA and PNA formation and inhibiting cytokine production may be new strategies for the treatment of ACS. However, further investigations are required to explore these parameters in the clinical diagnosis of ACS.

Keywords: acute coronary syndrome; atherosclerosis; cytokine; platelet‐monocyte aggregate; platelet‐neutrophil aggregate.