Objectives: Premature Coronary Artery Disease (PCAD) has taken the form of an epidemic in Pakistan and its incidence in young individuals is on the rise. The objective was to evaluate role of Interleukin-6 (-174 G/C) gene promoter polymorphism and the serum level of (IL-6) in the identification of PCAD.
Methodology: The case-control study carried out at Army Medical College, Rawalpindi, Pakistan, from July, 2014 to Jan, 2015 in collaboration with University College London, UK. 150 patients <45 yrs of age with > 70% stenosis, in at least one coronary vessel on angiography, were labeled as cases. While 150 subjects who were angio-negative for disease were taken as controls. Genotyping was performed using Taqman Assay while serum IL-6 was measured using Enzyme Linked Immuno-sorbent Assay (ELISA).
Results: Total 300 subjects participated in the study. Mean ± SD age of PCAD patients was 40 ± 3.80 while in controls it was 38 ± 7.8 yrs. Serum IL-6 levels were significantly high in PCAD patients (p<0.01). In IL-6 -174 (G/C) polymorphism homozygous CC was significantly associated with occurrence of PCAD. Serum IL-6 levels were significantly higher in CC genotype subjects when compared to GC and GG (p<0.05). The serum IL-6 levels significantly correlated with the atherosclerotic burden (p<0.05). Sensitivity-specificity of IL-6 at cut off value of 3.7 ng/dl was 77% and 81% respectively.
Conclusion: IL-6 has significant diagnostic potential for PCAD with moderately high sensitivity and specificity. IL-6 (-174 G/C) polymorphism CC genotype can aid in the risk prediction of PCAD.
Keywords: Gene promoter polymorphism; Interleukin-6; Premature Coronary Artery Disease; Risk prediction;
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