PMID- 27921405 OWN - NLM STAT- MEDLINE DCOM- 20170614 LR - 20170614 IS - 1735-1502 (Print) IS - 1735-1502 (Linking) VI - 15 IP - 4 DP - 2016 Aug TI - Thrombolytic Therapy Up-regulates Inflammatory Mediators Compared to Percutaneous Coronary Intervention (PCI). PG - 257-263 AB - The important role of reperfusion therapies in the treatment of acute myocardial infarction is well documented. However, reperfusion therapies can initiate inflammatory response and may damage the myocardium. The purpose of current study was to compare the effects of percutaneous coronary intervention and thrombolytic therapy on inflammatory markers in the setting of ST elevation myocardial infarction (STEMI). Eighty three patients with STEMI were enrolled in this study. 40 patients underwent percutaneous coronary intervention (PCI), and 43 patients received streptokinase (1.5 million IU) as a main medical reperfusion therapy. Monocyte expression of Toll-like receptor 4 (TLR4), serum levels of TNF-alpha and IL-1beta, red cell distribution width (RDW) and C- reactive protein (CRP) were compared between groups at admission time, two hours and four hours after termination of treatment. p<0.05 was considered as statistically significant for all tests. Compared to baseline, both treatments increased monocyte expression of TLR4, serum levels of cytokines and CRP. Compared to PCI, medical reperfusion therapy significantly raised both monocyte expression of TLR4 (39.8+/-4.7 % vs 49.1+/-3.6 %, p<0.01), and serum levels of TNF-alpha (13.2+/-3.7 pg/ml vs 25.1+/-2.6pg/mlp<0.05). No effect was seen on RDW levels. Moreover, medical reperfusion therapy caused significant rise in CRP levels (p<0.01). The present study demonstrates that thrombolytic therapy is associated with higher inflammatory responses compared to PCI. Our findings suggest that thrombolytic therapy may increase the likelihood of detrimental effects of reperfusion therapy on the myocardium. FAU - Garjani, Alireza AU - Garjani A AD - Department of Pharmacology, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran. FAU - Sohrabi, Bahram AU - Sohrabi B AD - Shahid Madani Heart Hospital, Tabriz University of Medical Sciences, Tabriz, Iran. FAU - Movassaghpour, Ali Akbar AU - Movassaghpour AA AD - Hematology Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran. FAU - Andalib, Sina AU - Andalib S AD - Department of Pharmacology, Faculty of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran. FAU - Shokri, Mehriar AU - Shokri M AD - Shahid Madani Heart Hospital, Tabriz University of Medical Sciences, Tabriz, Iran. FAU - Taherkhanchi, Bahar AU - Taherkhanchi B AD - Department of Pediatrics, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran. FAU - Bagheri, Bahador AU - Bagheri B AD - Cancer Research Center and Department of Pharmacology, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran. LA - eng PT - Clinical Trial PT - Journal Article PL - Iran TA - Iran J Allergy Asthma Immunol JT - Iranian journal of allergy, asthma, and immunology JID - 101146178 RN - 0 (Inflammation Mediators) RN - EC 3.4.- (Streptokinase) SB - IM MH - Aged MH - Female MH - Humans MH - Inflammation Mediators/*blood/immunology MH - Male MH - Middle Aged MH - *Percutaneous Coronary Intervention MH - ST Elevation Myocardial Infarction/*blood/immunology/*therapy MH - Streptokinase/*administration & dosage MH - *Thrombolytic Therapy MH - *Up-Regulation OTO - NOTNLM OT - Inflammation OT - Percutaneous coronary interventions OT - Reperfusion therapy OT - ST elevation myocardial infarction OT - Toll-like receptor 4 EDAT- 2016/12/07 06:00 MHDA- 2017/06/15 06:00 CRDT- 2016/12/07 06:00 PHST- 2016/08/30 00:00 [accepted] PHST- 2016/12/07 06:00 [entrez] PHST- 2016/12/07 06:00 [pubmed] PHST- 2017/06/15 06:00 [medline] PST - ppublish SO - Iran J Allergy Asthma Immunol. 2016 Aug;15(4):257-263.