Tumor Necrosis Factor-Alpha in Very Elderly Patients with Coronary Artery Disease

Background/Purpose: Limited data are available on tumor necrosis factor-alpha (TNF-alpha) in elderly patients with coronary artery disease (CAD), therefore, we evaluated TNF-alpha levels and their relationships with various disorders. Methods: 130 patients were enrolled in the cross-sectional study: 102 with CAD in the study group, 28 without CAD in the control. Patient's age varied from 77 to 101 years; 56.2% of patients were over 90 years old. Serum TNF-alpha levels (N <8.1 pg/ml) were determined by enzyme-linked immunosorbent assay. Results: Mean TNF-alpha concentration was 9.2 +/- 4.7 (3.9-31.9) pg/ml. Increased TNF-alpha levels were found in 54.6% of patients. In patients with CAD mean TNF-alpha concentration reached 10.0 +/- 4.9 pg/ml, in control group was 6.1 +/- 1.8 pg/ml (p <0.001). TNF-alpha levels were higher in patients with heart failure (p=0.002). Among patients younger than 90 years, much more significant relationships between TNF-alpha levels and echocardiographic parameters were observed in comparison with patients older than 90 years. In patients with hyperuricemia mean TNF-alpha concentration was 10.9 +/- 5.3 pg/ml, in patients with normal uric acid was 7.5 +/- 2.5 pg/ml (p <0.001). In patients with CAD positive correlations were found between TNF-alpha and uric acid (r=0.45; p <0.001), creatinine (r=0.24; p=0.01), urea (r=0.38; p <0.001), negative correlations were registered between TNF-alpha and high density lipoprotein (HDL)-cholesterol levels (r=-0.42; p <0.001), but there were no significant relationships in the control group. In patients younger than 90 years old mean TNF-alpha values reached 10.5 pg/ml, in patients older than 90 years was 8.1 pg/ml (p=0.003). Conclusion: The study results demonstrated frequent TNF-alpha increase in very elderly patients with CAD. Increased TNF-alpha levels are associated with various pathology. Copyright (C) 2021, Asian Association for Frailty and Sarcopenia and Taiwan Association for Integrated Care. Published by Full Universe Integrated Marketing Limited.