Enhanced inflammatory response to coronary angioplasty in patients with severe unstable angina.

Abstract:

BACKGROUND:Systemic markers of inflammation have been found in unstable angina. Disruption of culprit coronary stenoses may cause a greater inflammatory response in patients with unstable than those with stable angina. We assessed the time course of C-reactive protein (CRP), serum amyloid A protein (SAA), and interleukin-6 (IL-6) after single-vessel PTCA in 30 patients with stable and 56 patients with unstable angina (protocol A). We also studied 12 patients with stable and 15 with unstable angina after diagnostic coronary angiography (protocol B). METHODS AND RESULTS:Peripheral blood samples were taken before and 6, 24, 48, and 72 hours after PTCA or angiography. In protocol A, baseline CRP, SAA, and IL-6 levels were normal in 87% of stable and 29% of unstable patients. After PTCA, CRP, SAA, and IL-6 did not change in stable patients and unstable patients with normal baseline levels but increased in unstable patients with raised baseline levels (all P<0.001). In protocol B, CRP, SAA, and IL-6 did not change in stable angina patients after angiography but increased in unstable angina patients (all P<0.05). Baseline CRP and SAA levels correlated with their peak values after PTCA and angiography (all P<0.001). CONCLUSIONS:Our data suggest that plaque rupture per se is not the main cause of the acute-phase protein increase in unstable angina and that increased baseline levels of acute-phase proteins are a marker of the hyperresponsiveness of the inflammatory system even to small stimuli. Thus, an enhanced inflammatory response to nonspecific stimuli may be involved in the pathogenesis of unstable angina.

journal_name

Circulation

journal_title

Circulation

authors

Liuzzo G,Buffon A,Biasucci LM,Gallimore JR,Caligiuri G,Vitelli A,Altamura S,Ciliberto G,Rebuzzi AG,Crea F,Pepys MB,Maseri A

doi

10.1161/01.cir.98.22.2370

subject

Has Abstract

pub_date

1998-12-01 00:00:00

pages

2370-6

issue

22

eissn

0009-7322

issn

1524-4539

journal_volume

98

pub_type

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