title: Increased leukocyte activity as a predictor for flow-limiting coronary lesions in patients with angina pectoris.
abstract: Myocardial ischemia initiates an acute inflammatory response, in which polymorphonuclear leukocytes (PMNs) are major participants. We investigated whether increased PMN activity in the peripheral blood is a marker for high-grade coronary artery stenosis in patients with angina pectoris. PMN activity was examined in 45 patients by measuring the luminol-dependent chemiluminescence (CL) response of the peripheral blood upon addition of phorbol myristate acetate (PMA). The CL of patients with angiographic filling delay was 1.6-fold higher than in patients without delay (480+/-54 vs. 302+/-33 counts/PMN, P<0.01). The CL of patients with a filling delay of the left anterior descending artery (LAD) was 1.7-fold higher than in patients without an LAD filling delay (537+/-79 vs. 317+/-27 counts/PMN, P<0.01). With the CL cut-off at 400 counts/PMN, the sensitivity and specificity for detecting an angiographic filling delay of the LAD were 69 and 75%, respectively. These data indicate that PMN activity in the peripheral blood is increased with the presence of a flow-limiting coronary lesion showing an angiographic filling delay. Measuring PMN activity may be a useful approach to assess indications for and timing of angiography and/or adjunctive invasive therapies in patients with angina pectoris.
authors.affiliation: Department of Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi, Tokyo 173-8605, Japan. stake@blue.ocn.ne.jp
authors.forename: S
authors.initials: S
authors.lastname: Takeshita
authors.forename: H
authors.initials: H
authors.lastname: Hashimoto
authors.forename: Y
authors.initials: Y
authors.lastname: Ono
authors.forename: M
authors.initials: M
authors.lastname: Ochiai
authors.forename: N
authors.initials: N
authors.lastname: Yokoyama
authors.forename: M
authors.initials: M
authors.lastname: Terakura
authors.forename: T
authors.initials: T
authors.lastname: Sato
authors.forename: T
authors.initials: T
authors.lastname: Isshiki
mesh_terms: D000787:Angina Pectoris / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D017023:Coronary Angiography; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008163:Luminescent Measurements; D008165:Luminol / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D018375:Neutrophil Activation; D012680:Sensitivity and Specificity; D013755:Tetradecanoylphorbol Acetate / Q000494:pharmacology
chemical_list: D008165:Luminol; D013755:Tetradecanoylphorbol Acetate