title: Is the beneficial effect of preinfarction angina related to an immune response?
abstract: Immune-mediated mechanisms are thought to play a key role in the development of coronary artery disease and its thrombotic complications. Preinfarction angina has been suggested to improve left ventricular function and short-term outcomes. The purpose of the present study was to investigate the relation between the immune response and in-hospital clinical course in preinfarction angina. We prospectively evaluated 93 patients. Forty-three patients exhibited preinfarction angina within 24 hours before the onset of acute myocardial infarction (AMI) (preinfarction angina group) and 50 patients were free from preinfarction angina (sudden onset group). The incidence of complications (heart failure, recurrent angina, arrhythmia and coronary interventions) and in-hospital mortality were assessed in the two study groups. We detected some immune markers, including white blood cells, C-reactive protein, immunoglobulins, and complement. White blood cells and CRP were significantly lower in the preinfarction angina group than in the sudden onset group (P < 0.001, P < 0.005, respectively). Conversely, IgE and C(4) were significantly higher in the preinfarction angina group than in the sudden onset group (P < 0.001, P < 0.001, respectively). The incidences of heart failure and severe arrhythmias were lower in the preinfarction group than in the sudden onset group (P < 0.005, P < 0.05 respectively). The beneficial effect of preinfarction angina may be associated with an immune-inflammatory response modified by a brief ischemic episode.
authors.affiliation: Cardiology Department, Faculty of Medicine, Selcuk University, Konya, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Tokac
authors.forename: Ayse
authors.initials: A
authors.lastname: Ozdemir
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yazici
authors.forename: Bülent B
authors.initials: BB
authors.lastname: Altunkeser
authors.forename: Akif
authors.initials: A
authors.lastname: Düzenli
authors.forename: Ismail
authors.initials: I
authors.lastname: Reisli
authors.forename: Kurtulus
authors.initials: K
authors.lastname: Ozdemir
mesh_terms: D000328:Adult; D000789:Angina, Unstable / Q000276:immunology* / Q000503:physiopathology; D002097:C-Reactive Protein / Q000032:analysis; D003181:Complement C4 / Q000032:analysis; D017023:Coronary Angiography; D004452:Echocardiography; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D007136:Immunoglobulins / Q000097:blood; D019157:Ischemic Preconditioning, Myocardial; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D011446:Prospective Studies; D016277:Ventricular Function, Left
chemical_list: D003181:Complement C4; D007136:Immunoglobulins; D007073:Immunoglobulin E; D002097:C-Reactive Protein