[Polymorphonuclear neutrophils in myocardial ischemia and reperfusion injury. Influence of coronary intervention?].
Circulating polymorphonuclear neutrophils (PMNs) are known to contribute to the pathophysiology of myocardial ischemia and reperfusion injury. The present study was designed to examine whether the duration of ischemia in myocardial infarction, the type of coronary intervention (angioplasty vs. angioplasty plus stenting) and duration of the procedure itself modulate the inflammatory responses of PMNs.


RESULTS
In patients with acute myocardial infarction (AMI; n = 20) neutrophil beta-2-integrin Mac-1 (CD11b/CD18) and L-selectin (CD62L) were determined at different time points before and after PTCA or PTCA plus stenting. After PTCA alone but not after PTCA plus stenting a significant rise in Mac-1 (136 +/- 43%) was demonstrated. This elevation decreased after 60 minutes if the duration of the recanalization procedure was shorter than 30 minutes but remained elevated after longer interventions. After delayed intervention a significant and more pronounced increase of Mac-1 (142 +/- 37%) was observed, while early intervention prevented this increase. After PTCA alone or delayed intervention a significant shedding of L-selectin (77 +/- 20%; 77 +/- 23%) was demonstrated. Early intervention or PTCA plus stenting caused no significant changes in L-selectin.


CONCLUSIONS
It is concluded that PMN activation is attenuated by early and short intervention as well as by stenting. Induction of PMN activation might contribute to the superior outcome following stenting and early intervention compared to conventional PTCA in particular when performed delayed.
Link
Andreas
A
Medizinische Klinik und Poliklinik, Innere Medizin III Universitätskliniken des Saarlandes, 66421 Homburg/Saar, Germany. andreas.link@telemed.de
Schwerdt
Holger
H
Hennen
Benno
B
Böhm
Michael
M
D000367:Age Factors; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D039481:CD11b Antigen / Q000378:metabolism; D018821:CD18 Antigens / Q000378:metabolism; D003627:Data Interpretation, Statistical; D005260:Female; D005453:Fluorescence; D006801:Humans; D039641:Integrin beta Chains / Q000378:metabolism; D019041:L-Selectin / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000276:immunology* / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D015428:Myocardial Reperfusion Injury / Q000276:immunology* / Q000378:metabolism / Q000503:physiopathology; D018375:Neutrophil Activation; D009504:Neutrophils / Q000502:physiology*; D015607:Stents; D013997:Time Factors
D039481:CD11b Antigen; D018821:CD18 Antigens; D039641:Integrin beta Chains; D019041:L-Selectin