title: Inflammation, endothelial cell activation, and coronary microvascular dysfunction in women with chest pain and no obstructive coronary artery disease.
abstract: BACKGROUND
  Coronary artery microvascular dysfunction is prevalent in women with chest pain in the absence of obstructive coronary artery disease (CAD) and is manifested by attenuated coronary flow reserve (CFR). Markers of inflammation and endothelial cell activation have been found to be elevated in patients with chest pain but without CAD. The relationship between inflammation, endothelial activation, and CFR is not known.
  
  
  METHODS
  Ninety-four women with chest pain in the absence of obstructive angiographic CAD underwent catheterization-based assessment of CFR and measurement of levels of inflammatory markers (n = 78) and endothelial cell activation in the NHLBI WISE study.
  
  
  RESULTS
  Coronary flow reserve did not correlate with levels of C-reactive protein (high-sensitivity C-reactive protein) (rs = -0.07, P = .53), interleukin (IL)-6 (rs = -0.12, P = .31), IL-18 (rs = 0.14, P = .23), tumor necrosis factor alpha (rs = -0.09, P = .43), transforming growth factor beta1 (rs = 0.02, P = .84), and soluble intracellular adhesion molecule-1 (rs = 0.04, P = .68). Median levels of markers of inflammation and endothelial cell activation did not differ between the 57 women with abnormal CFR (< 2.5) and the 37 women with normal coronary microvascular function (high-sensitivity C-reactive protein 0.32 vs 0.25 mg/dL, P = .80; IL-6 2.89 vs 2.39 pg/mL, P = .63; IL-18 218 vs 227 pg/mL, P = .59; tumor necrosis factor alpha 2.7 vs 2.4 pg/mL, P = .43; transforming growth factor beta1 9928 vs 12436 pg/mL, P = .76; soluble intracellular adhesion molecule-1 286 vs 287 pg/mL, P = .95). Multivariable models demonstrated no evidence of associations between markers of inflammation and of endothelial cell activation and CFR.
  
  
  CONCLUSIONS
  Coronary microvascular dysfunction is not associated with markers of inflammation and endothelial cell activation in women with chest pain in the absence of obstructive CAD. These results suggest that inflammation and endothelial cell activation may not play a pathophysiological role in coronary microvascular dysfunction.
authors.affiliation: Cardiovascular Institute, Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA. marroquinoc@upmc.edu
authors.forename: Oscar C
authors.initials: OC
authors.lastname: Marroquin
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Kip
authors.forename: Suresh R
authors.initials: SR
authors.lastname: Mulukutla
authors.forename: Paul M
authors.initials: PM
authors.lastname: Ridker
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Pepine
authors.forename: Tjendimin
authors.initials: T
authors.lastname: Tjandrawan
authors.forename: Sheryl F
authors.initials: SF
authors.lastname: Kelsey
authors.forename: Sunil
authors.initials: S
authors.lastname: Mankad
authors.forename: William J
authors.initials: WJ
authors.lastname: Rogers
authors.forename: C Noel Bairey
authors.initials: CN
authors.lastname: Merz
authors.forename: George
authors.initials: G
authors.lastname: Sopko
authors.forename: Barry L
authors.initials: BL
authors.lastname: Sharaf
authors.forename: Steven E
authors.initials: SE
authors.lastname: Reis
mesh_terms: D015415:Biomarkers / Q000097:blood; D002637:Chest Pain / Q000097:blood / Q000276:immunology* / Q000503:physiopathology*; D003327:Coronary Disease / Q000097:blood / Q000276:immunology* / Q000503:physiopathology*; D042783:Endothelial Cells / Q000276:immunology*; D005260:Female; D006801:Humans; D007249:Inflammation; D008833:Microcirculation; D008875:Middle Aged
chemical_list: D015415:Biomarkers