Acute neutrophil activation in direct stenting: comparison of stable and unstable angina patients.
BACKGROUND
Polymorphonuclear neutrophils have been implicated in the pathophysiology of atherosclerosis. A substantial body of evidence has emerged to implicate the role of specific leucocyte derived enzyme myeloperoxidase in atherogenesis, since its initiation through progression until destabilization. The aim of the study was to determine the presence of polymorphonuclear neutrophils activation after coronary stenting, to compare this activation between stable and unstable setting and to evaluate the kinetic relation of this activation with inflammatory response following atherosclerotic plaque rupture.


METHODS
Myeloperoxidase, lactoferrin, elastase, C-reactive protein and cytokine plasma levels were assessed in 15 patients undergoing direct coronary stenting for unstable angina (Group A) and compared to 11 patients undergoing this procedure for stable angina (Group B). Serial sampling starting before arteriography and continued for 24 h was carried out in all patients.


RESULTS
A significant elevation in myeloperoxidase and lactoferrin levels was observed after stenting in both group A (p<0.0001) and group B (p<0.0001), but was higher in group A. Interleukin-8, interleukin-12 and interleukin-6 levels increased temporarily after stenting in the 2 groups. Baseline values of C-reactive protein were similar in the 2 groups and a progressive increase was observed after the intervention.


CONCLUSIONS
Direct coronary artery stenting is associated with an early polymorphonuclear neutrophils activation followed by release of inflammatory cytokines (interleukin-6, interleukin-8, interleukin-12) and C-reactive protein elevation in both stable and unstable patients. We conclude that stenting by itself is associated with myeloperoxidase liberation with a significantly enhanced response in unstable patients.
Gach
Olivier
O
Centre Hospitalier Universitaire du Sart-Tilman, Service de Cardiologie, Domaine Universitaire du Sart-Tilman B-35, 4000 Liège 1, Belgium. oliviergach@swing.be
Nys
Monique
M
Deby-Dupont
Ginette
G
Chapelle
Jean-Paul
JP
Lamy
Maurice
M
Piérard
Luc A
LA
Legrand
Victor
V
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000787:Angina Pectoris / Q000097:blood* / Q000628:therapy; D000789:Angina, Unstable / Q000097:blood* / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D019917:Blood Vessel Prosthesis Implantation; D002097:C-Reactive Protein / Q000378:metabolism; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D007781:Lactoferrin / Q000097:blood; D008297:Male; D008875:Middle Aged; D018375:Neutrophil Activation; D010196:Pancreatic Elastase / Q000097:blood; D009195:Peroxidase / Q000097:blood; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers; D016207:Cytokines; D002097:C-Reactive Protein; D009195:Peroxidase; D007781:Lactoferrin; D010196:Pancreatic Elastase