title: Differences in inflammatory and thrombotic markers between unstable angina and acute myocardial infarction.
abstract: BACKGROUND
  Unstable coronary syndromes are characterised by increased inflammatory process and endothelial activation. However, the underlying mechanisms of the acute coronary syndromes are still obscure. We evaluated the differences of inflammatory and thrombotic markers, at the acute phase of unstable angina (UA) and acute myocardial infarction (AMI).
  
  
  METHODS
  The population of the study consisted of 216 subjects: 136 patients with UA, 57 patients with AMI and 23 healthy controls. Blood samples were taken by their admission to the hospital. Inflammatory and thrombotic markers were measured by ELISA.
  
  
  RESULTS
  Patients with UA had significantly higher levels of interleukin-6 (IL-6), soluble vascular cells adhesion molecule (sVCAM-1) and von Willebrand factor (vWF) (p<0.05 vs controls), and lower levels of antithrombin III (ATIII) (p<0.01 vs controls) and protein C (PrtC) (p<0.05 vs controls). Similarly, patients with AMI had higher levels of IL-6, sVCAM-1, vWF and tissue plasminogen activator (tPA) (p<0.01 vs controls) and lower levels of ATIII (p<0.01 vs controls) and prtC (p<005 vs controls). Patients with AMI had significantly higher levels of vWF, tPA and sVCAM-1 compared to UA patients (p<0.05).
  
  
  CONCLUSIONS
  Patients with unstable coronary syndromes had increased levels of IL-6, sVCAM-1 and vWF as well as decreased levels of ATIII and PrtC by their admission. However, patients with AMI had higher levels of all the endothelium-derived inflammatory (e.g. sVCAM-1) of thrombotic/fibrinolytic (e.g. tPA and vWF) markers, compared to those with UA. These findings imply that patients with myocardial infarction show further increase of endothelium-derived inflammatory and thrombotic markers compared to patients with unstable angina, in response to a similar proinflammatory stimuli.
authors.affiliation: Cardiology Unit, Hippokration Hospital, Athens University Medical School, 69 S. Karagiorga, 16675, Glifada, Athens, Greece. drtousoulis@hotmail.com
authors.forename: Dimitris
authors.initials: D
authors.lastname: Tousoulis
authors.forename: Charalambos
authors.initials: C
authors.lastname: Antoniades
authors.forename: Erini
authors.initials: E
authors.lastname: Bosinakou
authors.forename: Maria
authors.initials: M
authors.lastname: Kotsopoulou
authors.forename: Costas
authors.initials: C
authors.lastname: Tsoufis
authors.forename: Kyriakoula
authors.initials: K
authors.lastname: Marinou
authors.forename: Marietta
authors.initials: M
authors.lastname: Charakida
authors.forename: Elli
authors.initials: E
authors.lastname: Stefanadi
authors.forename: Manolis
authors.initials: M
authors.lastname: Vavuranakis
authors.forename: George
authors.initials: G
authors.lastname: Latsios
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: D000789:Angina, Unstable / Q000097:blood*; D001779:Blood Coagulation Factors / Q000032:analysis*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood*
chemical_list: D001779:Blood Coagulation Factors; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D019010:Vascular Cell Adhesion Molecule-1