Differences in inflammatory and thrombotic markers between unstable angina and acute myocardial infarction.
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.
Tousoulis
Dimitris
D
Cardiology Unit, Hippokration Hospital, Athens University Medical School, 69 S. Karagiorga, 16675, Glifada, Athens, Greece. drtousoulis@hotmail.com
Antoniades
Charalambos
C
Bosinakou
Erini
E
Kotsopoulou
Maria
M
Tsoufis
Costas
C
Marinou
Kyriakoula
K
Charakida
Marietta
M
Stefanadi
Elli
E
Vavuranakis
Manolis
M
Latsios
George
G
Stefanadis
Christodoulos
C
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*
D001779:Blood Coagulation Factors; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D019010:Vascular Cell Adhesion Molecule-1