Dissociation of the Inflammatory Reaction following PCI for Acute Myocardial Infarction.
OBJECTIVE
Neutrophils are activated and infiltrate the myocardium after ischemia and reperfusion. The involvement of neutrophils in irreversible reperfusion injury is suggested by numerous experimental studies. The aim of this study was to investigate markers of neutrophil activation following reperfusion of acute myocardial infarction (AMI) accomplished with percutaneous coronary intervention (PCI) and their relationship to markers of lipid peroxidation, cytokines and highly-sensitive C-reactive protein (hsCRP).


METHODS
Non-consecutive patients with their first myocardial infarction were evaluated. Setting. University hospital as primary referral center, single center.


METHODS
Forty-nine patients with AMI were evaluated. All were treated with primary PCI and infusion of abciximab. Reperfusion was verified by angiography. Blood samples for analyses of myeloperoxidase (MPO), neutrophil gelatinase-associated lipocalin (NGAL), matrix metalloproteinase-9 (MMP-9), malondialdehyde (MDA), 8-isoprostane-prostaglandin F2alpha (Iso-P), interleukin 6 (IL-6), interleukin 8 (IL-8), tumor necrosis factoralpha (TNFalpha), hsCRP, creatine kinase-monobasic fraction (CK-MB) and troponin-T (TnT) were obtained at baseline with the occluded coronary vessel, and subsequently after verified reperfusion at 1.5, 3 and 24 hours.


RESULTS
Significant increases in MMP-9, IL-6, IL-8, TNFalpha and hsCRP were observed, and a significant decrease in MPO and MDA was also observed over the same period. No significant changes in Iso-P and NGAL were found.


CONCLUSIONS
We found a dissociation of the inflammatory reaction after PCI for AMI: a decrease of markers of neutrophil activation and MDA, but an increase in cytokines and hsCRP. An antineutrophil effect of the PCI procedure including treatment with abciximab, an antiplatelet drug and a modulator of inflammation, is conceivable.
Aström-Olsson
Karin
K
Department of Cardiology, Sahlgrenska University Hospital/S, SE 413 45, Goteborg, Sweden. karin.astrom-olsson@vgregion.se
Hedström
Erik
E
Hultén
Lillemor Mattsson
LM
Wiklund
Olov
O
Arheden
Håkan
H
Ohlin
Ann-Kristin
AK
Gottsäter
Anders
A
Ohlin
Hans
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D015227:Lipid Peroxidation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000276:immunology* / Q000628:therapy*; D009504:Neutrophils / Q000276:immunology; D018384:Oxidative Stress / Q000276:immunology; D014657:Vasculitis / Q000209:etiology* / Q000276:immunology*
D015415:Biomarkers; D016207:Cytokines; D002097:C-Reactive Protein