Oxidative stress and inflammation due to peripheral polymorphonuclear leukocytes after coronary angiography vs percutaneous coronary intervention.
OBJECTIVE
Percutaneous coronary intervention (PCI) as an invasive procedure includes inflation of a balloon and/or implantation of an endovascular prosthesis (stent) in an atherosclerotic coronary vessel at a level where the plaque narrows its cross-sectional area by more than 75%. Various reports have demonstrated that balloon inflation or stent implantation trigger inflammation and subsequent growth of smooth muscle cells. Both oxidative stress (OS) and inflammation parameters worsen, increasing the risk of complications. The polymorphonuclear leukocyte (PMNL) is one of the inflammatory cells releasing reactive oxygen species contributing to OS, inflammation and endothelial injury. The aim of this study was to study the contribution of PMNLs during coronary intervention.


METHODS
Patients enrolled in this study were randomized into two groups, namely nine patients undergoing PCI procedure, compared to 11 undergoing diagnostic coronary angiography. PMNLs were separated from patient blood, before and following PCI. PMNL priming was measured by rate of superoxide release from PMNLs and flow cytometry analysis of CD11b levels. PMNL-related inflammation was estimated by white blood cells (WBC) and PMNL count. Systemic inflammation was monitored by C-reactive protein (CRP) and fibrinogen.


RESULTS
Tested patients were divided into patients undergoing PCI procedure, compared to those undergoing diagnostic coronary angiography; already at time ''0'', OS and inflammation parameters were higher in the PCI group of patients. OS parameters decreased significantly following PCI procedure. PCI itself induces increased OS and inflammation. Significant positive correlation was found between serum creatine phosphokinase and rate of superoxide release from PMNLs, indicating correlation between PMNL priming and the severity of cardiac disease. Systemic inflammation parameters, such as fibrinogen and CRP, showed significant decrease in the PCI group after the procedure, while those related to PMNLs did not.


CONCLUSIONS
PMNL contribution to OS and inflammation is lower in patients undergoing diagnostic coronary angiography, compared to the PCI group. This research adds new facet to evaluation of cardiac patients whether they will undergo PCI procedure or diagnostic coronary angiography.
Farah
R
R
Department of Internal Medicine F, Western Galilee Hospital, Nahariya, Israel. raymond.f@ziv.health.gov.il
Shurtz-Swirski
R
R
Bolotin
Y
Y
Brezins
M
M
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000379:methods; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D039481:CD11b Antigen / Q000097:blood; D002797:Choline Kinase / Q000097:blood; D017023:Coronary Angiography / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy*; D005340:Fibrinogen / Q000032:analysis; D005434:Flow Cytometry / Q000379:methods; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000276:immunology*; D009504:Neutrophils / Q000276:immunology*; D018384:Oxidative Stress / Q000276:immunology*; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D015607:Stents; D013481:Superoxides / Q000097:blood
D015415:Biomarkers; D039481:CD11b Antigen; D013481:Superoxides; D005340:Fibrinogen; D002097:C-Reactive Protein; D002797:Choline Kinase