Increased expression of C-reactive protein and tissue factor in acute coronary syndrome lesions: Correlation with serum C-reactive protein, angioscopic findings, and modification by statins.
BACKGROUND
Serum C-reactive protein (CRP) is a strong risk predictor of cardiovascular events, and tissue factor (TF) plays a central role in thrombus formation of advanced atherosclerotic plaques. Aim of the present study was to quantify in situ CRP and TF in coronary atherectomy specimens associated with acute coronary syndromes (ACS) or stable angina (SA). In addition, the effect of statin treatment on both intimal determinants was analyzed.


RESULTS
Serial sections from atherectomy probes retrieved from coronary primary target lesions of 42 ACS and 70 SA patients were examined for CRP and TF expression using immunostaining. CRP and TF intimal expression was consistently higher in ACS lesions and a positive correlation between both determinants was detected. In both subgroups intimal staining intensity of CRP but not TF was strongly associated with serum CRP levels. Using angioscopy, complex plaques revealed a higher intimal CRP and TF expression than white/yellow plaques. Both CRP and TF were consistently lower expressed in target lesions of patients with pre-existing statin treatment.


CONCLUSIONS
CRP and TF expression is markedly increased in plaques derived from patients with ACS as compared to SA patients. Statin treatment appears to reduce vascular expression of CRP and TF.
Andrié
René P
RP
Department of Internal Medicine II/Cardiology, University of Bonn, Bonn, Germany. Rene.Andrie@ukb.uni-bonn.de
Bauriedel
Gerhard
G
Braun
Peter
P
Höpp
Hans W
HW
Nickenig
Georg
G
Skowasch
Dirk
D
D054058:Acute Coronary Syndrome / Q000378:metabolism*; D000368:Aged; D000787:Angina Pectoris / Q000378:metabolism / Q000473:pathology; D017546:Angioscopy; D017225:Atherectomy, Coronary; D050197:Atherosclerosis / Q000378:metabolism / Q000473:pathology; D002097:C-Reactive Protein / Q000096:biosynthesis*; D005260:Female; D005786:Gene Expression Regulation; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D013925:Thromboplastin / Q000096:biosynthesis*; D013927:Thrombosis / Q000378:metabolism
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002097:C-Reactive Protein; D013925:Thromboplastin