Acute phase proteins activation in subjects with coronary atherosclerosis and micro-vessel coronary circulation impairment.
OBJECTIVE
To investigate possible correlations between acute phase proteins (APPs) activation and coronary flow in subjects with coronary artery disease (CAD) undergoing coronary angiography.


METHODS
Fifty-nine consecutive patients with CAD who underwent coronary angiography were enrolled in the study: blood samples were taken in order to evaluate plasmatic concentrations of C-reactive protein (CRP) and APPs such as alpha-1-anti-trypsin (A1AT), alpha-1-glyco-protein (A1GP) and haptoglobin (HG). Coronary flow on left anterior descending (LAD) was assessed with TIMI frame count (TFC). Patients with TIMI flow 0-1 were excluded from the study.


RESULTS
Coronary atherosclerosis expressed in terms of number of coronary vessels with severe (>70%) lumen narrowing was related to serum concentrations of all considered APPs (A1GP: r 0.282, P < 0.05; A1AT: r 0.256, P 0.055; HG: r 0.335, P < 0.01). TFC on LAD was related to all considered APPs (A1GP: r 0.24, P 0.06; A1AT: r 0.28, P < 0.05; HG: r 0.43, P < 0.01; log CRP: r 0.57, P < 0.001); correlations remained significant even after correction for age, gender, risk factors, diagnosis and treatment. Among 12 patients who were previously treated with coronary angioplasty, those implanted with a drug eluting stent showed a significantly slower coronary flow on LAD (19.6 +/- 2.07 vs. 16.71 +/- 2.06, P < 0.05) if compared with those implanted with a bare metal stent.


CONCLUSIONS
An increased inflammatory systemic activation featured by plasmatic concentrations of CRP and APPs might be associated with both coronary atherosclerosis and an impaired coronary micro-circulation.
Brunetti
Natale Daniele
ND
Cardiology Department, University of Foggia, Foggia, Italy. dr.natale.daniele.brunetti@hotmail.it
Padalino
Roberto
R
De Gennaro
Luisa
L
Cuculo
Andrea
A
Ziccardi
Luigi
L
Pellegrino
Pier Luigi
PL
Di Biase
Matteo
M
D000209:Acute-Phase Proteins / Q000032:analysis*; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003324:Coronary Artery Disease / Q000097:blood* / Q000503:physiopathology* / Q000628:therapy; D003326:Coronary Circulation; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged
D000209:Acute-Phase Proteins