Beta2-integrin activation on T cell subsets is an independent prognostic factor in unstable angina pectoris.
BACKGROUND
Cardiac troponins provide excellent risk stratification in unstable angina (UA), but no reliable markers are available in troponin-negative patients. Beta2-integrin mediated T cell recruitment plays a pivotal role in coronary atherosclerotic plaque rupture. The present study investigates beta2-integrin activation on T cell subsets as a risk marker in UA.


METHODS
Functional activation (affinity/avidity) of beta2-integrins on T cells was measured using a flow cytometry-based whole blood assay in 87 patients with UA.


RESULTS
Beta2-integrin activation was significantly higher in patients with severe coronary artery disease (sC) and myocardial infarction (MI) compared to patients with no/minimal coronary atherosclerosis (no/mC), irrespective of troponin status. Adjusted for cardiovascular risk factors, medication, left ventricular function, MI at enrollment and high sensitivity C-reactive protein (hsCRP), beta2-integrin activation was independently associated with incidence of revascularization, hospitalization and all major cardiovascular events during 9 months of follow-up after index investigation. The highest prognostic value of beta2-integrin activation was seen in troponin-and hsCRP-negative patients.


CONCLUSIONS
Quantitative assessment of T cell beta2-integrin activation allows to identify high risk patients with UA and sC without established MI; furthermore, it is associated with incidence of future cardiovascular events independent of conventional risk factors (troponin, hsCRP).
Konstandin
Mathias H
MH
Dept. of Cardiology, Ruprecht-Karls-University, Heidelberg, Germany. mathias.konstandin@med.uni-heidelberg.de
Aksoy
Hülya
H
Wabnitz
Guido H
GH
Volz
Christian
C
Erbel
Christian
C
Kirchgessner
Henning
H
Giannitsis
Evangelos
E
Katus
Hugo A
HA
Samstag
Yvonne
Y
Dengler
Thomas J
TJ
D000368:Aged; D000789:Angina, Unstable / Q000276:immunology / Q000378:metabolism* / Q000401:mortality; D015415:Biomarkers / Q000378:metabolism*; D018821:CD18 Antigens / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000150:complications; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016176:T-Lymphocyte Subsets / Q000378:metabolism*
D015415:Biomarkers; D018821:CD18 Antigens