title: Beta2-integrin activation on T cell subsets is an independent prognostic factor in unstable angina pectoris.
abstract: 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).
authors.affiliation: Dept. of Cardiology, Ruprecht-Karls-University, Heidelberg, Germany. mathias.konstandin@med.uni-heidelberg.de
authors.forename: Mathias H
authors.initials: MH
authors.lastname: Konstandin
authors.forename: Hülya
authors.initials: H
authors.lastname: Aksoy
authors.forename: Guido H
authors.initials: GH
authors.lastname: Wabnitz
authors.forename: Christian
authors.initials: C
authors.lastname: Volz
authors.forename: Christian
authors.initials: C
authors.lastname: Erbel
authors.forename: Henning
authors.initials: H
authors.lastname: Kirchgessner
authors.forename: Evangelos
authors.initials: E
authors.lastname: Giannitsis
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Katus
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Samstag
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Dengler
mesh_terms: 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*
chemical_list: D015415:Biomarkers; D018821:CD18 Antigens