Acute versus chronic myocardial ischemia: a differential biological profile study.
OBJECTIVE
To determine the possible differences in lipid, thrombogenic and inflammatory marker concentrations and the presence of chronic and acute coronary artery disease (stable and unstable angina, respectively), comparing them with a group of control patients with normal coronary arteries.


METHODS
This prospective cohort study included 125 patients with unstable angina, 189 with stable angina and a control group of 83 patients with normal coronary arteries. Marker concentrations were measured in all 3 groups. Logistic regression analysis was performed to determine whether such factors could predict unstable or stable angina.


RESULTS
Lipid parameter concentrations were similar in the 2 coronary disease groups and significantly lower than in controls. Haemostatic and inflammatory marker concentrations were higher in patients with coronary disease, but were statistically significant only when comparing unstable angina patients with normal controls. Unstable angina patients had significantly higher levels of lipoprotein (a) [Lp(a)], fibrinogen, C-reactive protein (CRP) and leucocytes. Multiple logistic regression analysis showed that CRP (OR 2.635, 95% CI 1.417-4.898), smoking (OR 3.416, 95% CI 1.773-6.584), leucocytes (OR 2.034, 95% CI 1.079-3.836) and Lp(a) (OR 2.269, 95% CI 1.188-4.334) were independent risk factors of unstable versus stable angina.


CONCLUSIONS
Patients with unstable angina present a more atherogenic profile than patients with stable angina. Together with smoking, elevated Lp(a), CRP and leucocyte concentrations proved to be associated with the presence of unstable angina.
Sagastagoitia
José Domingo
JD
Servicio Cardiología, Hospital de Basurto, Departamento de Medicina, Universidad del País Vasco UPV/EHU, Bilbao, Spain.
Sáez
Yolanda
Y
Vacas
Marta
M
Narváez
Idoia
I
de Lafuente
Jesús Pablo Sáez
JP
Molinero
Enrique
E
Escobar
Antonio
A
Lafita
Manuel
M
Iriarte
José Antonio
JA
D000208:Acute Disease; D000368:Aged; D000789:Angina, Unstable / Q000097:blood / Q000209:etiology* / Q000473:pathology; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007249:Inflammation; D007958:Leukocyte Count; D008055:Lipids / Q000097:blood*; D017270:Lipoprotein(a) / Q000097:blood; D008297:Male; D017566:Microvascular Angina / Q000097:blood / Q000209:etiology* / Q000473:pathology; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000209:etiology* / Q000473:pathology; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking; D013927:Thrombosis
D015415:Biomarkers; D008055:Lipids; D017270:Lipoprotein(a)