Delayed neutrophil apoptosis in patients with unstable angina: relation to C-reactive protein and recurrence of instability.
OBJECTIVE
To investigate spontaneous polymorphonuclear neutrophils (PMNs) apoptosis in unstable angina (UA) and its association with recurrence of instability.


RESULTS
We compared PMNs apoptotic rate at 4 and 24 h in patients with UA, stable angina (SA), and controls (H) with two different protocols by flow cytometry. We measured apoptotic rate of isolated PMNs (Protocol 1) in 30 UA patients, 13 SA patients, and 34 H; and apoptosis of PMNs in whole blood culture (Protocol 2) in further 10 UA patients, 7 SA patients, and 6 H. Serum high-sensitivity C-reactive protein was also measured. Polymorphonuclear neutrophils of UA patients showed a decreased apoptotic rate compared with SA patients and H at 4 h in Protocol 1 (both P < 0.01), and at 24 h in Protocol 2 (P < 0.05 and <0.01, respectively). In overall population, a negative correlation was found between apoptotic rate at 4 h and high-sensitivity C-reactive protein levels (P < 0.01). Six among 40 patients with UA had early recurrence of symptoms and their apoptotic rate was significantly reduced compared with UA patients without recurrence of symptoms (P = 0.024).


CONCLUSIONS
Our study demonstrates delayed PMN apoptosis in UA. This alteration might be involved in the persistence of inflammatory activation and affects recurrence of instability.
Biasucci
Luigi M
LM
Instituto di Cardiologia, Catholic University of Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy. lmbiasucci@virgilio.it
Liuzzo
Giovanna
G
Giubilato
Simona
S
Della Bona
Roberta
R
Leo
Milena
M
Pinnelli
Michela
M
Severino
Anna
A
Gabriele
Mario
M
Brugaletta
Salvatore
S
Piro
Maddalena
M
Crea
Filippo
F
D000368:Aged; D000789:Angina, Unstable / Q000097:blood / Q000473:pathology*; D017209:Apoptosis / Q000502:physiology*; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology*; D012008:Recurrence
D002097:C-Reactive Protein