title: Diagnostic coronary angiography is related to decreased TNF-alpha production after ex-vivo whole blood stimulation with LPS.
abstract: BACKGROUND
  Several studies showed serum markers elevation as a result to coronary angiography. We investigated the effect of diagnostic coronary angiography (DCA) on the development of systemic inflammatory response syndrome (SIRS) and on whole blood cytokine production capacity after ex-vivo LPS stimulation.
  
  
  METHODS
  In this observational study, clinical characteristics and serum cytokines of the patients were recorded at baseline and at 2, 6, 12, and 24h after DCA. Peripheral blood was collected at baseline and at 2, and 24h for complete blood count, coagulation profile and ex-vivo (100 microl) stimulation with LPS (500 pg) for subsequent cytokine measurement. Values are expressed as median+/-IQR and were compared using Wilcoxon's signed rank test with Bonferroni adjustment.
  
  
  RESULTS
  We included 23 male patients (mean age 52.0+/-18.0 years) undergoing DCA. None of the patients developed clinical or laboratory signs of SIRS. Serum IL-6 significantly increased at 12h. There was a significant decrease in TNF-alpha production after ex-vivo LPS stimulation of whole blood at 2 and 24h compared to baseline (median+/-IQR; 716.0+/-319.0; 576.0+/-715.0 vs. 1154+/-844.0 pg/ml; respectively) suggesting that DCA may cause transient endotoxin tolerance.
  
  
  CONCLUSIONS
  DCA is related to increased serum IL-6 levels but does not cause clinical SIRS. Development of SIRS after DCA is indicative of other in origin complication. DCA is associated with immune cells hyporesponsiveness, possibly through monocyte depression, expressed as decreased TNF-alpha production after whole blood stimulation with LPS ex vivo.
authors.affiliation: Department of Cardiology, Nicosia General Hospital, Nicosia, Cyprus.
authors.forename: Michael
authors.initials: M
authors.lastname: Myrianthefs
authors.forename: Nikos
authors.initials: N
authors.lastname: Kafkas
authors.forename: Christos
authors.initials: C
authors.lastname: Demponeras
authors.forename: Kyriaki
authors.initials: K
authors.lastname: Venetsanou
authors.forename: Aspasia
authors.initials: A
authors.lastname: Kyroudi
authors.forename: Myrsini
authors.initials: M
authors.lastname: Kouloukousa
authors.forename: Pavlos
authors.initials: P
authors.lastname: Myrianthefs
authors.forename: George
authors.initials: G
authors.lastname: Baltopoulos
mesh_terms: D002097:C-Reactive Protein / Q000378:metabolism; D017023:Coronary Angiography / Q000379:methods*; D003710:Demography; D006801:Humans; D008070:Lipopolysaccharides / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000000981:diagnostic imaging; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis* / Q000097:blood*
chemical_list: D008070:Lipopolysaccharides; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein