title: Fractional flow reserve is not associated with inflammatory markers in patients with stable coronary artery disease.
abstract: BACKGROUND
  Atherosclerosis is an inflammatory condition and increased blood levels of inflammatory biomarkers have been observed in acute coronary syndromes. In addition, high expression of inflammatory markers is associated with worse prognosis of coronary artery disease. The presence and extent of inducible ischemia in patients with stable angina has previously been shown to have strong prognostic value. We hypothesized that evidence of inducible myocardial ischemia by local lesions, as measured by fractional flow reserve (FFR), is associated with increased levels of blood based inflammatory biomarkers.
  
  
  METHODS
  Whole blood samples of 89 patients with stable angina pectoris and 16 healthy controls were analyzed. The patients with stable angina pectoris underwent coronary angiography and FFR of all coronary lesions. We analyzed plasma levels of cytokines IL-6, IL-8 and TNF-α and membrane expression of Toll-like receptor 2 and 4, CD11b, CD62L and CD14 on monocytes and granulocytes as markers of inflammation. Furthermore, we quantified the severity of hemodynamically significant coronary artery disease by calculating Functional Syntax Score (FSS), an extension of the Syntax Score.
  
  
  RESULTS
  For the majority of biomarkers, we observed lower levels in the healthy control group compared with patients with stable angina who underwent coronary catheterization. We found no difference for any of the selected biomarkers between patients with a positive FFR (≤ 0.75) and negative FFR (>0.80). We observed no relationship between the investigated biomarkers and FSS.
  
  
  CONCLUSIONS
  The presence of local atherosclerotic lesions that result in inducible myocardial ischemia as measured by FFR in patients with stable coronary artery disease is not associated with increased plasma levels of IL-6, IL-8 and TNF-α or increased expression of TLR2 and TLR4, CD11b, CD62L and CD14 on circulating leukocytes.
authors.affiliation: Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands. jan-willem.sels@cze.nl
authors.forename: Jan-Willem E M
authors.initials: JW
authors.lastname: Sels
authors.forename: Ellen H A M
authors.initials: EH
authors.lastname: Elsenberg
authors.forename: Imo E
authors.initials: IE
authors.lastname: Hoefer
authors.forename: Anton Jan
authors.initials: AJ
authors.lastname: van Zonneveld
authors.forename: Johan
authors.initials: J
authors.lastname: Kuiper
authors.forename: J Wouter
authors.initials: JW
authors.lastname: Jukema
authors.forename: Nico H J
authors.initials: NH
authors.lastname: Pijls
authors.forename: Gerard
authors.initials: G
authors.lastname: Pasterkamp
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D039481:CD11b Antigen / Q000378:metabolism; D003324:Coronary Artery Disease / Q000378:metabolism* / Q000503:physiopathology*; D016207:Cytokines / Q000378:metabolism; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D018836:Inflammation Mediators / Q000378:metabolism*; D019041:L-Selectin / Q000378:metabolism; D007958:Leukocyte Count; D007962:Leukocytes / Q000378:metabolism; D018950:Lipopolysaccharide Receptors / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D051195:Toll-Like Receptor 2 / Q000378:metabolism; D051197:Toll-Like Receptor 4 / Q000378:metabolism
chemical_list: D015415:Biomarkers; D039481:CD11b Antigen; D016207:Cytokines; D018836:Inflammation Mediators; D018950:Lipopolysaccharide Receptors; D051195:Toll-Like Receptor 2; D051197:Toll-Like Receptor 4; D019041:L-Selectin