title: Clinical outcome in patients with acute coronary syndrome and outward remodeling is associated with a predominant inflammatory response.
abstract: BACKGROUND
  Pro-inflammatory molecules and low-density lipoproteins play essential roles in the atherosclerosis. The aim of our study was to establish an association among the cytokines secreted by peripheral blood mononuclear cells and the serum concentration in patients with unstable angina and coronary outward remodeling before and after percutaneous coronary intervention. The clinical and coronary responses were evaluated 6 months after the procedure.
  
  
  RESULTS
  Twenty-two patients with unstable angina were evaluated prior to after percutaneous coronary intervention and 6 months after procedure by coronary intravascular ultrasound. Eleven of the patients had recurrent angina, while 9 presented restenosis and an increase in the percentage of total plaque area. These 11 patients displayed higher levels of C-reactive protein than those without coronary events (1.27 vs. 0.43 mg/dl, respectively; p = 0.029) and a tendency to increase levels of interleukin (IL)-8 and transforming growth factor-β1, but lower levels of IL-10 (52.09 vs. 141.5 pg/ml, respectively; p = 0.035). Activated peripheral blood mononuclear cells from patients with restenosis presented higher levels of proliferation, CD86 expression and higher IL-1, and increased IL-10 compared to those in patients without restenosis.
  
  
  CONCLUSIONS
  Patients with unstable angina and coronary outward remodeling who displayed a pro-inflammatory response experienced recurrent coronary events and an increased percentage of total plaque area. In contrast, better outcomes were observed in patients with anti-inflammatory responses. This response could be secondary to low-density lipoproteins.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Madrid-Miller
authors.forename: Luis
authors.initials: L
authors.lastname: Chávez-Sánchez
authors.forename: Guillermo
authors.initials: G
authors.lastname: Careaga-Reyna
authors.forename: Gabriela
authors.initials: G
authors.lastname: Borrayo-Sánchez
authors.forename: Karina
authors.initials: K
authors.lastname: Chávez-Rueda
authors.forename: Silvestre Armando
authors.initials: SA
authors.lastname: Montoya-Guerrero
authors.forename: Arturo
authors.initials: A
authors.lastname: Abundes Velazco
authors.forename: Mariano
authors.initials: M
authors.lastname: Ledesma-Velasco
authors.forename: María Victoria
authors.initials: MV
authors.lastname: Legorreta-Haquet
authors.affiliation: Unidad de Investigación Médica en Inmunología, Unidad Médica de Alta Especialidad, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Avenida Cuauhtémoc 330, Col, Doctores, CP: 06720 México City, México. fblanco1@terra.com.mx.
authors.forename: Francisco
authors.initials: F
authors.lastname: Blanco-Favela
mesh_terms: D054058:Acute Coronary Syndrome / Q000473:pathology / Q000628:therapy*; D000368:Aged; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007249:Inflammation / Q000473:pathology*; D008297:Male; D008875:Middle Aged