title: Free Light Chains in patients with acute coronary syndromes: Relationships to inflammation and renal function.
abstract: OBJECTIVE
  We assessed changes of serum combined free immunoglobulin light chains (cFLC) levels, which are associated with increased all-cause mortality, in ST-elevation myocardial infarction (STEMI) in relation to inflammation and renal function indices.
  
  
  METHODS
  cFLC were measured in 48 patients with STEMI on days 1, 3, 7 and 30 with assessment of their relationships with monocyte subsets, high sensitivity C-reactive protein (hsCRP), and cystatin C. Day 1 levels in STEMI patients were compared to 40 patients with stable coronary artery disease, and 37 healthy controls.
  
  
  RESULTS
  There were no significant differences in cFLC levels between the study groups. In STEMI patients, cFLC values peaked on day 7 post-MI and remained elevated on day 30 (p<0.001 vs. day 1 for both). hsCRP concentrations peaked on day 3 of STEMI followed by their gradual reduction to the levels seen in the controls (p<0.001). In STEMI cFLC correlated with cystatin C (r=0.55, p<0.001), and negatively correlated with counts of CD14++CD16- monocytes (r=-0.55, p<0.001). On multivariate Cox regression analysis, cFLC concentrations were associated with increased need for future percutaneous coronary intervention (PCI) (p=0.019).
  
  
  CONCLUSIONS
  cFLC levels increase during STEMI with peak values on day 7 after presentation and predict the need for future PCI.
authors.affiliation: University of Birmingham, Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom.
authors.forename: Eduard
authors.initials: E
authors.lastname: Shantsila
authors.affiliation: University of Birmingham, Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom.
authors.forename: Luke D
authors.initials: LD
authors.lastname: Tapp
authors.affiliation: University of Birmingham, Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. Electronic address: g.y.h.lip@bham.ac.uk.
authors.forename: Gregory Y H
authors.initials: GY
authors.lastname: Lip
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D002423:Cause of Death / Q000639:trends; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D005060:Europe / Q000453:epidemiology; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000097:blood*; D007249:Inflammation / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011379:Prognosis
chemical_list: D015415:Biomarkers; D007147:Immunoglobulin Light Chains
keywords: Coronary artery disease; Free light chains; Heart failure; ST-elevation myocardial infarction