Increased neutrophil elastase release in unstable angina pectoris and acute myocardial infarction

Department of Medicine, University of Florida, College of Medicine, Gainesville 32610.

Neutrophils, a source of proteolytic enzymes and oxygen free radicals, have been shown to participate in animal models of myocardial ischemic injury. To characterize neutrophil activation in human ischemic heart disease, a specific neutrophil elastase-derived fibrinopeptide in plasma was measured in 25 patients with stable angina pectoris, 29 patients with unstable angina pectoris, 17 patients with acute myocardial infarction and 22 control subjects. Mean plasma levels (+/- standard error) of a neutrophil elastase-derived fibrinopeptide (B beta 30-43) measured by a specific radioimmunoassay were fivefold higher in patients with acute myocardial infarction (877 +/- 337 pmol/liter, p less than 0.02) and 13-fold higher in patients with unstable angina (2,277 +/- 613 pmol/liter, p less than 0.006) as compared with control subjects (172 +/- 74 pmol/liter). Mean plasma levels of peptide B beta 30-43 in patients with stable angina (676 +/- 334 pmol/liter), although higher than in control subjects, were not significantly increased (p = 0.64). Total leukocyte counts were 11.0 +/- 0.6 x 10(6)/ml in those with acute myocardial infarction, 9.2 +/- 0.7 x 10(6)/ml in those with unstable angina, 7.1 +/- 0.3 x 10(6)/ml in those with stable angina and 7.7 +/- 0.4 x 10(6)/ml in control subjects. Although total leukocyte counts in patients with unstable angina pectoris and acute myocardial infarction were higher (p less than 0.01) than in patients with stable angina or in control subjects, elevations in peptide B beta 30-43 levels were independent of the differences in both leukocyte count and absolute neutrophil count as well as in history of smoking, hypertension, diabetes mellitus or treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				A. M. Arruda-Olson, G. S. Reeder, M. R. Bell, S. A. Weston, and V. L. Roger Neutrophilia Predicts Death and Heart Failure After Myocardial Infarction: A Community-Based Study Circ Cardiovasc Qual Outcomes, November 1, 2009; 2(6): 656 - 662. [Abstract] [Full Text] [PDF]

				A. Zernecke, I. Bot, Y. Djalali-Talab, E. Shagdarsuren, K. Bidzhekov, S. Meiler, R. Krohn, A. Schober, M. Sperandio, O. Soehnlein, et al. Protective Role of CXC Receptor 4/CXC Ligand 12 Unveils the Importance of Neutrophils in Atherosclerosis Circ. Res., February 1, 2008; 102(2): 209 - 217. [Abstract] [Full Text] [PDF]

				M. L. Narducci, A. Grasselli, L. M. Biasucci, A. Farsetti, A. Mule, G. Liuzzo, G. La Torre, G. Niccoli, R. Mongiardo, A. Pontecorvi, et al. High Telomerase Activity in Neutrophils From Unstable Coronary Plaques J. Am. Coll. Cardiol., December 18, 2007; 50(25): 2369 - 2374. [Abstract] [Full Text] [PDF]

				R. Lo Presti, M. Montana, G. Amodeo, E. Incalcaterra, and G. Caimi Persistence of High Plasma Elastase Level in Young Subjects With Acute Myocardial Infarction Clinical and Applied Thrombosis/Hemostasis, April 1, 2007; 13(2): 224 - 225. [PDF]

				V. Rizzello, G. Liuzzo, S. Brugaletta, A. Rebuzzi, L. M. Biasucci, and F. Crea Modulation of CD4+CD28null T Lymphocytes by Tumor Necrosis Factor-{alpha} Blockade in Patients With Unstable Angina Circulation, May 16, 2006; 113(19): 2272 - 2277. [Abstract] [Full Text] [PDF]

				K. A. Lindstedt, M. J. Leskinen, and P. T. Kovanen Proteolysis of the Pericellular Matrix: A Novel Element Determining Cell Survival and Death in the Pathogenesis of Plaque Erosion and Rupture Arterioscler Thromb Vasc Biol, August 1, 2004; 24(8): 1350 - 1358. [Abstract] [Full Text] [PDF]

				C. D. Garlichs, S. Eskafi, I. Cicha, A. Schmeisser, B. Walzog, D. Raaz, C. Stumpf, A. Yilmaz, J. Bremer, J. Ludwig, et al. Delay of neutrophil apoptosis in acute coronary syndromes J. Leukoc. Biol., May 1, 2004; 75(5): 828 - 835. [Abstract] [Full Text] [PDF]

				A. Sajadieh, O. W. Nielsen, V. Rasmussen, H. O. Hein, S. Abedini, and J. F. Hansen Increased heart rate and reduced heart-rate variability are associated with subclinical inflammation in middle-aged and elderly subjects with no apparent heart disease Eur. Heart J., March 1, 2004; 25(5): 363 - 370. [Abstract] [Full Text] [PDF]

				J. Vinten-Johansen Involvement of neutrophils in the pathogenesis of lethal myocardial reperfusion injury Cardiovasc Res, February 15, 2004; 61(3): 481 - 497. [Abstract] [Full Text] [PDF]

				M.-L. Brennan, M. S. Penn, F. Van Lente, V. Nambi, M. H. Shishehbor, R. J. Aviles, M. Goormastic, M. L. Pepoy, E. S. McErlean, E. J. Topol, et al. Prognostic Value of Myeloperoxidase in Patients with Chest Pain N. Engl. J. Med., October 23, 2003; 349(17): 1595 - 1604. [Abstract] [Full Text] [PDF]

				D. J. Angiolillo, G. Liuzzo, S. Pelliccioni, E. De Candia, R. Landolfi, F. Crea, A. Maseri, and L. M. Biasucci Combined role of the Lewis antigenic system, Chlamydia pneumoniae, and C-reactive protein in unstable angina J. Am. Coll. Cardiol., February 19, 2003; 41(4): 546 - 550. [Abstract] [Full Text] [PDF]

				T. Naruko, M. Ueda, K. Haze, A. C. van der Wal, C. M. van der Loos, A. Itoh, R. Komatsu, Y. Ikura, M. Ogami, Y. Shimada, et al. Neutrophil Infiltration of Culprit Lesions in Acute Coronary Syndromes Circulation, December 3, 2002; 106(23): 2894 - 2900. [Abstract] [Full Text] [PDF]

				A. Buffon, L. M. Biasucci, G. Liuzzo, G. D'Onofrio, F. Crea, and A. Maseri Widespread Coronary Inflammation in Unstable Angina N. Engl. J. Med., July 4, 2002; 347(1): 5 - 12. [Abstract] [Full Text] [PDF]

				N. S. Rost, P. A. Wolf, C. S. Kase, M. Kelly-Hayes, H. Silbershatz, J. M. Massaro, R. B. D'Agostino, C. Franzblau, and P. W.F. Wilson Plasma Concentration of C-Reactive Protein and Risk of Ischemic Stroke and Transient Ischemic Attack: The Framingham Study Stroke, November 1, 2001; 32(11): 2575 - 2579. [Abstract] [Full Text] [PDF]

				C. Monaco, F. Crea, G. Niccoli, F. Summaria, D. Cianflone, R. Bordone, G. Bellomo, and A. Maseri Autoantibodies against oxidized low density lipoproteins in patients with stable angina, unstable angina or peripheral vascular disease; pathophysiological implications Eur. Heart J., September 1, 2001; 22(17): 1572 - 1577. [Abstract] [PDF]

				N T Mulvihill, J B Foley, R T Murphy, R Curtin, P A Crean, and M Walsh Risk stratification in unstable angina and non-Q wave myocardial infarction using soluble cell adhesion molecules Heart, June 1, 2001; 85(6): 623 - 627. [Abstract] [Full Text]

				A Mazzone, S De Servi, I Mazzucchelli, I Bossi, E Ottini, M Vezzoli, F Meloni, M Lotzinker, and G Mariani Increased concentrations of inflammatory mediators in unstable angina: correlation with serum troponin T Heart, May 1, 2001; 85(5): 571 - 575. [Abstract] [Full Text]

				R.R Azar, S Rinfret, P Theroux, P.H Stone, R Dakshinamurthy, Y.-J Feng, A.H.B Wu, G Range, and D.D Waters A randomized placebo-controlled trial to assess the efficacy of antiinflammatory therapy with methylprednisolone in unstable angina (MUNA trial) Eur. Heart J., December 2, 2000; 21(24): 2026 - 2032. [Abstract] [PDF]

				J.L Mehta and D.Y Li Inflammation in ischemic heart disease: Response to tissue injury or a pathogenetic villain? Cardiovasc Res, August 1, 1999; 43(2): 291 - 299. [Full Text] [PDF]

				W. Koenig, M. Sund, M. Frohlich, H.-G. Fischer, H. Lowel, A. Doring, W. L. Hutchinson, and M. B. Pepys C-Reactive Protein, a Sensitive Marker of Inflammation, Predicts Future Risk of Coronary Heart Disease in Initially Healthy Middle-Aged Men : Results From the MONICA (Monitoring Trends and Determinants in Cardiovascular Disease) Augsburg Cohort Study, 1984 to 1992 Circulation, January 19, 1999; 99(2): 237 - 242. [Abstract] [Full Text] [PDF]

				F. Kosar, E. Varol, S. Ayaz, E. Kutuk, A. Oguzhan, and E. Diker Plasma Leukocyte Elastase Concentration and Coronary Artery Disease Angiology, March 1, 1998; 49(3): 193 - 201. [Abstract] [PDF]

				A. Y Antipenko and M. A Kirchberger Membrane phosphorylation protects the cardiac sarcoplasmic reticulum Ca2+-ATPase against chlorinated oxidants in vitro Cardiovasc Res, October 1, 1997; 36(1): 67 - 77. [Abstract] [Full Text] [PDF]

				B.C. Yang, J.C. Williams, and J.L. Mehta Protective Effect of Elastase Inhibition Against Myocardial Dysfunction and Injury Induced by Ischemia and Reperfusion in Isolated Rat Hearts Journal of Cardiovascular Pharmacology and Therapeutics, January 1, 1996; 1(1): 31 - 39. [Abstract] [PDF]

				K. Kaikita, H. Ogawa, H. Yasue, T. Sakamoto, H. Suefuji, H. Sumida, and K. Okumura Soluble P-Selectin Is Released Into the Coronary Circulation After Coronary Spasm Circulation, October 1, 1995; 92(7): 1726 - 1730. [Abstract] [Full Text]

				F.-J. Neumann, I. Ott, M. Gawaz, G. Richardt, H. Holzapfel, M. Jochum, and A. Schomig Cardiac Release of Cytokines and Inflammatory Responses in Acute Myocardial Infarction Circulation, August 15, 1995; 92(4): 748 - 755. [Abstract] [Full Text]

				P. R. Hansen Role of Neutrophils in Myocardial Ischemia and Reperfusion Circulation, March 15, 1995; 91(6): 1872 - 1885. [Abstract] [Full Text]