Clinical and angiographic correlates of leukocyte activation in unstable angina

Division of Cardiology, IRCCS S. Matteo Hospital, University of Pavia, Italy.

OBJECTIVES. This study sought to evaluate the relation, if any, between clinical and angiographic findings in patients with unstable angina and monocyte and neutrophil CD11b/CD18 receptor density. The expression of HLA-DR molecules on T lymphocytes, an index of activation of these cells, was also investigated. BACKGROUND. Although activation of neutrophils and monocytes has recently been shown in unstable angina, no studies have correlated activation indexes with clinical and angiographic features of patients with this clinical condition. METHODS. Sixty patients underwent diagnostic coronary arteriography and simultaneous blood sampling from the aorta and coronary sinus before injection of contrast medium. Cell surface receptors were detected by direct immunofluorescence evaluated by flow cytometry using monoclonal antibodies tagged with fluorescent markers. RESULTS. In 38 patients with unstable angina, neutrophils and monocytes showed a significantly higher expression of CD11b/CD18 adhesion receptors in coronary sinus than aortic blood (p < 0.0001 and p < 0.001, respectively). When these patients were analyzed according to clinical characteristics or angiographic findings, no difference in CD11b/CD18 receptor expression in coronary sinus blood was found between the various subgroups, except for patients with at least one episode of chest pain at rest within 48 h of coronary arteriography and a higher neutrophil adhesion molecule density than patients who remained asymptomatic (p = 0.04). Lymphocytes in patients with stable and unstable angina showed a similar percent expression of CD2/CD19 and CD3/HLA-DR antigens, with no difference between aortic and coronary sinus blood. CONCLUSION. These results in a larger cohort confirm previous data that neutrophil and monocyte CD11b/CD18 adhesion molecules show a higher expression in the coronary sinus blood of patients with unstable angina. Among clinical and angiographic findings in patients with unstable angina, only the occurrence of chest pain within 48 h of coronary angiography was related to significantly higher values of neutrophil fluorescence intensity, suggesting that the degree of neutrophil activation is related to the proximity of rest angina episodes to blood sampling. Finally, our data do not support the concept of systemic or transcardiac lymphocyte activation in unstable angina.

This article has been cited by other articles:

				A. Alipour, A. J.H. H.M van Oostrom, A. Izraeljan, C. Verseyden, J. M. Collins, K. N. Frayn, T. W.M. Plokker, J. W. F. Elte, and M. Castro Cabezas Leukocyte Activation by Triglyceride-Rich Lipoproteins Arterioscler Thromb Vasc Biol, April 1, 2008; 28(4): 792 - 797. [Abstract] [Full Text] [PDF]

				H. Ranjbaran, S. I. Sokol, A. Gallo, R. E. Eid, A. O. Iakimov, A. D'Alessio, J. R. Kapoor, S. Akhtar, C. J. Howes, M. Aslan, et al. An Inflammatory Pathway of IFN-{gamma} Production in Coronary Atherosclerosis J. Immunol., January 1, 2007; 178(1): 592 - 604. [Abstract] [Full Text] [PDF]

				S. De Servi, M. Mariani, G. Mariani, and A. Mazzone C-Reactive Protein Increase in Unstable Coronary Disease: Cause or Effect? J. Am. Coll. Cardiol., October 18, 2005; 46(8): 1496 - 1502. [Abstract] [Full Text] [PDF]

				S. Baldus, C. Heeschen, T. Meinertz, A. M. Zeiher, J. P. Eiserich, T. Munzel, M. L. Simoons, C. W. Hamm, and on behalf of the CAPTURE Investigators Myeloperoxidase Serum Levels Predict Risk in Patients With Acute Coronary Syndromes Circulation, September 23, 2003; 108(12): 1440 - 1445. [Abstract] [Full Text] [PDF]

				A. Mazzone, C. Cusa, I. Mazzucchelli, M. Vezzoli, E. Ottini, R. Pacifici, P. Zuccaro, and C. Falcone Increased production of inflammatory cytokines in patients with silent myocardial ischemia J. Am. Coll. Cardiol., December 1, 2001; 38(7): 1895 - 1901. [Abstract] [Full Text] [PDF]

				A. Mazzone, I. Mazzucchelli, M. Vezzoli, E. Ottini, C. Auguadro, A. Serio, and C. Falcone Increased expression of peripheral benzodiazepine receptors on leukocytes in silent myocardial ischemia J. Am. Coll. Cardiol., September 1, 2000; 36(3): 746 - 750. [Abstract] [Full Text] [PDF]

				X. Garcia-Moll, F. Coccolo, D. Cole, and J. C. Kaski Serum neopterin and complex stenosis morphology in patients with unstable angina J. Am. Coll. Cardiol., March 15, 2000; 35(4): 956 - 962. [Abstract] [Full Text] [PDF]

				X Garcia-Moll, D Cole, E Zouridakis, and J C Kaski Increased serum neopterin: a marker of coronary artery disease activity in women Heart, March 1, 2000; 83(3): 346 - 350. [Abstract] [Full Text]

				V. Pasceri and E. T. H. Yeh A Tale of Two Diseases : Atherosclerosis and Rheumatoid Arthritis Circulation, November 23, 1999; 100(21): 2124 - 2126. [Full Text] [PDF]

				K. Miwa, A. Igawa, K. Nakagawa, T. Hirai, and H. Inoue Consumption of vitamin E in coronary circulation in patients with variant angina Cardiovasc Res, January 1, 1999; 41(1): 291 - 298. [Abstract] [Full Text] [PDF]

				G. Caligiuri, G. Liuzzo, L. M. Biasucci, and A. Maseri Immune system activation follows inflammation in unstable angina: pathogenetic implications J. Am. Coll. Cardiol., November 1, 1998; 32(5): 1295 - 1304. [Abstract] [Full Text] [PDF]