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CLINICAL STUDIES

Clinical significance of increased plasma concentration of macrophage colony–stimulating factor in patients with angina pectoris

^a First Department of Internal Medicine, Nippon Medical School, Tokyo, Japan

Manuscript received December 3, 1998; revised manuscript received September 21, 1999, accepted November 3, 1999.

Reprint requests and correspondence: Dr. Tsutomu Saitoh, First Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi Bunkyo-ku, Tokyo, 113-8603, Japan.

OBJECTIVES

To determine the effect of macrophage colony–stimulating factor (MCSF) on atherogenesis in patients with coronary artery disease (CAD), we assessed the relation between the plasma concentration of MCSF and the incidence of acute coronary events in patients with CAD.

BACKGROUND

Cytokines such as MCSF play a central role in inflammatory and proliferative responses in patients with acute coronary syndromes. However, the effect of MCSF on the clinical course in patients with CAD is still not known.

METHODS

We measured the plasma MCSF concentration in 142 patients with documented CAD (62 ± 9 years) and followed up for a mean period of 14 ± 6 months. The study included 97 patients with stable angina (SA), 45 patients with unstable angina (UA) and 22 age-matched control subjects. The predictors of coronary events were analyzed by using a Cox proportional hazards model.

RESULTS

The mean plasma MCSF concentration in patients with UA was significantly higher than that in patients with SA and in control subjects (981 ± 277 vs. 693 ± 223 vs. 680 ± 158 pg/ml, p < 0.001). The mean plasma MCSF concentration in the 20 patients with coronary events was significantly higher than that in patients without coronary events (1,192 ± 232 vs. 690 ± 213 pg/ml, p < 0.001). The predictors of unfavorable outcome were an increased MCSF concentration, the presence of CAD and a low ejection fraction.

CONCLUSIONS

These findings suggest that an increased circulating MCSF concentration reflects atherosclerotic progression in patients with CAD and predicts future cardiac events.

Abbreviations and Acronyms   CABG = coronary artery bypass graft surgery   CAD = coronary artery disease   HDL = high density lipoprotein   LDL = low density lipoprotein   LVEF = left ventricular ejection fraction   MCSF = macrophage colony–stimulating factor   PTCA = percutaneous transluminal coronary angioplasty   SA = stable angina   UA = unstable angina   VLDL = very low density lipoprotein

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