This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Wilbert-Lampen, U. Articles by Steinbeck, G. Search for Related Content PubMed PubMed Citation Articles by Wilbert-Lampen, U. Articles by Steinbeck, G. Related Collections Related Articles

CLINICAL RESEARCH: CORONARY ARTERY DISEASE

Modified Serum Profiles of Inflammatory and Vasoconstrictive Factors in Patients With Emotional Stress-Induced Acute Coronary Syndrome During World Cup Soccer 2006

Ute Wilbert-Lampen, MD^_*,_*, Thomas Nickel, MD^_*, David Leistner, MD^_*, Denise Güthlin, MS, Tomas Matis, MD^_*, Christoph Völker, MD^_*, Sebastian Sper, MD^_*, Helmut Küchenhoff, PhD, Stefan Kääb, PhD^_* and Gerhard Steinbeck, PhD^_*

^_* Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität München, Munich, Germany
Statistisches Beratungslabor, Institut für Statistik, Ludwig-Maximilians-Universität München, Munich, Germany

Manuscript received March 24, 2009; revised manuscript received June 26, 2009, accepted July 14, 2009.

^_* Reprint requests and correspondence: Dr. Ute Wilbert-Lampen, Medizinische Klinik und Poliklinik I, Campus Grosshadern, Marchioninistrasse 15, Munich DE-81377, Germany (Email: ute.wilbert-lampen{at}med.uni-muenchen.de).

Objectives: We sought to assess whether emotional stress-induced acute coronary syndrome (ACS) is mediated by increased inflammatory and vasoconstrictive mediators.

Background: The World Cup soccer 2006 has been shown to provoke levels of stress sufficient to increase the incidence of ACS. However, the mechanisms by which stress translates into vascular injury up to plaque rupture still remain elusive.

Methods: Serum levels of soluble CD40L (sCD40L), soluble vascular cell adhesion molecule (sVCAM)-1, monocyte chemoattractant protein (MCP)-1, tumor necrosis factor (TNF)-, high-sensitivity C-reactive protein (hsCRP), regulated on activation, normal T-cell expressed and secreted (RANTES), and endothelin (ET)-1 were determined in patients who experienced an ACS during World Cup matches, in ACS reference patients (not associated with emotional stress), and in healthy volunteers. Correlations and receiver-operating characteristic curves were calculated to develop multivariable analysis and to investigate the diagnostic value of each parameter.

Results: The sCD40L, sVCAM-1, MCP-1, TNF-, and ET-1 were significantly higher in study patients compared with the reference group. The hsCRP was similar in both groups, whereas RANTES was decreased in study patients. A positive correlation was found between ET-1 and soccer-induced enhanced levels of sCD40L, sVCAM-1, MCP-1, and TNF-. Receiver-operating characteristic analysis displayed high performance of both MCP-1 and ET-1 as a measure to discriminate between stress-induced ACS and ACS controls.

Conclusions: Stress-induced ACS is associated with a profound increase of inflammatory and vasoconstrictive mediators. The evaluation of a targeted drug delivery, such as anti-inflammatory agents, ET-1 receptor antagonists, or inhibition of endothelin-converting enzyme is warranted to reduce stress-mediated cardiovascular morbidity.

Key Words: emotional stress • atherosclerosis • inflammation • endothelin-1

Abbreviations and Acronyms   ACS = acute coronary syndrome   ELISA = enzyme-linked immunosorbent assay   ET = endothelin   hsCRP = high-sensitivity C-reactive protein   MCP = monocyte chemoattractant protein   RANTES = regulated on activation, normal T-cell expressed and secreted   ROC = receiver-operating characteristic   sCD40L = soluble CD40L   sVCAM = soluble vascular cell adhesion molecule   TNF = tumor necrosis factor

Related Articles

Endothelin-1 Release and Stimulation of the Inflammatory Cascade: Is Acute Coronary Syndrome Triggered by Watching Spectator Sports?

Karina W. Davidson, Matthew Burg, and Daichi Shimbo
J. Am. Coll. Cardiol. 2010 55: 643-644. [Full Text] [PDF]

This article has been cited by other articles:

				V. Culic Football matches and acute cardiac events: potential effects of a complex psychosocial phenomenon on cardiovascular health Int. J. Epidemiol., October 1, 2011; 40(5): 1422 - 1425. [Full Text] [PDF]

				G. R. Guthjonsdottir, M. Kristjansson, O. Olafsson, D. O. Arnar, L. Getz, J. A. Sigurthsson, S. Guthmundsson, and U. Valdimarsdottir Immediate surge in female visits to the cardiac emergency department following the economic collapse in Iceland: an observational study Emerg. Med. J., September 22, 2011; (2011) emermed-2011-200518v1. [Abstract] [Full Text]

				R. P. Giugliano and E. Braunwald The Year in Non-ST-Segment Elevation Acute Coronary Syndrome J. Am. Coll. Cardiol., December 14, 2010; 56(25): 2126 - 2138. [Full Text] [PDF]

				K. W. Davidson, M. Burg, and D. Shimbo Endothelin-1 Release and Stimulation of the Inflammatory Cascade: Is Acute Coronary Syndrome Triggered by Watching Spectator Sports? J. Am. Coll. Cardiol., February 16, 2010; 55(7): 643 - 644. [Full Text] [PDF]