This Article Abstract 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 Google Scholar Google Scholar Articles by Liuzzo, G. Articles by Maseri, A. Search for Related Content PubMed PubMed Citation Articles by Liuzzo, G. Articles by Maseri, A.

Enhanced inflammatory response in patients with preinfarction unstable angina

Giovanna Liuzzo, MD^* , Luigi M. Biasucci, MD, FACC^* , J. Ruth Gallimore, BSc^* , Giuseppina Caligiuri, MD^* , Antonino Buffon, MD^* , Antonio G. Rebuzzi, MD^* , Mark B. Pepys, MD^* and Attilio Maseri, MD, FACC^*

^* Department of Cardiology, Catholic University, Rome, Italy
Immunological Medicine Unit, Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, W12 ONN, United Kingdom

View larger version (14K): [in a new window]   Figure 1 Plasma CK values. Data are presented as mean and standard error. Unheralded MI (open circle) (Group 1), preinfarction UA (solid circle) (Group 2). Plasma CK values did not significantly differ in the 2 groups of patients. CK = creatine kinase; MI = myocardial infarction; UA = unstable angina.

View larger version (9K): [in a new window]   Figure 2 Plasma levels of CRP (Panel A) and SAA (Panel B) at the time of hospital admission. On admission, within 3 h from onset of prolonged chest pain, patients with preinfarction UA had significantly higher levels of CRP and SAA than patients with unheralded MI (all p < 0.001). CRP = C-reactive protein; MI = myocardial infarction; SAA = serum amyloid A protein; UA = unstable angina.

View larger version (13K): [in a new window]   Figure 3 Changes in serum levels of IL-6 in response to myocardial cell necrosis. Data are presented as medians. Unheralded MI (open box) (Group 1), preinfarction UA (solid box) (Group 2). In Group 1, IL-6 median levels showed a slight but not significant increase in response to myocardial cell necrosis. In Group 2, in contrast, the serum concentration of IL-6 significantly increased at 6 h, reaching the peak value at 24 h. IL-6 = interleukin-6.

View larger version (11K): [in a new window]   Figure 4 Changes in plasma levels of CRP (Panel A) and SAA (Panel B) in response to myocardial cell necrosis. Data are presented as medians. Unheralded MI (open box) (Group 1), preinfarction UA (solid box) (Group 2). Group 2 patients showed a striking higher acute phase response during the study period than Group 1 patients. C-reactive protein levels were significantly higher in Group 2 than in Group 1 at 6, 24 and 48 h and SAA levels at 6, 24, 48 and 72 h. Abbreviations as in Figure 2.

View larger version (11K): [in a new window]   Figure 5 Correlation between baseline and peak levels of CRP (Panel A) and SAA (Panel B) after myocardial cell necrosis. Unheralded MI (open circle) (Group 1), preinfarction UA (solid circle) (Group 2). In the overall population of 36 patients, there was a significant correlation between the baseline levels of CRP and SAA and the respective increases after MI (r = 0.55, 95% CI 0.27–0.75 and r = 0.65, 95% CI 0.40–0.82, respectively; all p < 0.001). CI = confidence interval. All other abbreviations as in Figure 2.