The role of inflammation and mast cell activation has been implicated in atherosclerotic plaque destabilization and rupture. To investigate the role of immunoglobulin E (IgE) in acute coronary syndrome, a prospective clinical study was conducted in patients with acute myocardial infarction (AMI), unstable angina pectoris (UAP), stable angina pectoris (SAP), and healthy controls. IgE levels were serially measured and compared in consecutive patients with AMI (n = 16) and UAP (n = 14) on days 1, 3, 7, 21 after admission and 3 months later and only once in stable angina pectoris (n = 15) and healthy controls (n = 14). In addition, blood eosinophil and basophil levels on admission were measured in all groups and compared. Initial IgE levels determined at admission in patients with AMI, UAP, and SAP were significantly higher than levels in the control group (p = 0.002). Initial high IgE level in AMI on day 1 increased to a peak by day 7 (p = 0.024), then gradually decreased by day 21 and at 3 months (p = 0.052). High IgE level in UAP persisted by day 7 and gradually decreased by day 21 and 3 months (p = 0.037 and p = 0.018, respectively). Blood eosinophil count on admission was significantly higher in UAP than in the control group (p = 0.005). Basophil levels of both AMI and UAP groups on admission were found to be elevated as opposed to control group (p = 0.02 and p = 0.012, respectively). This study demonstrates that the level of IgE significantly increased during the acute phase of acute coronary syndromes and gradually decreased, supporting the role of acute inflammatory response and mast cell involvement in plaque rupture.
Behçet's disease (BD) is a chronic, multisystem disorder characterized by genital and oral aphthae, skin lesions, uveitis, and tendency to thrombosis. Pulse wave velocity (PWV) is an important factor in determining cardiovascular mortality and morbidity. It is an index of arterial wall stiffness and inversely related to the arterial distensibility. In this study we investigated the arterial distensibility in BD by PWV. We studied 14 patients with BD (18-44 years old, 10 men) and 28 healthy subjects (18-39 years old, 21 men) without known cardiovascular disease. Arterial distensibility was assessed by automatic carotid-femoral PWV measurement using the Complior Colson device. PWV is calculated from measurements of pulse transit time and the distance traveled by the pulse between two recording sites, according to the following formula: pulse wave velocity (m/s)=distance (m)/transit time(s). The mean ages, systolic blood pressure, diastolic blood pressure, pulse pressure, heart rate, and PWV of Behçet's disease and control subjects were 32.1+/-7.4 vs 27.9+/-6.1 years, 112.9+/-12.0 vs 108.7+/-10.0 mmHg, 72.1+/-10.7 vs 67.7+/-7.5 mmHg, 40.7+/-12.2 vs 41.0+/-10.7 mmHg, 74.1+/-10.2 vs 77.2+/-10.1 bpm, and 8.4+/-1.4 vs 8.5+/-1.1 m/s, respectively. Differences between all parameters studied were not found to be statistically significant (p>0.05). The carotid-femoral PWV, an index of arterial stiffness and a marker of atherosclerosis, is not increased in patients with BD compared with control subjects.
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