Differences in Inflammatory Activity at the Onset of Acute Myocardial Infarction According to the Clinical Presentation of Preinfarction Angina

Abstract

he pathogenetic mechanisms of acute myocardial infarction (AMI) remain incompletely understood, and although many studies have shown that an underlying inflammatory process plays an important role in the pathogenesis, 1-3 the inflammatory activity differs according to the clinical severity of angina pectoris (AP). 4 We therefore postulated that pathogenetic mechanisms leading to AMI might differ according to the clinical presentation of preinfarction angina and so we examined the relation between preinfarction angina, inflammatory activity, and the onset of AMI. Plasma levels of C-reactive protein (CRP), a sensitive marker of acute inflammation, were measured in patients experiencing their first AMI in whom the serum creatine kinase levels were normal on admission and increased subsequently. Methods Patient PopulationTwo hundred eighty patients (215 men, 65 women; mean age [±SD], 60±11 years; range, 30-87) with transmural AMI who fulfilled the following inclusion criteria were admitted to our coronary care unit between