Systemic and coronary levels of CRP, MPO, sCD40L and PlGF in patients with coronary artery disease

Abstract

BackgroundBiomarkers play a pivotal role in the diagnosis and management of patients with acute coronary syndrome. This study aimed to investigate the differences in level of several biomarkers, i.e. C-reactive protein, myeloperoxidase, soluble CD40 ligand and placental growth factor, between acute coronary syndrome and chronic stable angina patients. The relationship between these biomarkers in the coronary circulation and systemic circulation was also investigated.MethodsA total of 79 patients were recruited in this study. The coronary blood was sampled from occluded coronary artery, while the peripheral venous blood was withdrawn from antecubital fossa. The serum concentrations of C-reactive protein, soluble CD40 ligand and placental growth factor and plasma concentration of myeloperoxidase were measured using ELISA method.ResultsThe systemic level of the markers measured in the peripheral venous blood was significantly increased in acute coronary syndrome compared to chronic stable angina patients. The concentrations of the C-reactive protein, myeloperoxidase and soluble CD40 ligand taken from peripheral vein were closely similar to the concentration found in coronary blood of ACS patients. The level of placental growth factor was significantly higher in coronary circulation than its systemic level.ConclusionThe concentration of these C-reactive protein, myeloperoxidase, soluble CD40 ligand and placental growth factor were significantly increased in acute coronary syndrome patients. The concentration of the markers measured in the systemic circulation directly reflected those in the local coronary circulation. Thus, these markers have potential to become a useful tool in predicting plaque vulnerability in the future.

A multi-site coronary sampling study on CRP in non-STEMI: Novel insights into the inflammatory process in acute coronary syndromes

“…Based on these observations, it has been suggested that there is local vascular production in addition to systemic production. Interestingly, several other studies investigating trans-lesional gradients did not reproduce an increase of CRP across the culprit lesion and disputed the finding of local vascular production [9][10][11]. Our study, in which a trans-lesional CRP gradient could not be shown, corroborates with these findings.…”

“…Appreciating that CRP binds to injured cells and activates inflammation, an evident role for CRP was suggested in the aftermath of MI [7]. Several studies focused on coronary CRP levels, varying from trans-lesional assessments (proximal and distal to the culprit lesion) [8][9][10][11][12] to studies on transcardiac gradients, i.e. from the aorta to the coronary sinus (CS) [12][13][14][15][16][17].…”

“…Despite evidence of high CRP mRNA content in unstable plaques [13] and a trans-lesional increase of CRP in patients with unstable angina [12], other studies on trans-lesional concentrations generally reported no evidence of a gradient in acute coronary syndrome (ACS) [9][10][11]. The few studies on trans-cardiac gradients showed conflicting results and varied in study design and population [12][13][14][15][16][17].…”

Intraplaque Expression of C-Reactive Protein Predicts Cardiovascular Events in Patients with Severe Atherosclerotic Carotid Artery Stenosis

“…Devaraj and Jialal demonstrated a pivotal activity of CRP in polarizing human monocyte differentiation toward a proinflammatory M1 macrophage phenotype (via NF κ b and by binding to the Fc- γ receptors CD32 and CD64) and inhibiting M2 macrophages [36]. The pathophysiological relevance of intraplaque CRP was further supported by its positive association with clinical instability of CAD patients [18, 37]. Considering the heterogeneity of atherosclerotic plaques, the main novelty of our study was the demonstration that intraplaque CRP levels can differentially be associated with plaque vulnerability parameters, depending on where the plaque is positioned.…”

Correlation between plasma myeloperoxidase and hs-troponin I, C-reactive protein and CKMB in acute coronary syndrome

“…6 Fong et al in their study concluded that MPO levels in systemic circulation directly reflects those in coronary circulation and is a potential marker in predicting coronary artery diseases. 7 Hence, predominance of evidence supports an association between MPO level and CAD and dose-response relationship between MPO level and CAD severity. 8 Cardiac troponin levels are very sensitive and specific for myocardial damage regardless of underlying cause.…”