on September 20, 2004
Published online before print September 20, 2004, doi: 10.1161/01.CIR.0000142664.18739.92
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Submitted on August 8, 2003
From the Coronary Artery Disease Research Unit, Department of Cardiological Sciences, St George’s Hospital Medical School, London, UK (E.Z., S.F., J.C.K.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (P.A.); and Hospital General Universitario, Guadalajara, Spain (R.A.-E.).
Background--Both endothelial cell activation and macrophage activation play a significant role in atherogenesis and atheromatous plaque vulnerability and may determine rapid coronary artery disease (CAD) progression. We sought to assess the association between serum inflammatory markers and rapid CAD progression in patients with chronic stable angina pectoris. Methods and Results--We studied 124 chronic stable angina pectoris patients (84 men; mean age, 61±10 years) who were on a waiting list for coronary angioplasty for a mean time of 4.8±2.4 months. CAD progression was defined as Conclusions--Rapid CAD progression in patients with stable angina pectoris is associated with increased C-reactive protein levels and raised concentrations of biochemical markers of endothelial and macrophage activation.
Revised on April 22, 2004
Accepted on May 21, 2004
Markers of Inflammation and Rapid Coronary Artery Disease Progression in Patients With Stable Angina Pectoris
Emmanouil Zouridakis MD,
10% diameter reduction of a pre-existing stenosis 50%, 30% diameter reduction of a stenosis <50%, development of a new stenosis 30% in a previously normal segment, or progression of any stenosis to total occlusion. CAD progression occurred in 35 patients (28%). After adjustment with binary logistic regression, neopterin (P<0.001), high-sensitivity C-reactive protein (P=0.017), matrix metalloproteinase-9 (P=0.002), soluble intercellular adhesion molecule 1 (P<0.001), and previous history of unstable angina (P=0.01) were independent predictors of rapid CAD progression. The association between rapid disease progression and inflammatory markers remained significant even when presence of complex lesions was introduced into the multivariate model.
Key words: C-reactive protein • cell adhesion molecules • coronary disease • inflammation • neopterin
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Circulation 2004 110: 1709.
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