Abstract 16212: Premature Atherosclerosis in Premenopausal Women: Does Cytokine Balance Play a Role?
Background: Contributory risk factors to premature coronary atherosclerosis in premenopausal women are poorly understood. Mechanistic insights from animal work suggest that cytokine balance is related to endothelial integrity and mediated by circulating progenitor cells. Specifically, serologic TH1-type (pro-inflammatory) and hematopoietic/regulatory (HR) cytokines and their counteraction by TH2-type (anti-inflammatory) are related to degree of atherosclerosis. We hypothesized that TH-1/TH-2 and HR cytokine balance is related to premature coronary atherosclerosis in premenopausal women. Objective: To compare the levels of TH-1 -, TH-2 and HR cytokines in premenopausal women with and without obstructive CAD.
Methods: Twenty-four women (mean age 44 ± 5 years) having undergone clinically-indicated invasive coronary angiography were enrolled. Premenopausal status was determined using our published algorithm based on hormone levels and cycling history. A core angiography laboratory evaluated the presence of obstructive CAD (defined as >50% stenosis) using our published methods. Group comparisons between CAD vs. no CAD women were made using nonparametric Kruskal-Wallis.
Results: A Rose-of-Wind diagram (figure) suggests that premenopausal women with obstructive CAD (n=7) had lower TH-1 cytokines and similar TH-2 and HR cytokines than premenopausal women without obstructive CAD (n=17). Among the five TH-1/TH-2 ratios available for comparison, 3/5 ratios were lower in CAD vs. no CAD women (IL8/MCP, P=0.003, ENA/MCP, P=0.007, RANTES/MCP, p=0.028).
Conclusions: These exploratory results suggest that premenopausal women with premature obstructive CAD demonstrate cytokine profiles characterized by lower TH-1/TH-2 cytokine ratios.These results suggest that despite relatively low inflammation, cytokine balance may play a role in CAD in young women. More work in larger sample sizes is needed.
- © 2011 by American Heart Association, Inc.