TY - JOUR
T1 - Patients with a history of stable or unstable coronary heart disease have different acute phase responses to an inflammatory stimulus
AU - Werba, José Pablo
AU - Veglia, Fabrizio
AU - Amato, Mauro
AU - Baldassarre, Damiano
AU - Massironi, Paola
AU - Meroni, Pier Luigi
AU - Riboldi, Piersandro
AU - Tremoli, Elena
AU - Camera, Marina
PY - 2008/2
Y1 - 2008/2
N2 - Increased levels of acute phase proteins (APP) in serum are associated with vulnerability of atherosclerotic plaques and acute manifestations of coronary heart disease (CHD). APP have been viewed as indexes of active vascular inflammation or as mediators of atherothrombosis. In the present study we tested the hypothesis that individuals who develop stable or unstable forms of CHD might have different innate responses to an inflammatory stimulus. We compared changes in plasma C-reactive protein (CRP) and serum amyloid A (SAA) concentrations 48 h after a standardized inflammatory stimulus (adjuvanted influenza vaccination) in patients with quiescent CHD that had been manifested at onset as inducible myocardial ischemia (Group 1, n = 26) or as acute coronary syndromes (ACS) (Group 2, n = 34). Selected patients were free from inflammatory or other conditions that might affect the immune response. CRP concentration increased significantly after vaccination in both groups (Group 1: 0.47 [0.21-0.86] to 0.56 [0.32-1.17] mg/L, p = 0.005; Group 2: 0.64 [0.21-1.09] to 0.75 [0.33-1.48] mg/L, p = 0.003), without significant differences between groups in absolute or percentage changes. By contrast, SAA did not change after vaccination in Group 1 (14.4 [8.9-19.5] to 14.8 [10.3-18.8] mg/L, p = 0.88) but increased significantly in Group 2 (16.9 [10.0-21.5] to 19.2 [11.3-29.1] mg/L, p = 0.002), with significant differences between the groups in absolute and percentage terms (p = 0.015 and 0.019, respectively). Changes in CRP and SAA, both absolute and percentage, were significantly correlated in Group 2 (r = 0.60 and 0.66, both p <0.001). The responsiveness of plasma SAA to an inflammatory stimulus in Group 2 alone suggests a pro-inflammatory status in patients prone to acute coronary syndrome but not in those with inducible myocardial ischemia.
AB - Increased levels of acute phase proteins (APP) in serum are associated with vulnerability of atherosclerotic plaques and acute manifestations of coronary heart disease (CHD). APP have been viewed as indexes of active vascular inflammation or as mediators of atherothrombosis. In the present study we tested the hypothesis that individuals who develop stable or unstable forms of CHD might have different innate responses to an inflammatory stimulus. We compared changes in plasma C-reactive protein (CRP) and serum amyloid A (SAA) concentrations 48 h after a standardized inflammatory stimulus (adjuvanted influenza vaccination) in patients with quiescent CHD that had been manifested at onset as inducible myocardial ischemia (Group 1, n = 26) or as acute coronary syndromes (ACS) (Group 2, n = 34). Selected patients were free from inflammatory or other conditions that might affect the immune response. CRP concentration increased significantly after vaccination in both groups (Group 1: 0.47 [0.21-0.86] to 0.56 [0.32-1.17] mg/L, p = 0.005; Group 2: 0.64 [0.21-1.09] to 0.75 [0.33-1.48] mg/L, p = 0.003), without significant differences between groups in absolute or percentage changes. By contrast, SAA did not change after vaccination in Group 1 (14.4 [8.9-19.5] to 14.8 [10.3-18.8] mg/L, p = 0.88) but increased significantly in Group 2 (16.9 [10.0-21.5] to 19.2 [11.3-29.1] mg/L, p = 0.002), with significant differences between the groups in absolute and percentage terms (p = 0.015 and 0.019, respectively). Changes in CRP and SAA, both absolute and percentage, were significantly correlated in Group 2 (r = 0.60 and 0.66, both p <0.001). The responsiveness of plasma SAA to an inflammatory stimulus in Group 2 alone suggests a pro-inflammatory status in patients prone to acute coronary syndrome but not in those with inducible myocardial ischemia.
KW - Acute coronary syndrome
KW - C-reactive protein
KW - Coronary heart disease
KW - Inflammation
KW - Serum amyloid A
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U2 - 10.1016/j.atherosclerosis.2007.01.033
DO - 10.1016/j.atherosclerosis.2007.01.033
M3 - Article
C2 - 17335831
AN - SCOPUS:38349137383
VL - 196
SP - 835
EP - 840
JO - Atherosclerosis
JF - Atherosclerosis
SN - 0021-9150
IS - 2
ER -