Patients with a history of stable or unstable coronary heart disease have different acute phase responses to an inflammatory stimulus

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)835-840
Number of pages6
JournalAtherosclerosis
Volume196
Issue number2
DOIs
Publication statusPublished - Feb 2008

Fingerprint

Serum Amyloid A Protein
Acute-Phase Reaction
Coronary Disease
C-Reactive Protein
Vaccination
Acute-Phase Proteins
Acute Coronary Syndrome
Myocardial Ischemia
Atherosclerotic Plaques
Human Influenza
Blood Vessels
Blood Proteins
Inflammation
Serum

Keywords

  • Acute coronary syndrome
  • C-reactive protein
  • Coronary heart disease
  • Inflammation
  • Serum amyloid A

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{5dbd709d51c5484486458108cf697c6e,
title = "Patients with a history of stable or unstable coronary heart disease have different acute phase responses to an inflammatory stimulus",
abstract = "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.",
keywords = "Acute coronary syndrome, C-reactive protein, Coronary heart disease, Inflammation, Serum amyloid A",
author = "Werba, {Jos{\'e} Pablo} and Fabrizio Veglia and Mauro Amato and Damiano Baldassarre and Paola Massironi and Meroni, {Pier Luigi} and Piersandro Riboldi and Elena Tremoli and Marina Camera",
year = "2008",
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language = "English",
volume = "196",
pages = "835--840",
journal = "Atherosclerosis",
issn = "0021-9150",
publisher = "Elsevier Ireland Ltd",
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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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DO - 10.1016/j.atherosclerosis.2007.01.033

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