Inflammation and acute coronary syndromes
L M Biasucci1, G Liuzzo, D J Angiolillo
1Institute of Cardiology, Catholic University, Rome, Italy. biasucci@pelagus.it
Herz
|June 1, 2000
Summary
Inflammation plays a key role in unstable coronary artery disease. Activated immune cells and inflammatory markers like C-reactive protein indicate ongoing inflammation, potentially leading to plaque rupture and acute coronary syndromes.
Area of Science:
- Cardiovascular Medicine
- Immunology
- Pathophysiology
Background:
- Unstable coronary plaques show inflammatory infiltrates, suggesting inflammation's role in acute coronary syndromes.
- Macrophages and T-lymphocytes are present at rupture/erosion sites in unstable angina, with activated inflammatory cells indicating ongoing inflammation.
Purpose of the Study:
- To investigate the role of inflammation in the pathogenesis of unstable coronary syndromes.
- To explore the association between inflammatory markers and coronary events.
Main Methods:
- Analysis of inflammatory cell presence and activation in coronary plaques.
- Clinical studies assessing circulating inflammatory cells and pro-inflammatory cytokines (e.g., IL-1, IL-6).
- Measurement of acute phase reactants, specifically C-reactive protein.
Main Results:
- Activated macrophages and T-lymphocytes are found at sites of plaque rupture or erosion in unstable angina.
- Elevated levels of circulating neutrophils, lymphocytes, monocytes, IL-1, IL-6, and C-reactive protein are observed in patients with unstable angina and myocardial infarction.
- High C-reactive protein levels correlate with increased risk of in-hospital and long-term coronary events, death, and myocardial infarction.
Conclusions:
- Inflammation is a significant factor in the pathogenesis of unstable coronary syndromes.
- Inflammation may lead to endothelial activation and plaque instability, causing myocardial infarction.
- Further research into the causes and localization of inflammation could offer new therapeutic approaches for acute coronary syndromes.
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