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Increased leukocyte activity as a predictor for flow-limiting coronary lesions in patients with angina pectoris

S Takeshita1, H Hashimoto, Y Ono

  • 1Department of Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi, Tokyo 173-8605, Japan. stake@blue.ocn.ne.jp

Atherosclerosis
|October 5, 2001
PubMed

Insights

Increased polymorphonuclear leukocyte (PMN) activity in peripheral blood may indicate significant coronary artery blockages in angina patients. Measuring PMN activity could help assess the need for angiography and interventions.

Area of Science:

  • Cardiology
  • Immunology
  • Biochemistry

Background:

  • Myocardial ischemia triggers an acute inflammatory response involving polymorphonuclear leukocytes (PMNs).
  • Coronary artery stenosis can lead to myocardial ischemia and associated inflammatory processes.

Purpose of the Study:

  • To determine if elevated peripheral blood PMN activity serves as a marker for high-grade coronary artery stenosis in patients experiencing angina pectoris.
  • To evaluate the diagnostic potential of PMN activity measurements for identifying flow-limiting coronary lesions.

Main Methods:

  • Assessed PMN activity in 45 angina patients by measuring luminol-dependent chemiluminescence (CL) response to phorbol myristate acetate (PMA).
  • Compared CL levels between patients with and without angiographic evidence of coronary artery filling delay, particularly in the left anterior descending (LAD) artery.

Main Results:

  • Patients with angiographic filling delay exhibited significantly higher PMN CL activity (1.6-fold increase) compared to those without.
  • A 1.7-fold higher CL response was observed in patients with LAD filling delay versus those without.
  • Using a CL cut-off of 400 counts/PMN, sensitivity and specificity for detecting LAD filling delay were 69% and 75%, respectively.

Conclusions:

  • Peripheral blood PMN activity is elevated in patients with flow-limiting coronary lesions indicated by angiographic filling delay.
  • Measuring PMN activity may aid in evaluating the necessity and timing of diagnostic angiography and invasive treatments for angina patients.

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