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Diagnostic coronary angiography induces a systemic inflammatory response in patients with stable angina

Alexander Goldberg1, Oren Zinder, Alexander Zdorovyak

  • 1Department of Cardiology, Rambam Medical Center and Rappaport Medical School, Haifa, Israel.

American Heart Journal
|November 5, 2003
PubMed

Insights

Diagnostic coronary angiography, not just percutaneous coronary intervention (PCI), triggers a systemic inflammatory response in stable angina patients. This inflammatory response from angiography should be considered when interpreting post-PCI marker changes.

Area of Science:

  • Cardiology
  • Immunology
  • Interventional Cardiology

Background:

  • Systemic inflammatory markers elevate post-percutaneous coronary intervention (PCI).
  • This rise is often attributed to the inflammatory stimulus from coronary artery injury during PCI.
  • The role of diagnostic coronary angiography alone in triggering inflammation is unclear.

Purpose of the Study:

  • To investigate whether diagnostic coronary angiography in stable angina patients induces a systemic inflammatory response.
  • To compare the inflammatory response between diagnostic coronary angiography and PCI.

Main Methods:

  • Prospective study of 26 stable angina patients (13 coronary angiography, 13 PCI).
  • Blood samples analyzed for C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) pre-procedure and at 24h, 48h, and 4 weeks post-procedure.
  • Exclusion of patients with periprocedural myocardial necrosis.

Main Results:

  • Both groups showed significant increases in CRP and IL-6 levels post-procedure, returning to baseline by 4 weeks.
  • TNF-alpha levels remained unchanged in both groups.
  • The magnitude of CRP and IL-6 elevation did not differ significantly between diagnostic coronary angiography and PCI groups.

Conclusions:

  • Uncomplicated diagnostic coronary angiography elicits a systemic inflammatory response in stable angina patients.
  • The inflammatory response from diagnostic coronary angiography contributes to the overall inflammation observed after PCI.
  • Angiography's inflammatory impact must be considered when interpreting post-PCI systemic markers.
Abstract

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