Increase of scavenger receptor A-positive monocytes in patients with acute coronary syndromes

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Iwao Emura1, Hiroyuki Usuda, Toshio Fujita

  • 1Department of Surgical Pathology, Nagaoka Red Cross Hospital, Nagaoka, Japan. emura@nagaoka.jrc.or.jp

Pathology International
|July 6, 2007
PubMed

Insights

The scavenger receptor A (SRA) index, a measure of SRA(+) monocytes in blood, can indicate disrupted plaque in patients with acute myocardial infarction and angina. An elevated SRA index suggests plaque instability.

Area of Science:

  • Cardiovascular Medicine
  • Hematology
  • Immunology

Background:

  • Scavenger Receptor A (SRA) positive monocytes are implicated in atherosclerotic plaque development.
  • The SRA index, derived from peripheral blood smears, is proposed as a marker for plaque vulnerability.

Purpose of the Study:

  • To assess the diagnostic utility of the SRA index for identifying disrupted, fissured, or eroded coronary plaque.
  • To correlate SRA index levels with acute myocardial infarction (AMI), unstable angina (UA), and stable angina (SA) patient cohorts.

Main Methods:

  • Peripheral blood smears were analyzed to quantify SRA(+) monocytes, establishing the SRA index (normal upper limit <30).
  • The SRA index was evaluated in 225 AMI, 79 UA, and 91 SA patients.
  • Thrombus analysis was performed in a subset of AMI patients.

Main Results:

  • A high SRA index (≥30) was observed in 82.4% of AMI, 75.9% of UA, and 70.3% of SA patients.
  • Residual mural thrombus (RMT) was found in 33.1% of AMI patients with an SRA index ≥30.
  • In AMI patients with an initial SRA index <30, levels increased above 30 within 2 days of hospitalization.

Conclusions:

  • The SRA index serves as a valuable indicator of disrupted, fissured, or eroded atherosclerotic plaque.
  • Elevated SRA(+) monocyte counts in peripheral blood are associated with acute coronary syndromes.
  • The SRA index may aid in risk stratification and management of patients with coronary artery disease.

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