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Published on: January 28, 2020
Association between plasma thiols and immune activation marker neopterin in stable coronary heart disease
Katharina Schroecksnadel1, Roland B Walter, Guenter Weiss
1Department of General Internal Medicine, Innsbruck Medical University, Innsbruck, Austria.
Insights
Elevated total cysteine levels correlate with the severity of coronary artery sclerosis, while total homocysteine does not appear to be a direct marker in stable coronary artery disease patients. These thiol markers may be interdependent with inflammation.
Area of Science:
- Cardiovascular Medicine
- Biochemistry
- Immunology
Background:
- Elevated plasma homocysteine and cysteine are linked to atherosclerosis risk.
- The relationship between these thiols, inflammation, and sclerosis severity requires further investigation.
Purpose of the Study:
- To investigate the association between plasma thiol levels (homocysteine, cysteine) and systemic inflammatory markers (neopterin, CRP) in patients with coronary artery disease (CAD).
- To determine if thiol levels correlate with the extent of coronary artery sclerosis.
Main Methods:
- Measured total homocysteine, total cysteine, neopterin, and C-reactive protein (CRP) in 242 patients undergoing coronary angiography.
- Categorized patients into those with significant coronary artery disease (CAD) and controls without relevant stenoses.
Main Results:
- Total cysteine concentrations were significantly higher in patients with coronary artery sclerosis and increased with sclerosis severity (p < 0.001).
- Total homocysteine and inflammatory markers (CRP, neopterin) did not differ between groups.
- Total homocysteine correlated with total cysteine, neopterin, and serum creatinine, indicating kidney function dependence.
Conclusions:
- Total cysteine is a suitable marker for estimating the extent of coronary artery sclerosis.
- In stable CAD patients, total homocysteine was not elevated compared to controls.
- The interdependence of homocysteine, cysteine, and inflammatory markers suggests a complex interplay in CAD pathogenesis.
Background:
Studies have associated elevated plasma levels of the thiols homocysteine and cysteine with an increased risk of atherosclerosis. Their relationship with systemic inflammatory parameters and sclerosis scores was investigated in this study.
Methods:
Total homocysteine, total cysteine, neopterin and C-reactive protein (CRP) concentrations were measured in blood samples of 242 patients undergoing elective coronary angiography. A total of 181 patients had coronary artery disease (CAD), as defined by occlusion of > 75% of at least one of the three main coronary arteries, and 61 subjects did not have relevant coronary stenoses.
Results:
Total cysteine concentrations were higher in patients suffering from coronary artery sclerosis with stepwise increases relative to the extent of coronary artery sclerosis (p < 0.001). In contrast, neither total homocysteine nor the inflammatory markers, CRP and neopterin, differed between patients and controls. However, total homocysteine concentrations correlated with total cysteine (r = 0.468) and neopterin concentrations (r = 0.290), as well as serum creatinine (r = 0.226; all p < 0.001), the latter indicating a dependence of total homocysteine concentrations on kidney function. Total cysteine concentrations were associated with increased neopterin levels (r = 0.231, p < 0.001).
Conclusions:
Total cysteine concentrations were well suited to estimate the extent of coronary artery sclerosis, while in our study of stable CAD patients total homocysteine was not increased compared to controls. The association between homocysteine, cysteine and parameters of immune activation and inflammation in our study suggests that these markers of CAD may be interdependent.
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