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Acute phase reactants and complement activation in patients with acute myocardial infarction
T E Mollnes1, K E Tambs, Y Myreng
1Institute of Immunology and Rheumatology, National Hospital, Oslo, Norway.
Insights
Acute myocardial infarction (AMI) patients show elevated levels of C-reactive protein (CRP) and orosomucoid, but not systemic complement activation. This study found no link between CRP, complement activation, and infarct size in non-complicated AMI.
Area of Science:
- Biochemistry
- Immunology
- Cardiology
Background:
- Acute phase proteins like C-reactive protein (CRP) and complement components are often elevated in acute myocardial infarction (AMI).
- The relationship between systemic inflammation markers and complement activation in AMI requires further investigation.
Purpose of the Study:
- To quantify acute phase proteins and complement activation markers in patients with non-complicated AMI.
- To determine if elevated CRP and other acute phase reactants correlate with systemic complement activation or infarct size.
Main Methods:
- Quantified CRP, orosomucoid, alpha 1-antitrypsin, haptoglobin, C3, C4, C3 activation products, and SC5b-9 in 21 AMI patients and 22 controls.
- Samples were collected at admittance and on days 1, 2, 3, and 6 post-admittance.
Main Results:
- Peak and median concentrations of all quantified proteins were higher in the AMI group compared to controls.
- Significant differences were observed only for C-reactive protein (CRP) and orosomucoid.
- No correlation was found between CRP levels and complement activation, nor between complement activation and infarct size.
Conclusions:
- Elevated CRP and orosomucoid are present in non-complicated AMI but do not appear to be associated with systemic fluid-phase complement activation.
- Systemic complement activation, unlike local activation in infarcted myocardium, could not be demonstrated in this cohort of non-complicated AMI patients.
Abstract:
The acute phase proteins, C-reactive protein (CRP), orosomucoid, alpha 1-antitrypsin and haptoglobin, the native complement components C3 and C4, activation products of C3, and the terminal SC5b-9 complement complex were quantified in samples obtained on admittance and on days 1, 2, 3 and 6 in 21 patients with non-complicated acute myocardial infarction (AMI) and in 22 controls. For all proteins peak and median concentrations were higher in the AMI group than in the controls, but the difference was significant only for CRP and orosomucoid. Median CRP concentration was 46 mg/l in the AMI group and 2.5 in the control group. The corresponding orosomucoid concentrations were 1.6 and 1.2 g/l. There was no correlation between the concentration of CRP in peripheral blood and the degree of complement activation. Furthermore, no correlation was observed between complement activation and the size of infarction. The present study cannot demonstrate that the increased concentrations of CRP and other acute phase reactants observed in patients with AMI, are associated with systemic fluid-phase complement activation. Furthermore, the complement activation previously shown locally in infarcted myocardium cannot be demonstrated systemically in non-complicated AMI.