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Published on: January 28, 2020
Interplay Between Inflammation and Hemostasis in Patients with Coronary Artery Disease
Medha Rajappa1, Binita Goswami2, A Balasubramanian1
1Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006 India.
Insights
Inflammation and hemostasis markers like high sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor-alpha (TNF-α) are elevated in acute myocardial infarction (AMI) patients. These factors, along with homocysteine, show a synergistic role in coronary artery disease (CAD) development.
Area of Science:
- Cardiology
- Biochemistry
- Immunology
Background:
- Coronary artery disease (CAD) represents a significant global health challenge.
- Understanding the interplay of inflammation and hemostasis in CAD pathogenesis is crucial.
Purpose of the Study:
- To evaluate inflammatory and hemostatic markers in patients with acute myocardial infarction (AMI).
- To investigate the association between these markers and CAD.
Main Methods:
- Assayed inflammatory markers (IL-10, hs-CRP, TNF-α), fibrinogen, fibrin D-dimer, and homocysteine in 60 AMI patients and 60 controls.
- Utilized multivariate analysis to identify key determinants of CAD.
Main Results:
- Significantly higher levels of hs-CRP, TNF-α, IL-10, fibrinogen, fibrin D-dimer, and homocysteine were observed in AMI patients compared to controls.
- A positive correlation was found between fibrin D-dimer and inflammatory markers (hs-CRP, TNF-α).
- Tumor necrosis factor-alpha (TNF-α) was identified as the strongest determinant of CAD via multivariate analysis.
Conclusions:
- Inflammation and hemostasis markers are elevated in AMI patients, suggesting a link to CAD.
- A potential interplay and synergistic role of inflammation and hemostasis in the pathogenesis of CAD are indicated.
Abstract:
Coronary artery disease (CAD) is a global epidemic currently. This study was planned to evaluate markers of inflammation and hemostasis and their possible association, if any, in patients with CAD. The study was carried out in 60 patients with acute myocardial infarction (AMI) and 60 age and gender matched controls. The following parameters were assayed in all study subjects-inflammatory-interleukin (IL)-10, high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor (TNF)-α, fibrinogen; hemostatic-fibrinogen, fibrin D-dimer and a novel risk factor-homocysteine. Inflammatory markers (hs-CRP, TNF-α and IL-10), fibrinogen, fibrin D-dimer and homocysteine levels were significantly higher in the patients with AMI, as compared with controls. A positive correlation was observed between D-dimer and the inflammatory markers-hs-CRP and TNF-α. Upon multivariate analysis, TNF-α emerged as the best determinant of CAD in our study. Our results indicate that there is a possible interplay of inflammation and hemostasis in CAD, underlining their synergistic role in the pathogenesis of CAD.
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