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Alternative complement pathway activation during invasive coronary procedures in acute myocardial infarction and

Zsófia Horváth1, Dorottya Csuka2, Katarina Vargova3

  • 1Research Group for Inflammation Biology and Immunogenomics of Hungarian Academy of Sciences and Semmelweis University, Róbert Károly krt. 44, 1134 Budapest, Hungary; Hungarian Defence Forces Medical Centre, Department of Cardiology, Róbert Károly krt. 44, 1134 Budapest, Hungary.

Clinica Chimica Acta; International Journal of Clinical Chemistry
|November 6, 2016
PubMed

Insights

Percutaneous coronary procedures activate the alternative complement pathway, especially with contrast dye. In ST-elevation myocardial infarction, this pathway is already active before procedures.

Area of Science:

  • Cardiovascular Medicine
  • Immunology
  • Interventional Cardiology

Background:

  • The impact of percutaneous coronary procedures on complement activation remains unclear.
  • Complement system activation is implicated in inflammatory responses and tissue injury.

Purpose of the Study:

  • To investigate the effect of elective percutaneous coronary intervention (PCI) and diagnostic coronary angiography (CA) on complement activation.
  • To compare complement activation in stable angina patients undergoing elective PCI (SA-PCI) versus ST-segment elevation myocardial infarction patients undergoing primary PCI (STEMI-PCI).

Main Methods:

  • Measurement of complement activation products (C1rC1sC1inh, C3bBbP, SC5b-9) in SA-PCI (n=24), CA (n=52), and STEMI-PCI (n=23) patients.
  • Blood samples collected at baseline, 6 hours, and 24 hours post-procedure.
  • Correlation analysis between complement levels and clinical parameters (CK, creatinine, contrast volume).

Main Results:

  • Elective PCI and CA induced a significant, reversible increase in the alternative pathway product C3bBbP 6 hours post-procedure (p<0.01).
  • C3bBbP levels at 6 hours correlated with post-procedural CK, creatinine, and contrast volume.
  • STEMI-PCI patients exhibited higher baseline C3bBbP and SC5b-9 levels compared to SA-PCI and CA patients (p<0.001 and p=0.011, respectively).
  • Primary PCI in STEMI patients did not lead to further complement activation.

Conclusions:

  • Elective coronary procedures trigger transient alternative complement pathway activation, influenced by contrast material volume.
  • In STEMI, the alternative complement pathway is activated by the acute atherothrombotic event, with PCI having no additional detectable effect.

Keywords:
Alternative pathwayComplement systemCoronary artery diseasePercutaneous coronary intervention

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