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Plasma leukocyte elastase concentration in angiographically diagnosed coronary artery disease
A Amaro1, F Gude, R González-Juanatey
1Cardiology Department, Hospital General y Clínico de Galicia, School of Medicine, Santiago de Compostela, Spain.
Insights
Leukocyte elastase levels in blood are a useful indicator for diagnosing coronary artery disease (CAD). Higher concentrations are linked to more complex plaques in patients with CAD.
Area of Science:
- Cardiology
- Biochemistry
- Medical Diagnostics
Background:
- Neutrophil-released elastase plays a role in coronary artery disease (CAD) pathogenesis.
- Understanding elastase's role can improve CAD diagnosis.
Purpose of the Study:
- To assess the clinical utility of measuring leukocyte elastase for diagnosing CAD.
- To determine if elastase levels correlate with plaque complexity.
Main Methods:
- Coronary angiography was performed on 141 patients with chest pain.
- Patient data included clinical factors and plasma elastase concentrations.
- CAD patients were categorized by plaque complexity (simple vs. complex).
Main Results:
- Elastase concentrations were significantly higher in CAD patients (49.7 µg/L) versus non-CAD patients (29.5 µg/L).
- Complex plaque CAD patients had higher elastase levels (65.2 µg/L) than simple plaque patients (38.6 µg/L).
- Logistic regression indicated elastase concentration, angina, age, and sex predict CAD risk.
Conclusions:
- Peripheral blood leukocyte elastase is a sensitive marker for CAD diagnosis.
- Elevated elastase levels suggest the presence of complex atheromatous plaques.
Objective:
To evaluate the clinical usefulness of leukocyte elastase determination in the diagnosis of coronary artery disease (CAD).
Background:
Recent research has shown the important role of elastase, a proteolytic enzyme released by neutrophils, in the pathogenesis of CAD.
Methods:
141 patients underwent coronary angiography during investigation of chest pain and/or heart valve disease. Ninety-six had coronary lesions and 45 non-stenotic coronaries. The patients were characterized as regards presence or absence of angina (stable or unstable), family history of CAD, smoking, diabetes mellitus, hypertension, leukocyte counts, and plasma lipid and elastase concentrations. Among CAD-group patients, those with simple atheromatous plaques were distinguished from those with complex plaques.
Results:
Elastase concentrations were greater in the CAD group than in the non-CAD group (49.7 +/- 2.8 micrograms.l-1; as against 29.5 +/- 2.2 micrograms.l-1; P < 0.001), and greater among complex-plaque CAD patients than among simple-plaque CAD patients (65.2 +/- 5.3 micrograms.l-1 as against 38.6 +/- 1.9 micrograms.l-1; P < 0.001). Logistic regression analysis showed (a) that the risk of CAD varied with elastase concentration, angina status, age and sex, increasing by 11% for every 1 microgram.l-1 increase in elastase concentration; and (b) that among CAD patients the risk of complex plaques was greatest for those with unstable angina and high elastase concentration, increasing by 6% for every 1 microgram.l-1 increase in elastase concentration.
Conclusions:
Peripheral blood leukocyte elastase concentration is a sensitive diagnostic marker of CAD. High values suggest the presence of complex atheromatous plaques.