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[Activity of leukocyte elastase in coronary disease diagnosed by coronarography]
A Amaro Cendón1, J R González-Juanatey, F Gude Sampedro
1Servicio de Cardiología, Hospital Xeral de Galicia, Santiago de Compostela, La Coruña.
Insights
Leukocyte elastase concentration is a useful marker for diagnosing coronary artery disease. Higher levels indicate a greater risk of complex plaques, suggesting advanced disease.
Area of Science:
- Cardiology
- Biochemistry
- Medical Diagnostics
Background:
- Neutrophil-released elastase plays a role in coronary atherosclerotic disease pathogenesis.
- Understanding elastase's role can improve diagnostic approaches for cardiovascular conditions.
Purpose of the Study:
- To assess the clinical utility of leukocyte elastase concentration in diagnosing coronary artery disease (CAD).
- To determine if elastase levels correlate with the severity and complexity of atherosclerotic plaques.
Main Methods:
- Coronary angiography was performed on 95 patients with chest pain or heart valve disease.
- Patients were categorized into groups with normal coronary arteries or lesions, and further classified by plaque complexity.
- Leukocyte elastase concentrations were measured and analyzed alongside clinical factors.
Main Results:
- Elastase concentrations were significantly higher in patients with coronary lesions compared to those without (41 vs 27 µg/L).
- Patients with complex atheromatous plaques exhibited higher elastase levels than those with simple plaques (53 vs 33 µg/L).
- Elastase concentration, angina, age, and sex were independent predictors of CAD, with a 7% increased risk per 1 µg/L rise in elastase.
Conclusions:
- Peripheral blood leukocyte elastase concentration serves as a sensitive diagnostic marker for coronary artery disease.
- Elevated elastase levels are indicative of complex atheromatous plaques, suggesting a more severe disease state.
Objective:
To evaluate the clinical usefulness of leukocyte elastase concentration for diagnosis of coronary artery disease.
Background:
Recent research has shown the important role elastase, a proteolytic enzyme released by neutrophils, in the pathogenesis of coronary atherosclerotic disease.
Methods:
95 patients underwent coronary angiography during investigation of chest pain and/or heart valve disease; 38 had normal coronary arteriograms (Group I) and 57 had coronary lesions (Group II). The patients were characterized as regards presence or absence of stable or unstable angina, family history of coronary artery disease, smoking, diabetes mellitus, hypertension, leukocyte counts, plasma lipid and elastase concentrations. Among Group II patients, those with simple atheromatous plaques were distinguished from those with complex plaques.
Results:
Elastase concentrations were greater in the Group II than in the Group I (41 +/- 21 vs 27 +/- 14 micrograms/L) (p < 0.001), and greater among complex plaque patients than among simple plaque patients (53 +/- 27 vs 33 +/- 12 micrograms/L) (p < 0.001). Logistic regression analysis showed than elastase concentration, angina, age and sex had independent value for prediction of coronary artery disease and that the risk increased by 7% for every 1 microgram/L increase in elastase concentration. Among Group II patients, the risk of complex plaque was greatest for those with unstable angina and high elastase concentration, increasing by 6% for every 1 microgram/L increase in elastase concentration.
Conclusions:
Peripheral blood leukocyte elastase concentration is a sensitive diagnostic marker of coronary artery disease. High values suggest the presence of complex atheromatous plaques.