Comparison of serum levels of inflammatory markers in patients with coronary vasospasm without significant fixed coronary artery disease versus patients with stable angina pectoris and acute coronary syndromes with significant fixed coronary artery disease
Comparison of serum levels of inflammatory markers in patients with coronary vasospasm without significant fixed coronary artery disease versus patients with stable angina pectoris and acute coronary syndromes with significant fixed coronary artery disease
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DOI：
10.1016/j.amjcard.2005.12.035
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发表时间：
2006-05-15
影响因子：
2.8
通讯作者：
Li, Li-Fu
中科院分区：
文献类型：
--
作者：
Hung, Ming-Jui;Cherng, Wen-Jin;Li, Li-Fu
对189例因疑似缺血性心脏病而入院行冠状动脉造影的患者的血清样本进行基线炎症标志物（白细胞介素-6、单核细胞趋化蛋白-1、可溶性细胞间粘附分子-1、可溶性血管粘附分子-1和C反应蛋白）血清水平测定。中位随访时间为28个月。我们样本中的患者被纳入4个诊断组：无血流动力学显著性冠状动脉疾病（CAD），无冠状动脉血管痉挛（对照组，n = 32），血流动力学显著的CAD和稳定型心绞痛（SAP组，n = 34），无血流动力学显著CAD的冠状动脉痉挛性心绞痛血管痉挛组31例，急性冠状动脉综合征（ACS）及血流动力学显著性CAD组92例。总体而言，血清炎症标志物水平在ACS组中最高，在对照组中最低，在SAP和血管痉挛中观察到中间值。可溶性细胞间粘附分子-1（sICAM-1）水平在血管痉挛组最高。多变量分析显示，log（白细胞介素-6）与无血流动力学显著性CAD患者的冠状动脉痉挛性心绞痛诊断独立相关（比值比8.48，p = 0.027）。ACS组患者的生存率显著低于其他3组，但在该患者队列中没有独立的预测因子。SAP、血管痉挛和ACS组心绞痛复发率相似。复发性心绞痛的独立预测因素是不包括氯吡格雷的治疗（优势比3.88，p = 0.007）。总之，本研究的结果表明，炎症可以存在于冠状动脉血管痉挛没有血流动力学显着的CAD。(c)2006爱思唯尔公司All rights reserved.
Serum levels of inflammatory markers (interleukin-6, monocyte chemoattractant protein-1, soluble intercellular adhesion molecule-1, soluble vascular adhesion molecule-1, and C-reactive protein) were measured at baseline in serum samples from 189 patients who were admitted for coronary angiography because of suspected ischemic heart disease. Median duration of follow-up was 28 months. Patients in our sample were enrolled in 4 diagnostic groups: no hemodynamically significant coronary artery disease (CAD) and no coronary vasospasm (control group, n = 32), hemodynamically significant CAD and stable angina pectoris (SAP group, n = 34), coronary vasospastic angina pectoris without hemodynamically significant CAD (vasospasm group, n 31), and acute coronary syndrome (ACS) and hemodynamically significant CAD (ACS group, n = 92). Overall, the level of serum inflammatory markers was highest in the ACS group and lowest, in the control group, with intermediate values observed in the SAP and vasospasm. groups, with the exception of soluble intercellular adhesion molecule-1, the level of which was highest in the vasospasm group. Multivariate analysis showed that log (interleukin-6) was independently associated with a diagnosis of coronary vasospastic angina pectoris in patients without hemodynamically significant CAD (odds ratio 8.48, p = 0.027). Patients in the ACS group had a significantly lower survival rate compared with the other 3 groups but without an independent predictor that could be identified in this patient cohort. Recurrent angina pectoris occurred with similar rates in the SAP, vasospasm, and ACS groups. The independent predictor for recurrent angina pectoris was treatment that did not include clopidogrel (odds ratio 3.88, p = 0.007). In conclusion, the results of this study suggest that inflammation can exist in coronary vasospasm without hemodynamically significant CAD. (c) 2006 Elsevier Inc. All rights reserved.