Objective: To assess the relation between markers of inflammation and the pres ence of multiple vulnerable plaques in patients with non ST segment elevation a cute coronary syndromes. Design: Prospective cohort study ...Objective: To assess the relation between markers of inflammation and the pres ence of multiple vulnerable plaques in patients with non ST segment elevation a cute coronary syndromes. Design: Prospective cohort study of 55 patients with no n ST segment elevation acute coronary syndromes and angiographically documented coronary disease. Blood samples were obtained at study entry for the assessment of high sensitivity C reactive protein(CRP), n eopterin, and neutrophil count. Coronary stenoses were assessed by quantitative computerised angiography and classified as “complex”(irregular borders, ulcera tion, or filling defects) or “smooth”(absence of complex features). Extent of disease was also assessed by a validated angiographic score. Results: Neutrophil count (r=0.36, p=0.007), CRP concentration(r=0.33, p=0.02), and neopterin conce ntration(r=0.45, p< 0.001) correlated with the number of complex stenoses. Patie nts with multiple (three or more) complex stenoses, but not patients with multi ple smooth lesions, had a higher neutrophil count (5.9(1.4)×109/l v 4.8(1.4)×1 09/l, p=0.02), CRP concentration (log transformed) (1.08(0.63) v 0.6(0.6), p=0.0 3), and neopterin concentration(log transformed) (0.94(0.18) v 0.79(0.15), p=0.0 02). Multiple regression analysis showed that neopterin concentration (B=4.8, 95 %confidence interval(CI) 1.9 to 7.7, p=0.002) and extent of coronary artery dis ease(B=0.6, 95%CI 0.03 to 1.2, p=0.04) were independently associated with the n umber of complex stenoses. Conclusions: Acute inflammatory markers such as high neutrophil count, CRP concentration, and neopterin concentration correlate with the presence of multiple angiographically complex coronary stenoses. Neopterin c oncentration was a stronger predictor of multiple complex plaques than were neut rophil count and CRP concentration. These findings suggest that a relation exist s between inflammation and pancoronary plaque vulnerability.展开更多
文摘Objective: To assess the relation between markers of inflammation and the pres ence of multiple vulnerable plaques in patients with non ST segment elevation a cute coronary syndromes. Design: Prospective cohort study of 55 patients with no n ST segment elevation acute coronary syndromes and angiographically documented coronary disease. Blood samples were obtained at study entry for the assessment of high sensitivity C reactive protein(CRP), n eopterin, and neutrophil count. Coronary stenoses were assessed by quantitative computerised angiography and classified as “complex”(irregular borders, ulcera tion, or filling defects) or “smooth”(absence of complex features). Extent of disease was also assessed by a validated angiographic score. Results: Neutrophil count (r=0.36, p=0.007), CRP concentration(r=0.33, p=0.02), and neopterin conce ntration(r=0.45, p< 0.001) correlated with the number of complex stenoses. Patie nts with multiple (three or more) complex stenoses, but not patients with multi ple smooth lesions, had a higher neutrophil count (5.9(1.4)×109/l v 4.8(1.4)×1 09/l, p=0.02), CRP concentration (log transformed) (1.08(0.63) v 0.6(0.6), p=0.0 3), and neopterin concentration(log transformed) (0.94(0.18) v 0.79(0.15), p=0.0 02). Multiple regression analysis showed that neopterin concentration (B=4.8, 95 %confidence interval(CI) 1.9 to 7.7, p=0.002) and extent of coronary artery dis ease(B=0.6, 95%CI 0.03 to 1.2, p=0.04) were independently associated with the n umber of complex stenoses. Conclusions: Acute inflammatory markers such as high neutrophil count, CRP concentration, and neopterin concentration correlate with the presence of multiple angiographically complex coronary stenoses. Neopterin c oncentration was a stronger predictor of multiple complex plaques than were neut rophil count and CRP concentration. These findings suggest that a relation exist s between inflammation and pancoronary plaque vulnerability.
