Association of platelet‐monocyte aggregates with platelet activation, systemic inflammation, and myocardial injury in patients with non‐st elevation acute coronary syndromes

Abstract

SummaryBackground: Platelet-monocyte aggregates (PMA) and C-reactive protein (CRP) are increased in unstable coronary disease. The interrelation of PMA with platelet activation, systemic inflammation, and their association with markers of myocardial injury has not been studied extensively.Hypothesis: The study was undertaken to evaluate the association of CRP, PMA, and cardiac troponin I (cTnI) in patients admitted with non-ST elevation acute coronary syndromes (NSTE-ACS).Methods: In all, 69 consecutive patients with NSTE-ACS, 58 patients with stable angina pectoris (SAP), and 46 control patients without coronary artery disease were selected; PMA, sP-selectin, sCD40L inter leukin, (IL)-6, CRP, and cTnI concentrations were measured in these patients at the time of admission. Patients with NSTE-ACS were classified into two groups: those with troponin normal (cTnI < 0.06 ng/ml) and those with troponin elevation (cTnI ≥ 0.06 ng/ml). Their risk for clinical inhospital cardiac events (death and nonfatal myocardial infarction) was analyzed.

Association of monocyte count on admission with angiographic no-reflow after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction

“…In previous studies, high monocyte count was shown to be significantly associated with cardiovascular prognosis including mortality in STEMI [11,12]. Increased circulating platelet-monocyte aggregates were observed in patients with acute coronary syndromes [13,14], which could induce expression and release of chemotactic factors, including monocyte-chemoattractant-protein-1 (MCP-1) and interleukin-8 (IL-8) from monocytes [15]. Besides activation of monocyte adhesion onto endothelial cells, MCP-1 induces the expression of tissue factor, superoxide anions, and exerts prothrombotic effects [16,17].…”

White blood cell count to mean platelet volume ratio as a novel non-invasive marker predicting long-term outcomes in patients with non-ST elevation acute coronary syndrome

“…Platelet-leukocyte complex assessed by flow cytometry has been found as a pathophysiologic mechanism for the development of thrombogenesis [6], and monocyte-platelet aggregation was also shown as an early marker for acute MI [28] and NSTE-ASC patients [30]. Rinder et al [5] showed that this cellular interaction is a dynamic process, in which platelet activation status and the ability of leukocytes to adhere result in different bindings.…”

Admission Levels of C-Reactive Protein and Plasminogen Activator Inhibitor-1 in Patients With Acute Myocardial Infarction With and Without Cardiogenic Shock or Heart Failure on Admission

“…Circulating CRP levels on admission have been shown to be elevated in AMI patients. 2,3) The increase in CRP levels in these patients has been mainly explained by the stimulating effects of myocardial damage and necrosis on systemic inflammatory response. 27) However, there are also studies suggesting that elevated CRP levels in AMI patients may result from inflammation caused by the plaque rupture.…”

“…1) It has been demonstrated in acute myocardial infarction (AMI) patients that admission levels of plasma C-reactive protein (CRP), which is a sensitive inflammatory marker, are elevated 2,3) and associated with short-and long-term outcomes, [2][3][4][5] including the occurrence of heart failure (HF) during the hospitalization period. 6) Moreover, inflammatory processes have also been suggested to play a role in the pathogenesis of cardiogenic shock (CS) complicating AMI.…”

“…However, there are also studies reporting that the diurnal rhythm of PAI-1 is abolished in AMI patients. 11,22) The aims of this study in patients in whom both plasma markers and LV functional status were determined on admission were to determine whether: (1) there is a significant alteration in diurnal rhythm of PAI-1 in AMI patients with different LV functional status, (2) there is an association between CRP and PAI-1 levels and the occurrence and severity of left ventricular dysfunction (LVD), (3) the values of these biomarkers would differ from the normative data in AMI patients without LVD, and (4) higher levels of these biomarkers are associated with in-hospital and 1-year mortality in AMI patients with CS.…”