You are here

Article Text

Article menu

Download PDFPDF

XML
Cardiovascular medicine
Research
Influence of pre-existing inflammation on the outcome of acute coronary syndrome: a cross-sectional study
  1. Jacob Odeberg1,2,
  2. Michael Freitag3,
  3. Henrik Forssell4,
  4. Ivar Vaara5,
  5. Marie-Louise Persson5,
  6. Håkan Odeberg4,
  7. Anders Halling6,
  8. Lennart Råstam7,
  9. Ulf Lindblad8
  1. 1Department of Proteomics, KTH, Science for Life Laboratory Stockholm, Solna, Sweden
  2. 2Centre for Hematology, Karolinska University Hospital, Stockholm, Sweden
  3. 3Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
  4. 4Blekinge Centre of Competence, Karlskrona, Sweden
  5. 5Department of Laboratory Medicine, Blekinge County Hospital, Karlskrona, Sweden
  6. 6Research Unit of General Practice, University of Southern Denmark, Odense, Denmark
  7. 7Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
  8. 8Department of Community Medicine/Primary Health Care, University of Gothenburg, Göteborg, Sweden
  1. Correspondence to Dr Jacob Odeberg; jacob.odeberg{at}scilifelab.se

Abstract

Objectives Inflammation is a well-established risk factor for the development of coronary artery disease (CAD) and acute coronary syndrome (ACS). However, less is known about its influence on the outcome of ACS. The aim of this study was to determine if blood biomarkers of inflammation were associated specifically with acute myocardial infarction (MI) or unstable angina (UA) in patients with ACS.

Design Cross-sectional study.

Setting Patients admitted to the coronary care unit, via the emergency room, at a central county hospital over a 4-year period (1992–1996).

Participants In a substudy of Carlscrona Heart Attack Prognosis Study (CHAPS) of 5292 patients admitted to the coronary care unit, we identified 908 patients aged 30–74 years, who at discharge had received the diagnosis of either MI (527) or UA (381).

Main outcome measures MI or UA, based on the diagnosis set at discharge from hospital.

Results When adjusted for smoking, age, sex and duration of chest pain, concentrations of plasma biomarkers of inflammation (high-sensitivity C reactive protein>2 mg/L (OR=1.40 (1.00 to 1.96) and fibrinogen (p for trend=0.035)) analysed at admission were found to be associated with MI over UA, in an event of ACS. A strong significant association with MI over UA was found for blood cell markers of inflammation, that is, counts of neutrophils (p for trend<0.001), monocytes (p for trend<0.001) and thrombocytes (p for trend=0.021), while lymphocyte count showed no association. Interestingly, eosinophil count (p for trend=0.003) was found to be significantly lower in patients with MI compared to those with UA.

Conclusions Our results show that, in patients with ACS, the blood cell profile and degree of inflammation at admission was associated with the outcome. Furthermore, our data suggest that a pre-existing low-grade inflammation may dispose towards MI over UA.

  • acute coronary syndrome
  • Inflammation

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2015-009968

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text