Clinical investigationDiagnostic coronary angiography induces a systemic inflammatory response in patients with stable angina
Section snippets
Patients
We prospectively studied patients with chronic stable angina who were referred to our institute for coronary angiography. Exclusion criteria included: 1) known inflammatory, neoplastic, or infectious disease; 2) treatment with steroids, immunosuppressive drugs, or non-steroidal anti-inflammatory drugs, with the exception of low-dose aspirin; 3) myocardial infarction or unstable angina pectoris within the previous month; 4) coronary angiography with or without PCI within the previous month; and
Results
A total of 34 patients with chronic stable angina who were admitted for elective cardiac catheterization were enrolled. In 21 patients (62%), the diagnostic angiography was immediately followed by an interventional procedure. In the PCI group, 8 patients were excluded from subsequent analysis because of IIb/IIIa inhibitors use (n = 6), postprocedural CK-MB and troponin T level elevations (n = 1), and groin hematoma (n = 1). The baseline clinical characteristics of the remaining 26 patients are
Discussion
This study shows that uncomplicated coronary angiography is sufficient to induce a substantial systemic inflammatory response, as evidenced by the elevation of plasma CRP levels and its chief stimulator, interleukin-6. Furthermore, the magnitude of the inflammatory response after diagnostic coronary angiography appears to be close to that induced by PCI. To the best of our knowledge, this study is the first to provide evidence that diagnostic coronary angiography, without any coronary artery
Conclusion
Uncomplicated diagnostic coronary angiography triggers a systemic inflammatory response in patients with stable angina. The magnitude of the inflammatory response after coronary angiography is close to that induced by PCI, suggesting that the inflammatory response to PCI is primarily caused by the diagnostic, rather than the interventional, procedure. The contribution of coronary angiography should be considered in interpreting the significance of the systemic inflammatory response observed
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