Higher circulating levels of chemokines CXCL10, CCL20 and CCL22 in patients with ischemic heart disease.

Recruitment of leukocytes is one of the earliest events in the pathogenesis of ischemic heart disease (IHD) and chemokines play an important role in the migration of these cells into the inflammation sites. The aim of this study was to evaluate the CXCL10, CCL20 and CCL22 levels and the single nucleotide polymorphisms (SNPs) rs4508917, rs6749704 and rs4359426 in chemokine genes in patients with IHD to clarify any association. A total of 300 patients with IHD as having acute myocardial infarction (AMI; n=100), stable angina (SA; n=100) or unstable angina (UA; n=100) and 100 healthy subjects as a control group were enrolled to study. Serum samples from all participants were tested for the CXCL10, CCL20 and CCL22 levels by using ELISA. The SNPs were determined by polymerase chain reaction-restriction length polymorphism (PCR-RFLP) method. The mean serum concentrations of CXCL10, CCL20 and CCL22 in AMI patients (395.97±21.20Pg/mL, 108.38±10.31Pg/mL and 1852.58±205.77Pg/mL), SA patients (405.48±27.36Pg/mL, 90.20±7.69Pg/mL and 2322.04±231.23Pg/mL) and UA patients (396.69±22.79Pg/mL, 141.87±18.10Pg/mL and 2754.89±211.70Pg/mL) were significantly higher than in the healthy group (179.38±8.85Pg/mL, 51.92±4.62Pg/mL and 451.82±23.76Pg/mL, respectively; P<0.001). Similarly, the serum levels of CXCL10, CCL20 and CCL22 in total IHD patients (399.38±13.77Pg/mL, 113.49±7.48Pg/mL and 2309.84±126.39Pg/mL, respectively) were also significantly higher as compared with healthy subjects (P<0.001). The serum levels of CCL20 and CCL22 in UA patients were significantly higher than those in SA and AMI patients, respectively (P<0.01 and P<0.003, respectively). The serum levels of CXCL10 and CCL20 in diabetic patients were significantly higher in comparison to non-diabetic patients (P<0.05 and P<0.02, respectively). The serum levels of CCL22 in dyslipidemic- and obese patients were also significantly higher in comparison with non-dyslipidemic- and non-obese patients, correspondingly (P<0.05 and P<0.01, respectively). There were no significant differences between men and women or between patients who treated with statin, aspirin, ß-blockers or angiotensin converting enzyme (ACE) inhibitors and patients without mentioned treatment regarding the levels of chemokines. The frequency of the GG genotype at SNP rs4508917 in CXCL10 gene was higher, whereas the frequency of the AA genotype at SNP rs4359426 in CCL22 gene was lower in total patients with IHD as compared with healthy subjects (P<0.04 and P<0.002, respectively). These results showed that the higher levels of CXCL10, CCL20 and CCL22 were associated with IHD. The serum levels of chemokines may influence by the certain traditional risk factors of IHD and some studied SNPs, but did not influence by treatment and gender of patients.

The role of high-sensitivity C-reactive protein for assessing coronary artery disease severity and left ventricular end diastolic pressure in patients with suspected coronary artery disease.

OBJECTIVE: Much attention has recently been focused on the underlying role of circulating inflammatory biomarkers such as high-sensitivity C-reactive protein for predicting cardiovascular disease progression. We therefore set out to assess the relationship between the value of high-sensitivity C-reactive protein and (i) coronary artery disease severity, and (ii) left ventricular end diastolic pressure. DESIGN: A cross-sectional study. SETTING: The Shafa hospital in Kerman, Iran. PATIENTS: A total of 107 consecutive patients referred for coronary angiography from January 2008 to January 2009 were prospectively studied. INTERVENTION AND MAIN OUTCOME MEASURES: All patients underwent coronary angiography. They all had undergone left ventricular end diastolic pressure measurement, involving a 6-Fr pigtail catheter and a properly zeroed fluid-filled pressure transducer. For each patient, the level of high-sensitivity C-reactive protein was also determined using enzyme-linked immunosorbent assay kits. RESULTS: The high-sensitivity C-reactive protein levels could strongly predict increased left ventricular end diastolic pressure (standardised beta=1.010; P=0.008), with other patient variables being confounders, but there was no significant association between these levels and Gensini scores. Multiple linear regression analysis showed that among the study parameters, systolic hypertension (standardised beta=1.611; P=0.047) and a family history of coronary artery disease (standardised beta=1.911; P=0.005) were the main predictors of high Gensini scores in study patients. CONCLUSION: High-sensitivity C-reactive protein level is a clinical parameter that could predict left ventricular end diastolic pressure and left ventricular dysfunction, but was not associated with the severity of coronary artery disease.

Relationship between serum level of high-sensitive C-reactive protein and extension of myocardial involvement in patients with acute myocardial infarction.

INTRODUCTION: The high-sensitive C-reactive protein (HS-CRP) assay is being increasingly used as a marker for cardiac risk assessment and as a prognostic tool in heart disease. In current study, we assessed the relationship between serum level of HS-CRP and extension of myocardial involvement in acute myocardial infarction. METHODS: In a cross-sectional study, 50 patients with the final diagnosis of acute myocardial infarction and admitted for the first time in CCU wards of the Kerman University in 2010 were studied. Serum HS-CRP and Troponin I level was measured using commercial ELISA kits, 24 hours after the appearance of first manifestations. All patients underwent 2-dimensional echocardiography for assessing the number and severity of involved segments as well as wall motion abnormality. RESULTS: There was a strong positive correlation between the serum level of HS-CRP and serum Troponin I level (beta = 0.509, p < 0.001). Multivariable linear regression showed that the level of HS-CRP could strongly predict serum level of Troponin I within the first 24 hours of MI appearance (Beta = 0.308, Standard Error = 0.080, p < 0.001). But, no significant relationships were revealed between the mean serum HS-CRP level and the location of myocardial infarction, the number of involved segments, left ventricular ejection fraction, and ST-segment elevation score. CONCLUSION: For a strong correlation between HS-CRP and Troponin I, HS-CRP can be a useful biomarker for predicting extended myocardial involvement in patients with acute myocardial infarction.