Saleh Nawsad, Svane Bertil, Jensen Jens, Hansson Lars-Olof, Nordin Margareta, Tornvall Per
Department of Cardiology, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden.
Am Heart J. 2005 May;149(5):876-82. doi: 10.1016/j.ahj.2004.07.039.
The systemic inflammatory response to percutaneous coronary intervention (PCI) is associated with recurrent cardiac events; however, the pathophysiology of this inflammatory response is not well understood. The present study was performed to investigate the role of pathogen burden of infection in determining the magnitude of C-reactive protein (CRP) and interleukin 6 (IL-6) response to PCI.
One hundred patients with stable angina pectoris undergoing elective PCI at a single center were recruited. Antibodies against cytomegalovirus, Chlamydia pneumoniae , Epstein-Barr virus, Helicobacter pylori , and herpes simplex virus types 1 and 2 were determined before PCI. Plasma CRP and IL-6 levels were measured before and 6, 24, 48, 72 hours after PCI and data presented as area under the curve.
Plasma CRP and IL-6 concentrations increased significantly after PCI. Neither antibodies against single nor multiple pathogens were associated with the CRP or IL-6 response to PCI. No correlations were found between the inflammatory markers and troponin T levels after PCI. With the exception for CRP and body mass index (R = 0.20, P < .05), neither risk factors for coronary heart disease nor medication but stent implantation was associated with increased plasma CRP (76 vs 61 mg/L, P < .005) and IL-6 (74 vs 64 pg/mL, P < .005) levels after PCI.
Stent implantation, but not pathogen burden, is associated with the plasma CRP and IL-6 response to PCI.
经皮冠状动脉介入治疗(PCI)引发的全身炎症反应与心脏事件复发相关;然而,这种炎症反应的病理生理学尚未完全明确。本研究旨在探讨感染病原体负荷在决定C反应蛋白(CRP)和白细胞介素6(IL-6)对PCI反应程度中的作用。
招募了100例在单一中心接受择期PCI的稳定型心绞痛患者。在PCI术前检测抗巨细胞病毒、肺炎衣原体、爱泼斯坦-巴尔病毒、幽门螺杆菌以及1型和2型单纯疱疹病毒的抗体。在PCI术前以及术后6、24、48、72小时测量血浆CRP和IL-6水平,并将数据表示为曲线下面积。
PCI术后血浆CRP和IL-6浓度显著升高。针对单一或多种病原体的抗体均与CRP或IL-6对PCI的反应无关。PCI术后炎症标志物与肌钙蛋白T水平之间未发现相关性。除CRP与体重指数相关外(R = 0.20,P <.05),冠心病危险因素、药物治疗均与PCI术后血浆CRP(76 vs 61 mg/L,P <.005)和IL-6(74 vs 64 pg/mL,P <.005)水平升高无关,只有支架植入与之相关。
与病原体负荷无关,支架植入与PCI术后血浆CRP和IL-6反应相关。