Institute of Cardiology, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, 00168 Rome, Italy.
Atherosclerosis. 2010 Aug;211(2):606-11. doi: 10.1016/j.atherosclerosis.2010.02.038. Epub 2010 Mar 4.
Coronary atherosclerosis is a chronic inflammatory disease, but different inflammatory biomarkers may reflect different phases of atherosclerotic plaque evolution. We aimed at assessing the role of eosinophil cationic protein (ECP), a sensitive marker of eosinophil activation, and C-reactive protein (CRP) in coronary artery disease (CAD).
Consecutive anginal patients with angiographic evidence of CAD [stable angina (SA) or non-ST-elevation acute coronary syndrome (NSTE-ACS)], or with angiographically normal coronary arteries (NCA) were enrolled. The severity of CAD was graded according to Bogaty's score and coronary lesion morphology was defined as smooth or complex. Baseline ECP and high sensitivity CRP were measured in all patients. Of 198 patients (64 + or - 10 years, male 74%), 91 had SA, 57 had NSTE-ACS and 50 had NCA. ECP levels were significantly higher in SA [30 microg/L (13.8-46.9), p<0.001] and NSTE-ACS [21.8 microg/L (5.5-46.3), p=0.016] compared to NCA [9.7 microg/L (6.1-13.6)], without significant difference between SA and NSTE-ACS (p=0.45). CRP levels were significantly higher in NSTE-ACS [2.38 mg/L (1.11-11.94)] compared to SA [1.48 mg/L (0.82-2.83), p=0.03], and NCA [1.09 mg/L (0.8-2.1), p<0.001], without significant difference between SA and NCA (p=0.20). The addition of ECP to main cardiovascular risk factors improved the area under the curve from 0.88 to 0.92, p=0.007 for the angiographic diagnosis of CAD; further addition of CRP increased the area to 0.94, p=0.014. At multiple linear regression analysis ECP levels independently predicted CAD severity (p=0.001), whereas CRP levels independently predicted lesion complexity (p=0.01).
Our study shows that ECP is a marker of CAD and that different inflammatory biomarkers reflect different phases of atherosclerotic plaque evolution.
冠状动脉粥样硬化是一种慢性炎症性疾病，但不同的炎症生物标志物可能反映了动脉粥样斑块演变的不同阶段。我们旨在评估嗜酸性粒细胞阳离子蛋白（ECP），一种敏感的嗜酸性粒细胞激活标志物，以及 C 反应蛋白（CRP）在冠状动脉疾病（CAD）中的作用。
连续入选了有冠状动脉造影 CAD 证据的心绞痛患者[稳定型心绞痛（SA）或非 ST 段抬高急性冠脉综合征（NSTE-ACS）]，或有冠状动脉造影正常的患者（NCA）。根据 Bogaty 评分对 CAD 的严重程度进行分级，冠状动脉病变形态定义为光滑或复杂。所有患者均检测了基线 ECP 和高敏 CRP。在 198 名患者（64 ± 10 岁，男性 74%）中，91 名患有 SA，57 名患有 NSTE-ACS，50 名患有 NCA。SA [30 μg/L（13.8-46.9），p<0.001]和 NSTE-ACS [21.8 μg/L（5.5-46.3），p=0.016]中 ECP 水平明显高于 NCA [9.7 μg/L（6.1-13.6）]，但 SA 和 NSTE-ACS 之间无显著差异（p=0.45）。NSTE-ACS 中 CRP 水平[2.38 mg/L（1.11-11.94）]明显高于 SA [1.48 mg/L（0.82-2.83），p=0.03]和 NCA [1.09 mg/L（0.8-2.1），p<0.001]，但 SA 和 NCA 之间无显著差异（p=0.20）。将 ECP 与主要心血管危险因素相加，使 CAD 血管造影诊断的曲线下面积从 0.88 增加到 0.92，p=0.007；进一步增加 CRP，曲线下面积增加到 0.94，p=0.014。在多元线性回归分析中，ECP 水平独立预测 CAD 严重程度（p=0.001），而 CRP 水平独立预测病变复杂性（p=0.01）。
我们的研究表明，ECP 是 CAD 的标志物，不同的炎症生物标志物反映了动脉粥样斑块演变的不同阶段。
