Invasive Cardiology Unit, Centre of Cardiology, Medical Faculty, University of Szeged, Szeged, Hungary.
Department of Biochemistry, Medical Faculty, University of Szeged, Szeged, Hungary.
PLoS One. 2019 Apr 11;14(4):e0215209. doi: 10.1371/journal.pone.0215209. eCollection 2019.
The primary aim of this study was to examine whether markers of cell damage and of the psycho-neuroendocrino-inflammatory/immune (PNI) system could be associated in patients with stable coronary artery disease (CAD) on the next day following percutaneous coronary intervention (PCI).
Blood samples of 23 patients (18 men and five women, mean age 62.9 ± 10.6 years), were collected immediately before (pre-PCI), immediately after (post-PCI), and on the day following PCI (1d-PCI). Lactoferrin, LL-37 and interleukin-6 (IL-6) were assayed in plasma, in addition to cortisol and chromogranin A (CgA), as well as CK, ASAT and ALAT. Total and differential leukocyte counts were also analysed.
At all the three time points, the monocyte fractions, the monocyte-to-lymphocyte and the neutrophil-to-lymphocyte ratios and CgA levels were elevated. We detected significant peri-procedural changes in the plasma levels of our PNI markers: IL-6 (p<0.05), lactoferrin, LL-37 (both: p <0.0001), CgA, (p<0.05), and cortisol (p<0.01). On the first day after PCI, highly significant associations were found of ASAT with IL-6 and neutrophil count (both: r>0.75, p<0.0001), and of CgA with neutrophil count and monocyte count (both: r>0.79, p<0.0001); furthermore, cortisol was also associated with neutrophil count (r>0.7, p<0.0001).
The findings suggest that myocardial damage could correlate not only with an inflammatory reaction but, via neutrophil count, also with increased level of stress in stable CAD after PCI. Furthermore, 1d-PCI neutrophil count may serve as an easy-to-obtain integrative PNI measure in stable CAD.
本研究的主要目的是探讨在经皮冠状动脉介入治疗（PCI）后第二天稳定型冠状动脉疾病（CAD）患者中，细胞损伤标志物和心理神经内分泌炎症/免疫（PNI）系统标志物是否存在相关性。
采集 23 名患者（18 名男性，5 名女性，平均年龄 62.9±10.6 岁）的血液样本，分别在 PCI 前（PCI 前）、PCI 后即刻（PCI 后）和 PCI 后第 1 天（1d-PCI）采集。在血浆中检测乳铁蛋白、LL-37 和白细胞介素-6（IL-6），以及皮质醇和嗜铬粒蛋白 A（CgA），以及肌酸激酶（CK）、天门冬氨酸氨基转移酶（ASAT）和丙氨酸氨基转移酶（ALAT）。还分析了总白细胞和白细胞分类计数。
在所有三个时间点，单核细胞分数、单核细胞与淋巴细胞比值和中性粒细胞与淋巴细胞比值以及 CgA 水平均升高。我们检测到我们的 PNI 标志物血浆水平在围手术期发生显著变化：IL-6（p<0.05）、乳铁蛋白、LL-37（均：p<0.0001）、CgA（p<0.05）和皮质醇（p<0.01）。在 PCI 后第 1 天，ASAT 与 IL-6 和中性粒细胞计数（均：r>0.75，p<0.0001），CgA 与中性粒细胞计数和单核细胞计数（均：r>0.79，p<0.0001）高度相关；此外，皮质醇也与中性粒细胞计数相关（r>0.7，p<0.0001）。
这些发现表明，心肌损伤不仅与炎症反应相关，而且通过中性粒细胞计数，在 PCI 后稳定型 CAD 中还与应激水平升高相关。此外，稳定型 CAD 患者在 PCI 后第 1 天的中性粒细胞计数可作为一种易于获得的 PNI 综合指标。
