Department of Molecular Medicine, University of Pavia, Pavia.
Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale (EOC).
J Cardiovasc Med (Hagerstown). 2024 Nov 1;25(11):759-765. doi: 10.2459/JCM.0000000000001668. Epub 2024 Sep 27.
Neutrophils activation plays a pivotal role in the pathogenesis of atherosclerotic plaque formation, progression and rupture. An association between the leukocyte count and the risk of developing myocardial infarction has been well known for many years; however, only recently did Mendelian randomization studies show that a high neutrophil count is a causal risk factor for atherosclerotic cardiovascular disease. On the other hand, experimental studies show that depletion of circulating neutrophils impairs plaque development. Clopidogrel, an antiplatelet agent, is widely used in combination with aspirin to reduce the incidence of ischemic events in patients treated with coronary stenting. Chronic treatment with this drug reduces inflammatory markers and neutrophil numbers, rarely causing severe leukopenia. The purpose of this review is to present recent evidence showing the link between neutrophil number and the development of cardiovascular diseases and to discuss how the clopidogrel-induced reduction in the neutrophil count may be a beneficial off-target effect of this drug.
中性粒细胞的激活在动脉粥样硬化斑块形成、进展和破裂的发病机制中起着关键作用。多年来，人们已经知道白细胞计数与发生心肌梗死的风险之间存在关联；然而，直到最近，孟德尔随机化研究才表明，高中性粒细胞计数是动脉粥样硬化性心血管疾病的一个因果风险因素。另一方面，实验研究表明，循环中性粒细胞的耗竭会损害斑块的形成。氯吡格雷是一种抗血小板药物，广泛与阿司匹林联合使用，以降低接受冠状动脉支架置入术治疗的患者发生缺血事件的发生率。这种药物的慢性治疗可降低炎症标志物和中性粒细胞数量，很少导致严重的白细胞减少症。本文综述的目的是介绍最近的证据，表明中性粒细胞数量与心血管疾病的发展之间存在关联，并讨论氯吡格雷诱导的中性粒细胞计数减少可能是该药物的一种有益的脱靶效应。
