Copyright © 1995 by the European Society of Cardiology.
© 1995 The European Society of Cardiology
Plasma leukocyte elastase concentration in angiographically diagnosed coronary artery disease
Cardiology Department Santiago de Compostela, Spain
*Clinical Epidemiology Unit, Hospital General y Clinico de Galicia, School of Medicine Santiago de Compostela, Spain
revised 8 August 1994; accepted 5 September 1994.
Correspondence Antonio Amaro, MD, Cardiology Service, Hospital General y Clinico de Galicia, C/ Galeras, s/n, 15705 Santiago de Compostela, Spain.
Abstract
OBJECTIVE: To evaluate the clinical usefulness of leukocyte elastase determination in the diagnosis of coronary artery disease (CAD).
BACKGROUND: Recent research has shown the important role of elastase, a proteolytic enzyme released by neutrophils, in the pathogenesis of CAD.
METHODS: 141 patients underwent coronary angiography during investigation of chest pain and/or heart valve disease. Ninety-six had coronary or absence of angina (stable or unstable), family history of CAD, smoking, diabetes mellitus, hypertension, lesions and 45 non-stenotic coronaries. The patients were characterized as regards presence leukocyte counts, and plasma lipid and elastase concentrations. Among CAD-group patients, those with simple atheromatous plaques were distinguished from those with complex plaques.
RESULTS: Elastase concentrations were greater in the CAD group than in the non-CAD group (49.7 ± 2.8 µg. l–1 as against 29.5 ± 2.2 µg. l–1; P<0001), and greater among complex-plaque CAD patients than among simple-plaque CAD patients (65.2 ± 5.3 µg. l–1 as against 38.6 ± 1.9 µg. l–1 P<0.001). Logistic regression analysis showed (a) that the risk of CAD varied with elastase concentration, angina status, age and sex, increasing by 11% for every 1 µg. l–1 increase in elastase concentration; and (b) that among CAD patients the risk of complex plaques was greatest for those with unstable angina and high elastase concentration, increasing by 6% for every 1 µg. l–1 increase in elastase concentration.
CONCLUSIONS: Peripheral blood leukocyte elastase concentration is a sensitive diagnostic marker of CAD. High values suggest the presence of complex atheromatous plaques.
Key Words: Coronary artery disease • elastase
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