European Heart Journal Advance Access first published online on March 26, 2007
This version published online on April 12, 2007
European Heart Journal, doi:10.1093/eurheartj/ehm078
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Myeloid-related protein 8/14 complex is released by monocytes and granulocytes at the site of coronary occlusion: a novel, early, and sensitive marker of acute coronary syndromes
1 Cardiovascular Center, Cardiology, University Hospital Zürich, Rämistrasse 100, CH-8091 Zürich, Switzerland
2 The Institute of Clinical Chemistry, University Hospital Zürich, Zürich, Switzerland
3 The Division of Experimental Rheumatology, University Hospital Zürich, Zürich, Switzerland
4 Centre for Applied Information Technologies, University of Bremen, Germany
Received 17 January 2007; revised 7 March 2007; accepted 12 March 2007.
* Corresponding author. Tel: +41 44 255 8571; fax: + 41 44 255 4251. E-mail address: karmaiew{at}usz.unizh.ch
Aims: We investigated whether myeloid-related protein 8/14 complex (MRP8/14) expressed by infiltrating monocytes and granulocytes may represent a mediator and early biomarker of acute coronary syndromes (ACS).
Methods and results: Immunohistochemistry of coronary thrombi was done in 41 ACS patients. Subsequently, levels of MRP8/14 were assessed systemically in 75 patients with ACS and culprit lesions, with stable coronary artery disease (CAD), or with normal coronary arteries. In a subset of patients, MRP8/14 was measured systemically and at the site of coronary occlusion. Macrophages and granulocytes, but not platelets stained positive for MRP8/14 in 76% of 41 thrombi patients. In ACS, local MRP8/14 levels [22.0 (16.2–41.5) mg/L] were increased when compared with systemic levels [13.4 (8.1–14.7) mg/L, P = 0.03]. Systemic levels of MRP8/14 were markedly elevated [15.1 (12.1–21.8) mg/L, P = 0.001] in ACS when compared with stable CAD [4.6 (3.5–7.1) mg/L] or normals [4.8 (4.0–6.3) mg/L]. Using a cut-off level of 8 mg/L, MRP8/14 but not myoglobin or troponin, identified ACS presenting within 3 h from symptom onset.
Conclusion: In ACS, MRP8/14 is markedly expressed at the site of coronary occlusion by invading phagocytes. The occurrence of elevated MRP8/14 in the systemic circulation prior to markers of myocardial necrosis makes it a prime candidate for the detection of unstable plaques and management of ACS.
Key Words: Myeloid-related protein 8/14 complex • Acute coronary syndrome • Inflammation • Thrombus • Plaque
The originally published version of this paper contained black and white figures. The updated version shows the figures in colour.
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