The plasma levels of inflammatory cytokine interleukin-6 (IL-6) and anti-inflammatory cytokine interleukin-10 (IL-10) in the patients with unstable angina or stable angina were determined and compared. In 30 patients with unstable angina and 22 patients with stable angina, plasma levels of IL-10 and IL-6 were detected by ELISA and plasma lipid parameters by lipid research clinical methods respectively. The results showed plasma levels of IL-10 were significantly lower in unstable angina group than in stable angina group (P = 0.005), while those of IL-6 were significantly increased in unstable angina group as compared with those in stable angina group (P = 0.039). There was a significantly negative correlation between IL-10 and IL-6 in patients with unstable angina (r = -0.41, P = 0.003). In the unstable angina group, IL-6 levels were obviously positively correlated with TC (r = 0.314, P = 0.023), but not with TG and HDL. There were no significant correlations between IL-10 and plasma lipid parameters. It was suggested that the decreased IL-10 and increased IL-6 might be associated with the atheromatous plaque stability and progression of coronary heart diseases. IL-10 may play an important role in preventing coronary vascular lesions.
Angina, Unstable/*blood ; Interleukin-10/*blood ; Interleukin-6/*blood

Aged ; Angina, Unstable ; blood ; physiopathology ; Antioxidants ; metabolism ; Female ; Heart Rate ; physiology ; Homocysteine ; blood ; Humans ; Male ; Middle Aged

Postoperative autotransfusion is known as an effective method for blood conservation. We tried to examine whether the autotransfusion of shed mediastinal blood in patients with unstable angina would be valuable for reducing postoperative homologous transfusion by observing the hourly tendency of bleeding and transfusion. Between August and October, 1997, 26 patients with unstable angina underwent coronary arterial bypass surgery by a single surgeon at Asan Medical Center. In retrospective analysis, we found 90% of the patients received homologous transfusions and 85% of them were in the intensive care unit at the same day after operation. In many patients, the cause of transfusion was not anemia but volume replacement. Mean bleeding through the chest tubes was 340 cc for the first 5 hours and 69% (18 pts) showed more than 200 cc of bleeding, the amount generally considered as a initiating point for autotransfusion. Despite the adoption of multiple methods for blood conservation, 90% of the patients needed homologous transfusion. Moreover, many of them had received unnecessary transfusions. We conclude that some kind of blood for transfusion is needed during the immediate postoperative period, and the adoption of postoperative autotransfusion may help in reducing homologous transfusion.
Anemia ; Angina Pectoris ; Angina, Unstable ; Blood Transfusion ; Blood Transfusion, Autologous ; Chest Tubes ; Chungcheongnam-do ; Hemorrhage* ; Humans ; Intensive Care Units ; Postoperative Period ; Retrospective Studies

OBJECTIVE: To examine the serum levels of S100 calcium-binding protein A8/A9 complex (S100A8/ A9) in patients with acute coronary syndrome (ACS) and to explore the relation between the serum levels of S100A8/A9 and the degree of coronary lesion. METHODS: A total of 126 patients with coronary heart disease were enrolled from Xiangya Hospital of Central South University between September 2010 and January 2011, which included 51 patients with unstable angina pectoris (UAP group, n=51), 50 patients with acute myocardial infarction (AMI group, n=50), and 25 patients with stable angina pectoris (SAP group, n=25). Twenty-five healthy volunteers were served as a normal control group (NC group, n=25). According to the coronary artery lesion area, ACS patients were also divided into a single-branch group, a double-branch group and a triple-branch group. Serum levels of S100A8/A9 were measured by enzyme-linked immunosorbent assay on the day when the patients admitted to the hospital and on the day after one-week treatment (UAP group + AMI group). The serum levels were compared among the various branch groups. The short-term prognosis in patients with ACS was investigated by phone follow-up after 3 months. RESULTS: 1) The S100A8/A9 level in the SAP group was significantly higher than that in the normal control group (P<0.05). The serum levels of S100A8/A9 in the UAP group and the AMI group were significantly higher than that in the SAP group (all P<0.05); There was no significant difference in the S100A8/A9 level between the UAP group and the AMI group (P>0.05); 2) After one-week standard treatment, the serum levels of S100A8/A9 in patients with ACS were significantly reduced compared with that at the admission (P<0.01), but it was still elevated compared with that in the normal control group (P<0.01); 3) The serum level of S100A8/A9 in the triple-branch group was significantly higher than that in the single-branch group and the double-branch group (both P<0.05); 4) The short-term prognosis in patients with ACS was not correlated with the serum level of S100A8/A9 (r=0.012, P> 0.05). CONCLUSION The serum level of S100A8/A9 is significantly elevated in patients with ACS, which might be positively correlated with the number of the coronary lesion branches.
Acute Coronary Syndrome ; blood ; pathology ; Angina Pectoris ; Angina, Unstable ; Coronary Artery Disease ; Enzyme-Linked Immunosorbent Assay ; Humans ; Leukocyte L1 Antigen Complex ; blood ; Prognosis

Reninoma is a tumor of the renal juxtaglomerular cell apparatus that causes hypertension and hypokalemia because of hypersecretion of renin. We present a case of a 29-year-old female patient with reninoma and concomitant variant angina. The patient had uncontrolled hypertension and elevated plasma renin activity and aldosterone levels. Imaging studies revealed a mass in the left kidney, which was further confirmed as a renin-producing lesion via selective venous catheterization. During the evaluation, the patient had acute-onset chest pain that was diagnosed as variant angina after a provocation test. After partial nephrectomy, the plasma renin activity and plasma aldosterone levels decreased and blood pressure normalized. We report a case of reninoma with variant angina.
Adult ; Aldosterone ; Angina, Unstable ; Blood Pressure ; Catheterization ; Catheters ; Chest Pain ; Female ; Humans ; Hypertension ; Hypokalemia ; Kidney ; Kidney Neoplasms ; Nephrectomy ; Plasma ; Renin

The presence of pre-existing intracoronary thrombus has consistently been shown to be among the strongest predictors of unsuccessful angioplasty and abrupt vessel closure. Abciximab, platelet glycoprotein IIb/IIIa receptor antagonist, through prevention platelet aggregation and coronary thrombosis, has shown promise in helping to decrease the incidence of complications of PTCA when prophylatically administered in patients presenting with unstable angina or complex lesion morphology for PTCA and in lower risk patients as well. However, the cost of abciximab and its associated increased risk of bleeding may limit its use as a prophylactic treatment. This study was performed to evaluate the effect of the rescue administration of abciximab in seven patients with thrombus containing lesion during angioplasty. Thrombus was disappeared in 4 patients and decreased in 2 patients, and the follow-up angiogram showed normal brisk flow in all 6 patients. There were no death or myocardial infarction on clinical follow-up at a mean of 7 months except one which was developed restenosis at the angioplasty lesion. Dissolution of thrombus and restoration or maintenance of TIMI grade 3 flow were achieved without complications after administration of abciximab when delivered in a rescue manner on thrombus containing lesion during angioplasty. These results showed that failure to give preprocedural proph-ylactic abciximab did not appear to exclude the possibility of a beneficial effect of abciximab, given therapeutically during the early stage of thrombus formation in patients with complicated lesion during angioplasty.
Angina, Unstable ; Angioplasty ; Blood Platelets ; Coronary Thrombosis ; Follow-Up Studies ; Glycoproteins ; Hemorrhage ; Humans ; Incidence ; Myocardial Infarction ; Platelet Aggregation ; Thrombosis*

BACKGROUND AND OBJECTIVES: The reduction in the mean platelet component (MPC) concentration may be used to detect platelet activation. We performed this study to find the clinical usefulness of the MPC concentration in the differentiation of patients with stable angina from those with acute coronary syndrome (ACS). SUBJECTS AND METHOD: We evaluated 175 consecutive patients (57.9+/-10.4 years, 107 male) undergoing coronary angiography. The study patients were divided into two groups; patients with ACS (n=55, 57.5+/-11.8 years, 37 male) and those with stable angina (n=120, 58.1+/-9.7 years, 70 male). Venous blood samples were take into EDTA tube and immediately sent to laboratory room for measurement of the MPC concentration using the ADVIA(R) 120 hematology system. RESULTS: The MPC concentration was significantly decreased in those with ACS (27.3+/-1.2 g/dL vs. 28.6+/-0.9 g/dL, p=0.013) compared to those with stable angina, and also decreased in patients with unstable compared to stable angina (27.4+/-1.2 g/dL vs. 28.6+/-0.9 g/dL, p<0.001), but there was no difference in the MPC concentration between acute myocardial infarction and unstable angina (27.2+/-1.2 g/dL vs. 27.4+/-1.2 g/dL, p=0.939). An MPC concentration (28.05 g/dL demonstrated 74.5% sensitivity and 75.0% specificity in the differentiation of patients with ACS from the others in the Receiver Operating Curve analysis. The positive and negative predictive values were 51.6 and 86.5%, respectively, at that level. CONCLUSION: Measurement of the MPC concentration may be useful in the detection of ACS. Also, a decreased MPC concentration may be a very useful marker for the differentiation of unstable and stable angina.
Acute Coronary Syndrome* ; Angina, Stable ; Angina, Unstable ; Blood Platelets* ; Coronary Angiography ; Edetic Acid ; Hematology ; Humans ; Myocardial Infarction ; Platelet Activation ; Sensitivity and Specificity

Inflammation and activation of immune cells have important roles in the pathogenesis of atherosclerosis. We analyzed the plasma levels of inflammatory markers and the degree of activation of peripheral blood monocytes and T-lymphocytes isolated from 12 unstable angina, 12 stable angina, and 12 normal subjects. In 20%-33% of patients, monocytes expressed high basal levels of IL-8, tissue factor, IL-1beta, and monocyte chemoattractant protein-1 mRNA. Furthermore, basal mRNA levels of these cytokines showed strong correlation with each other (p < 0.01 in all combination) but not with tumor necrosis factor-alpha or transforming growth factor-beta1. Plasma level of C-reactive protein was highest in the unstable angina patients (1.63+/-0.70 mg/l) and lowest in the control subjects (0.22+/-0.08 mg/l) (P = 0.03). We also observed a high correlation between C-reactive protein level and the occurrence of minor and major coronary events during 6 months of follow-up. Activation status of T-cells, assessed by the percentage of HLA-DR positive cells, was highest in the unstable angina patients (26.8+/-1.4%) compared with that in the control (14.7+/-1.2%) (P = 0.0053). Our data represent the first case showing that the circulating monocytes in angina patients are activated to a state express numerous proatherogenic cytokines. These results may help to diagnose angina patients according to the inflammatory markers and evaluate the prognosis of the disease.
Aged ; Angina Pectoris/immunology* ; Angina Pectoris/diagnosis ; Angina, Unstable/immunology* ; Angina, Unstable/diagnosis ; Biological Markers/blood ; C-Reactive Protein/analysis ; Cytokines/blood* ; Female ; HLA-DR Antigens/immunology ; Human ; Interleukins/blood ; Lymphocyte Transformation ; Male ; Middle Age ; Monocyte Chemoattractant Protein-1/blood ; Monocytes/metabolism* ; RNA, Messenger/metabolism ; T-Lymphocytes/metabolism* ; Transforming Growth Factor beta/analysis ; Tumor Necrosis Factor/analysis

OBJECTIVETo observe the feasibility of measuring multiple circulating cytokines by protein chips in patients with acute coronary syndrome (ACS).

METHODSCirculating cytokines were determined by protein chips in 50 control cases and 104 ACS cases of unstable angina pectoris (UA, n = 50) and acute myocardial infarction (AMI, n = 54) cases.

RESULTSThe levels of serum MMP-9, sCD40L, CRP, IL-6, H-FABP, cTnI and plasma IL-8, NT-proBNP, sVCAM-1, ET-1 in ACS group were significantly higher than those in the control group (all P < 0.01). Serum H-FABP and cTnI were significantly higher in AMI patients than in UA patients (P < 0.01). Serum MMP-9, sCD40L, CRP, IL-6 and plasma sVCAM-1, ET-1 tended to be higher in AMI patients as compared to UA patients (all P > 0.05). Serum MMP-9, sCD40L, and H-FABP were positively correlated with the severity of angina(r = 0.653, r = 0.745, r = 0.933, P < 0.01, respectively). Serum MMP-9, sCD40L, and H-FABP increased in proportion to the levels of Braunwald angina classes in UA patients (angina class I < angina class II < angina class III, P < 0.01).

CONCLUSIONSCirculating cytokines were significantly increased in ACS patients and positively correlated to Braunwald angina classes in UA patients.

Acute Coronary Syndrome ; blood ; Aged ; Angina Pectoris ; blood ; Angina, Unstable ; blood ; C-Reactive Protein ; metabolism ; CD40 Ligand ; blood ; Cytokines ; blood ; Female ; Humans ; Male ; Matrix Metalloproteinase 9 ; blood ; Middle Aged ; Myocardial Infarction ; blood ; Protein Array Analysis

No abstract available.
Angina, Unstable/*enzymology/*immunology ; Female ; Humans ; Inflammation Mediators/*blood ; Interleukins/*blood ; Male ; Matrix Metalloproteinase 9/*blood ; Myocardial Infarction/*enzymology/*immunology ; Tissue Inhibitor of Metalloproteinase-1/*blood