Monocyte heterogeneity in myocardial infarction with and without ST elevation and its association with angiographic findings

Objectives Monocytes and mature macrophages play significant roles after myocardial infarction. Here, our aim is to investigate the monocyte heterogeneity in acute ST elevation myocardial infarction (STEMI) and non-STEMI separately and determine any possible relationships between monocyte heterogeneity and coronary angiographic characteristics.Methods Thirty STEMI, 30 non-STEMI, and 25 stable angina pectoris patients were enrolled. Blood samples were taken immediately at admission, and on days 2, 3, 4, 5, and 7 after STEMI or non-STEMI for cytometric analysis to determine monocyte heterogeneity. Peak creatine kinase (CK) and CK-myocardial band (CK-MB) levels were used to determine the severity of myocardial infarction. Coronary angiographic findings, such as the Gensini score, the presence of acute total occlusion, and development of no reflow after stenting, were noted.Results The peak levels of CD14++CD16- monocytes were higher and were reached later in the STEMI group (631.6 +/- 116.7 vs. 539.6 +/- 103.0/mm(3), P=0.003; day 2.73 +/- 0.64 vs. 2.27 +/- 0.74, P=0.011). Peak CK and CK-MB levels were correlated positively with CD14++CD16- monocytes in the non-STEMI group. The Gensini score was found to be correlated with the peak CD14+CD16+ monocyte levels in the non-STEMI and stable angina pectoris groups. Patients with total occlusion of the culprit artery had significantly higher levels of CD14++CD16- monocytes (642.3 +/- 113.2 vs. 532.5 +/- 98.2/mm(3), P<0.001). The peak levels of CD14++CD16- monocytes were higher in patients with no reflow compared with the patients with thrombolysis in myocardial infarction grade 3 flow after percutaneous coronary intervention of the culprit lesion (688.1 +/- 104.6 vs. 565.1 +/- 111.0, P=0.002). In patients with no reflow, we also found higher peak CD14+CD16+ monocyte levels (82.3 +/- 12.1 vs. 71.2 +/- 10.6, P=0.02).Conclusion Monocyte heterogeneity differs in STEMI and non-STEMI. Peak levels of CD14++CD16- monocytes were higher and were reached later in the STEMI group compared with the non-STEMI group. More importantly, worse angiographic characteristics related to prognosis are associated with monocyte heterogeneity in both STEMI and non-STEMI patients.