Acute phase proteins activation in subjects with coronary atherosclerosis and micro-vessel coronary circulation impairment

Aim To investigate possible correlations between acute phase proteins (APPs) activation and coronary flow in subjects with coronary artery disease (CAD) undergoing coronary angiography. Methods Fifty-nine consecutive patients with CAD who underwent coronary angiography were enrolled in the study: blood samples were taken in order to evaluate plasmatic concentrations of C-reactive protein (CRP) and APPs such as alpha-1-anti-trypsin (A1AT), alpha-1-glyco-protein (A1GP) and haptoglobin (HG). Coronary flow on left anterior descending (LAD) was assessed with TIMI frame count (TFC). Patients with TIMI flow 0-1 were excluded from the study. Results Coronary atherosclerosis expressed in terms of number of coronary vessels with severe (>70%) lumen narrowing was related to serum concentrations of all considered APPs (A1GP: r 0.282, P < 0.05; A1AT: r 0.256, P 0.055; HG: r 0.335, P < 0.01). TFC on LAD was related to all considered APPs (A1GP: r 0.24, P 0.06; A1AT: r 0.28, P < 0.05; HG: r 0.43, P < 0.01; log CRP: r 0.57, P < 0.001); correlations remained significant even after correction for age, gender, risk factors, diagnosis and treatment. Among 12 patients who were previously treated with coronary angioplasty, those implanted with a drug eluting stent showed a significantly slower coronary flow on LAD (19.6 +/- 2.07 vs. 16.71 +/- 2.06, P < 0.05) if compared with those implanted with a bare metal stent. Conclusions An increased inflammatory systemic activation featured by plasmatic concentrations of CRP and APPs might be associated with both coronary atherosclerosis and an impaired coronary micro-circulation.