Neutrophil count as the centerpiece in the joined association networks of inflammatory and cell damage markers, and neuroendocrine stress markers in patients with stable angina pectoris following stenting

ObjectiveThe primary aim of this study was to examine whether markers of cell damage and of the psycho-neuroendocrino-inflammatory/immune (PNI) system could be associated in patients with stable coronary artery disease (CAD) on the next day following percutaneous coronary intervention (PCI).Materials and methodsBlood samples of 23 patients (18 men and five women, mean age 62.9 ± 10.6 years), were collected immediately before (pre-PCI), immediately after (post-PCI), and on the day following PCI (1d-PCI). Lactoferrin, LL-37 and interleukin-6 (IL-6) were assayed in plasma, in addition to cortisol and chromogranin A (CgA), as well as CK, ASAT and ALAT. Total and differential leukocyte counts were also analysed.ResultsAt all the three time points, the monocyte fractions, the monocyte-to-lymphocyte and the neutrophil-to-lymphocyte ratios and CgA levels were elevated. We detected significant peri-procedural changes in the plasma levels of our PNI markers: IL-6 (p0.75, p0.79, p0.7, pConclusionsThe findings suggest that myocardial damage could correlate not only with an inflammatory reaction but, via neutrophil count, also with increased level of stress in stable CAD after PCI. Furthermore, 1d-PCI neutrophil count may serve as an easy-to-obtain integrative PNI measure in stable CAD.

研究目的
本研究的核心目标为探讨接受经皮冠状动脉介入治疗（percutaneous coronary intervention, PCI）次日的稳定型冠状动脉疾病（coronary artery disease, CAD）患者中，细胞损伤标志物与精神-神经-内分泌-炎症/免疫（psycho-neuroendocrino-inflammatory/immune, PNI）系统标志物是否存在相关性。

材料与方法
本研究纳入23例受试者（18例男性，5例女性，平均年龄62.9±10.6岁），分别于经皮冠状动脉介入治疗术前（pre-PCI）、术后即刻（post-PCI）以及术后次日（1d-PCI）采集外周血样本。对血浆中的乳铁蛋白、LL-37、白细胞介素-6（interleukin-6, IL-6）、皮质醇、嗜铬粒蛋白A（chromogranin A, CgA）、肌酸激酶（CK）、天门冬氨酸氨基转移酶（ASAT）以及丙氨酸氨基转移酶（ALAT）水平进行检测；同时分析白细胞总数及分类计数。

结果
在三个采样时间点，单核细胞比例、单核细胞/淋巴细胞比值、中性粒细胞/淋巴细胞比值以及嗜铬粒蛋白A水平均显著升高。本研究检测到精神-神经-内分泌-炎症/免疫系统标志物的围手术期血浆水平存在显著变化：白细胞介素-6（p0.75, p0.79, p0.7, p）。

结论
本研究结果提示，稳定型冠状动脉疾病患者接受经皮冠状动脉介入治疗后，心肌损伤不仅可与炎症反应相关联，还可通过中性粒细胞计数与应激水平升高产生关联。此外，术后次日的中性粒细胞计数可作为稳定型冠状动脉疾病患者中一种易于获取的整合型精神-神经-内分泌-炎症/免疫系统评估指标。