Document Detail

Sulfido-peptide leukotrienes in coronary heart disease - relationship with disease instability and myocardial ischaemia.
MedLine Citation:
PMID:  20415701     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Urinary excretion of leukotriene (LT) E(4) is an index of LTC(4) biosynthesis and platelet-neutrophil interactions, which may occur in coronary heart disease and contribute to myocardial ischaemia. Enhanced LTC(4) biosynthesis may be a consequence of myocardial ischaemia or be linked to its pathogenetic substrate. METHODS AND RESULTS: Overnight urine collections were obtained from 17 patients with chronic stable angina, three patients with Prinzmetal's angina, 16 patients with non ST-elevation acute coronary syndromes (NSTE-ACS) and six patients with acute ST-elevation myocardial infarction (STEMI). LTE(4) excretion was measured by enzyme immunoassay after HPLC separation. Compared with healthy controls (51.1 +/- 21.3 pg mg(-1) creatinine, mean +/- SD, n = 11) and with non-coronary cardiac controls (36.6 +/- 9.8 pg mg(-1) creatinine, n = 9), LTE(4) excretion was unchanged in stable angina (40.5 +/- 25.8 pg mg(-1) creatinine), but significantly (P < 0.01) increased in NSTE-ACS (122.7 +/- 137.2 pg mg(-1) creatinine) and STEMI (213.4 +/- 172.4 pg mg(-1) creatinine). In these patients, LTE(4) excretion rapidly dropped after day 1, consistent with effective coronary reperfusion. In patients with NSTE-ACS, the increase in LTE(4) excretion was entirely restricted to patients with recent (< 48 h) spontaneous anginal episodes. Myocardial ischaemia elicited by a positive exercise stress test was not accompanied by any detectable increase in LTE(4) excretion, while a significant (P < 0.01) increase was detected after a single-vessel percutaneous coronary interventions (PCI) procedure (n = 10), as compared with diagnostic angiography (n = 9). CONCLUSIONS: In coronary heart disease, increased LTC(4) biosynthesis is restricted to ACS and not linked to myocardial ischaemia per se, but likely to the occurrence of plaque disruption.
R De Caterina; D Giannessi; G Lazzerini; W Bernini; R Sicari; F Cupelli; S Lenzi; M M Rugolotto; R Madonna; J Maclouf
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of clinical investigation     Volume:  40     ISSN:  1365-2362     ISO Abbreviation:  Eur. J. Clin. Invest.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-04-26     Completed Date:  2010-06-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0245331     Medline TA:  Eur J Clin Invest     Country:  England    
Other Details:
Languages:  eng     Pagination:  258-72     Citation Subset:  IM    
C.N.R. Institute of Clinical Physiology, Pisa, Italy.
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MeSH Terms
Acute Coronary Syndrome / urine*
Angina Pectoris / urine*
Biological Markers / urine
Chromatography, High Pressure Liquid
Cross-Sectional Studies
Immunoenzyme Techniques
Leukotriene E4 / urine*
Middle Aged
Myocardial Infarction / urine*
Reg. No./Substance:
0/Biological Markers; 75715-89-8/Leukotriene E4

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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