Alternative complement pathway activation during invasive coronary procedures in acute myocardial infarction and stable angina pectoris.

Horváth, Zsófia and Csuka, Dorottya and Vargova, Katarina and Kovács, Andrea and Lee, Sarolta and Varga, Lilian and Prohászka, Zoltán and Kiss, Róbert Gábor and Préda, István and Tóth Zsámboki, Emese (2016) Alternative complement pathway activation during invasive coronary procedures in acute myocardial infarction and stable angina pectoris. CLINICA CHIMICA ACTA, 463. pp. 138-144. ISSN 0009-8981

Text Horvath_Csuka_AP_activation_in_AMI_and_SAP_2016_Clinica_Chimica_Acta_u.pdf Restricted to Registered users only Download (896kB) | Request a copy

Abstract

The effect of invasive percutaneous coronary procedures on complement activation has not been elucidated. We enrolled stable angina patients with elective percutaneous coronary intervention (SA-PCI, n=24), diagnostic coronary angiography (CA, n=52) and 23 patients with ST segment elevation myocardial infarction and primary PCI (STEMI-PCI). Complement activation products (C1rC1sC1inh, C3bBbP and SC5b-9) were measured on admission, 6 and 24h after coronary procedures. The alternative pathway product, C3bBbP significantly and reversibly increased 6h after elective PCI (baseline: 7.81AU/ml, 6h: 16.09AU/ml, 24h: 4.27AU/ml, p<0.01, n=23) and diagnostic angiography (baseline: 6.13AU/ml, 6h: 12.08AU/ml, 24h: 5.4AU/ml, p<0.01, n=52). Six hour C3bBbP values correlated with post-procedural CK, creatinine level and the applied contrast material volume (r=0.41, r=0.4, r=0.3, p<0.05, respectively). In STEMI-PCI, baseline C3bBbP level was higher, compared to SA-PCI or CA patients (11.33AU/ml vs. 7.81AU/ml or 6.13AU/ml, p<0.001). Similarly, the terminal complex (SC5b-9) level was already elevated at baseline compared to SA-PCI group (3.49AU/ml vs. 1.87AU/ml, p=0.011). Complement pathway products did not increase further after primary PCI. Elective coronary procedures induced transient alternative complement pathway activation, influenced by the applied contrast volume. In STEMI, the alternative complement pathway is promptly activated during the atherothrombotic event and PCI itself had no further detectable effect.

Actions (login required)

Edit Item