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.