We investigated the time course and prognostic value of fibrinogen (Fib), C-reactive protein (CRP), interleukin-6 (IL-6), and ceruloplasmin (CP) in patients with severe unstable angina. Methods. All 4 substances were measured on admission and after 6, 12, 24, 48, and 72 hours, and after 7 days and 6 months in 40 patients with Braunwald's classification class IIIB unstable angina. Results. All recorded substances increased significantly; 15 patients had cardiovascular events during hospitalization and 11 patients during follow-up. The time course and the mean values of Fib, CRP, and IL-6 were similar in patients with and without complications both during hospitalization and follow-up. However, CP levels from 6 hours until 6 months were significantly higher in patients with complications during follow-up (P < .05). Conclusions. Fib, CRP, IL-6, and CP levels alter in patients with severe unstable angina. However, only CP levels were related to 12-month follow-up prognosis.
Van SnickJ.Interleukin 6 an overview.Annu Rev Immunol.1990; 8: 253–278.
3.
DaneshJ., CollinsR., ApplebyP., PetoR.Association of fibrinogen, C-reactive protein, albumin or leukocyte count with coronary heart disease: meta-analyses of prospective studies.JAMA.1998; 279: 1477–1482.
4.
TossH., LindahlB., SiegbahnA., WallentinL.Prognostic influence of increased fibrinogen and C-reactive protein levels in unstable coronary artery disease.Circulation.1997; 96: 4204–4210.
5.
BeckerR., CannonC., BovillE.Prognostic value of plasma fibrinogen concentration in patients with unstable angina and non-Q wave myocardial infarction.Am J Cardiol.1996; 78: 142–147.
6.
LiuzzoG., BiasucciL.M., GallimoreJ.R.The prognostic value of C-reactive protein and serum amyloid A protein in severe unstable angina.N Engl J Med.1994; 331: 417–424.
7.
LindahlB., TossH., SiegbahnA., VengeP., WallentinL.Markers of myocardial damage and inflammation in relation to long-term mortality in unstable coronary artery disease. FRISC Study Group. Framing during instability in coronary artery disease.N Engl J Med.2000; 343: 1139–1147.
8.
FerreirosE.R., BoissonnetC.P., PizarroR.Independent prognostic value of elevated C-reactive protein in unstable angina.Circulation.1999; 100: 1958–1963.
9.
LindmarkE., DiderholmE., WallentinL., SiegbahnA.Relationship between interleukin-6 and mortality in patients with unstable coronary artery disease.JAMA.2001; 286: 2107–2113.
10.
BiasucciL.M., VitelliA., LiuzzoG.Elevated levels of interleukin-6 in unstable angina.Circulation.1996; 94: 874–877.
11.
BiasucciL.M., VitelliA., LiuzzoG.Increasing levels of interleukin (IL)-1Ra and IL-6 during the first 2 days of hospitalization in unstable angina are associated with increased risk of in-hospital coronary events.Circulation.1999; 99: 2079–2084.
12.
CalvinJ.E., KleinL.W., VandenBergB.J.Risk stratification in unstable angina. Prospective validation of the Braunwald classification.JAMA.1995; 273: 136–141.
13.
HolmvangL., LuscherM., ClemmensenP., ThygesenK., GrandeP.Very early risk stratification using combined ECG and biochemical assessment in patients with unstable coronary artery disease (a thrombin inhibition in myocardial ischemia [TRIM] substudy).Circulation.1998; 98: 2004–2009.
14.
SeresL., ValleV., MarrugatJ.Usefulness of hospital admission risk stratification for predicting nonfatal acute myocardial infarction or death six months later in unstable angina pectoris.Am J Cardiol.1999; 84: 963–969.
15.
OsierA., WhooleyM.A., OlerJ., GradyD.Adding heparin to aspirin reduces the incidence of myocardial infarction and death in patients with unstable angina.JAMA.1996; 276: 811–815.
16.
Fragmin during Instability in Coronary Artery Disease (FRISC) study group.Low-molecular-weight heparin during instability in coronary artery disease.Lancet.1996; 347: 561–568.
17.
Platelet Receptor Inhibition in Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms (PRISM-PLUS) Study Investigators.Inhibition of the platelet glycoprotein IIb-IIIa receptor with tirofiban in unstable angina and non-Q-wave myocardial infarction.N Engl J Med.1998; 338: 1488–1497.
18.
The PURSUIT Trial Investigators.Inhibition of platelet glycoprotein IIb/IIIa with eptifibatide in patients with acute coronary syndromes.N Engl J Med.1998; 339: 436–443.
19.
The TIMI IIIb Investigators.Effects of tissue plasminogen activator and a comparison of early invasive and conservative strategies in unstable angina and non-Q-wave myocardial infarction. Results of the TIMI IIIb trial.Circulation.1994; 89: 1545–1556.
20.
BodenW., O'RourkeR.A., CrawfordM.H.Outcomes in patients with acute non-Q-wave myocardial infarction randomly assigned to an invasive as compared with a conservative management strategy.N Engl J Med.1998; 338: 1785–1792.
HarrisE.D.A requirement for copper in angiogenesis.Nutr Rev.2004; 62: 60–64.
25.
HannanG.N., McAuslenB.R.Modulation of synthesis of specific proteins in endothelial cells by copper, cadmium, and disulfiram: an early response to an angiogenic inducer of cell migration.J Cell Physiol.1982; 111: 207–212.
26.
ShuklaN., MaherJ., MastersJ., AngeliniG.D., JeremyJ.Y.Does oxidative stress change ceruloplasmin from a protective to a vasculopathic factor.Atherosclerosis.2006; 187: 238–250.
27.
BustamanteJ.B., MateoM.C., FernandezJ., de QuirosB., ManchadoO.O.Zinc, copper and ceruloplasmin in arteriosclerosis.Biomedicine.1976; 25: 244–245.
28.
PowellJ.T., MullerB.R., GreenhalghR.M.Acute phase proteins in patients with abdominal aortic aneurysms.J Cardiovasc Surg.1987; 28: 528–530.
29.
JayakumariN., AmbikakumariV., BalakrishnanK.G., IyerK.S.Antioxidant status in relation to free radical production during stable and unstable anginal syndromes.Atherosclerosis.1992; 94: 183–190.
BraunwaldE.Unstable angina: a classification.Circulation.1989; 80: 410–414.
32.
KakafikaA.I., LiberopoulosE.N., MikhailidisD.P.Fibrinogen: a predictor of vascular disease.Curr Pharm Des.2007; 13: 1647–1659.
33.
FerriC., CroceG., CofiniV.C-reactive protein: interaction with the vascular endothelium and possible role in human atherosclerosis.Curr Pharm Des.2007; 13: 1631–1645.
34.
DubinskiA., ZdrojewiczZ.The role of interleukin-6 in development and progression of atherosclerosis.Pol Merkur Lekarski.2007; 22: 291–294.
35.
LiuzzoG., BuffonA., BiasucciL.M.Enhanced inflammatory response to coronary angioplasty in patients with severe unstable angina.Circulation.1998; 98: 2370–2376.
36.
HoffmeisterH., JurM., WendelH.P., HellerW., SeipelL.Alterations of coagulation and fibrinolytic and kallikrein-kinin systems in the acute and postacute phases in patients with unstable angina pectoris.Circulation.1995; 91: 2520–2527.
37.
FuchsJ., PinhasA., DavidsonE., RottenberZ., AgmonJ., WeinbergerI.Plasma viscosity, fibrinogen, and hematocrit in the course of unstable angina.Eur Heart J.1990; 11: 1029–1032.
38.
JayakumariN., AmbikakumariV., BalakrishnanK.G., IyerK.S.Antioxidant status in relation to free radical production during stable and unstable anginal syndromes.Atherosclerosis.1992; 94: 183–190.
39.
KlebanoffS.J.Bactericidal effect of Fe2+, ceruloplasmin, and phosphate.Arch Biochem Biophys.1992; 295: 302–308.
40.
SigalL.H., RonY.The acute phase response to inflammation. Immunology and inflammation. Basic mechanisms and clinical consequences.International Editions.1994; 16: 287–301.
41.
KushnerI., BroderM.L., KarpD.Control of the acute phase response: serum C-reactive protein kinetics after acute myocardial infarction.J Clin Invest.1978; 61: 235–242.
42.
LiuzzoG., BiasucciL.M., RebuzziA.G.Plasma protein acute phase response in unstable angina is not induced by ischemic injury.Circulation.1996; 94: 2374–2380.
43.
BiasucciL.M., LiuzzoG., CaligiuriG.Episodic activation of the coagulation system in unstable angina does not elicit an acute phase reaction.Am J Cardiol.1996; 77: 85–87.
44.
RallidisL.S., ZolindakiM.G., ManioudakiH.S., LaoutarisN.P., VelissaridouA.H., PapasteriadisE.G.Prognostic value of C-reactive protein, fibrinogen, interleukin-6, and macrophage colony stimulating factor in severe unstable angina.Clin Cardiol.2002; 25: 505–510.
45.
SanchisJ., BodiV., NavarroA.Prognostic factors in unstable angina with dynamic electrocardiographic changes. Value of fibrinogen.Rev Esp Cardiol.2002; 55: 921–927.
46.
MorrowD.A., RifaiN., AntmanE.M.C-reactive protein is a potent predictor of mortality independently or in combination with troponin T in acute coronary syndromes: A TIMI 11a substudyJ Am Coll Cardiol.1998; 31: 1460–1465.
47.
KoukkunenH., PenttilaK., KemppainenA.C-reactive protein, fibrinogen, interleukin-6 and tumour necrosis factor-alpha in the prognostic classification of unstable angina pectoris.Ann Med.2001; 33: 37–47.
48.
FordE.S.Serum copper concentration and coronary heart disease among US adults.Am J Epidemiol.2000; 151: 1182–1188.
TapieroH., TownsendD.M., TewK.D.Trace elements in human physiology and pathology.Copper Biomed Pharmacother.2003; 57: 386–398.
51.
DaimonM., SusaS., YamataniK.Hyperglycaemia is a factor for an increase in serum caeruloplasmin in type 2 diabetes.Diab Care.1998; 21: 1525–1528.
52.
WalterR.M.Jr., Uriu-HareJ.Y., OlinK.L.Copper, zinc, manganese and magnesium status and complications of diabetes mellitus.Diab Care.1991; 14: 1050–1056.
53.
ZargarA.H., ShahN.A., MasoodiS.R.Copper, zinc and magnesium levels in non-insulin dependent diabetes mellitus.Postgrad Med.1998; J74: 665–668.
54.
KimC.H., ParkJ.Y., KimJ.Y.Elevated serum ceruloplasmin levels in subjects with metabolic syndrome: a population-based study.Metabolism.2002; 51: 838–842.
55.
DudmanN.P., WilckenD.E.Increased plasma copper in patients with homocystinuria due to cystathionine β-synthase deficiency.Clin Chim Acta.1983; 127: 105–113.
56.
EngstromG., JanzonL., BerglundG.Blood pressure increase and incidence of hypertension in relation to inflammation-sensitive proteins.Arterioscler Thromb Vasc Biol.2002; 22: 2054–2058.
57.
EngstromG., StavenowL., HedbladB.Inflammation-sensitive plasma proteins, diabetes, and mortality and incidence of myocardial infarction and stroke.Diabetes.2003; 52: 442–447.
58.
EngstromG., HedbladB., StavenowL.Inflammation-sensitive plasma proteins are associated with future weight gain.Diabetes.2003; 52: 2097–2101.
59.
LindP., HedbladB., StavenowL., JanzonL., ErikssonK.F., LindgardeF.Influence of plasma fibrinogen levels on the incidence of myocardial infarction and death is modified by other inflammation-sensitive proteins: a long-term cohort study.Arterioscler Thromb Vasc Biol.2001; 21: 452–458.
60.
Klipstein-GrobuschK., GrobbeeD.E., KosterJ.F.Serum caeruloplasmin as a coronary risk factor in the elderly: the Rotterdam study.Br J Nutr.1999; 81: 139–144.
61.
EhrenwaldE., ChisolmG.M., FoxP.L.Intact human caeruloplasmin oxidatively modifies low density lipoprotein.J Clin Invest.1994; 93: 1493–1501.
62.
MukhopadhyayC.K., FoxP.L.Ceruloplasmin copper induces oxidant damage by a redox process utilizing cell-derived superoxide as a reductant.Biochemistry.1998; 37: 14222–14229.
63.
MukhopadhyayC.K., EhrenwaldE., FoxP.L.Ceruloplasmin enhances smooth muscle cell and endothelial cell mediated low density lipoprotein oxidation by a superoxide dependent mechanism.J Biol Chem.1996; 271: 1473–1478.
64.
SalonenJ.T., SalonenR., SeppanenK., KantolaM., SuntioinenS., KorpelaH.Interactions of serum copper, selenium, and low density lipoprotein cholesterol in atherogenesis.Br Med J.1991; 302: 756–760.
65.
MezzettiA., GuglielmiM.D., PierdomenicoS.D.Increased systemic oxidative stress after elective endarterectomy: relation to vascular healing and remodeling.Arterioscler Thromb Vasc Biol.1999; 19: 2659–2665.
66.
MänttäriM., ManninenV, HuttunenJ.K.Serum ferritin and ceruloplasmin as coronary risk factors.Eur Heart.1994; J15: 1599–1603.
