Serum neopterin levels and the angiographic extent of coronary arterial narrowing in unstable angina pectoris and in non-Q-wave acute myocardial infarction

Systemic serum markers of inflammation are elevated in diseases due to athe rosclerosis, but have not been associated with the extent of atheroscleroti c disease. We examined the role of neopterin, a byproduct of activated macr ophage metabolism, in patients with unstable angina. Baseline neopterin sam ples and clinical histories were obtained in 52 patients admitted with unst able angina pectoris, Coronary angiograms of 27 patients were reviewed usin g Sullivan's method to assess the total atherosclerotic burden in the coron ary arteries. Twenty-six of the 52 patients were eventually diagnosed with a non-Q-wave acute myocardial infarction (AMI) and had higher neopterin lev els (10.1 +/- 6.7 vs 7.2 +/- 4.0 nmol/L, p = 0.06) than patients with a fin al diagnosis of unstable angina. Patients with neopterin >8.7 were more lik ely to be diagnosed with a non-Q-wave AMI (75% vs 39%, p = 0.035) and were more likely to have significantly more severe and extensive angiographicall y determined atherosclerasis than patients with low neopterin levels. Neopt erin levels correlated with the score of atherosclerotic extension (Spearma n's rank correlation coefficient 0.4807, p = 0.034), This study demonstrate s a correlation between immune cell activation and the extent of angiograph ically determined atherosclerosis and the degree of myocardial ischemia. (C ) 1999 by Excerpta Medica, Inc.