PLASMA LEUKOCYTE ELASTASE CONCENTRATION AND CORONARY-ARTERY DISEASE

It has previously been shown that leukocyte elastase is involved in th e pathogenesis of atherosclerosis. Few: studies have addressed the rel ation between leukocyte elastase concentrations and coronary artery di sease (CAD). The authors investigated (1) the clinical significance of leukocyte elastase determination in the diagnosis of CAD and (2) the relation between plasma leukocyte elastase concentration and lesion mo rphology. The study included 185 subjects (140 men, 45 women) who unde rwent coronary angiography during investigation of chest pain; 135 had coronary stenosis (Group I) and 50 had nonstenotic coronaries (Group II). Among Group I patients, those with simple atheromatous plaques we re distinguished from those with complex plaques. Elastase concentrati ons in Group I were greater than in Group II (57.1 +/- 1.16 mu g I-1 v s 27.6 +/- 1.0 mu g I-1, P<0.001), and greater in complex plaque patie nts than in those with simple plaques (64.5 +/- 1.24 mu g I-1 vs 45.9 +/- 1.01 mu g I-1, P<0.001). Logistic regression analysis showed (1) t hat elastase concentration, age, and sex had independent value for pre diction of CAD and (2) that among Group I patients, the risk of comple x plaques was greatest for those with high elastase concentration. The se results suggest that plasma leukocyte elastase concentration,is a s ensitive diagnostic marker of CAD and that high values of elastase may indicate the presence of complex atheromatous plaques.