Activated protein C and inflammation in human myocardium after heart surgery

To assess possible interactions between inflammation and activation of the anticoagulant protein C system during post-ischemic reperfusion protein C, APC, neutrophil L-selectin expression and myocardial myeloperoxidase activi ty (MPO) were measured in 19 patients undergoing cardiopulmonary bypass. Af ter reperfusion for 10 min, APC to protein C ratio (APC/PC) increased from pre-reperfusion value 1.43 +/- 0.12 (mean +/- SEM) to 2.25 +/- 0.29, p = 0. 015, Negative correlations were observed between APC/PC and MPO activity (S pearman r -0.64, p = 0.007) and APC/PC and neutrophil L-selectin expression (r = -0.7, p = 0.007, demonstrating that post-ishemic protein C activation was associated with decreased neutrophil tissue sequestration. Thus, physi ological protein C activation may be involved in regulation of the inflamma tory injury during reperfusion of human ischemic coronary circulation, (C) 2001 Wiley-Liss, Inc.