Blood cell activation, coagulation, and inflammation in men and women withcoronary artery disease

We investigated in some detail the immunologic and procoagulant activation patterns in men and women with unstable (UA, n = 26) versus stable (SA, n = 40) coronary artery disease (CAD). Leukocyte activation and platelet-leuko cyte complex formation were assessed by flow cytometry. Plasma markers of c oagulation and inflammation were analyzed. Unstable patients displayed high er levels of platelet-leukocyte complexes (P < .001), of leukocyte CD11b (P < .01), and of T cell HLA-DR (P < .05) than healthy controls did. Female U A patients presented the highest degree of complexes. SA patients only diff ered significantly from controls with respect to HLA-DR (P = .02). UA patie nts had higher levels of C-reactive protein (P < .01), IL-6 (P < .001), IL- 10 (P < .01), and soluble fibrin (P < .001) than did stable ones. Regarding P-selectin levels, 25% of SA and 50% of UA patients were above normal rang e. Again, UA women presented the highest marker amounts. As for soluble tis sue factor, women had higher levels than men regardless of the severity of disease (P < .001 in SA). We conclude that in unstable coronary syndromes, there is an activation of both coagulation and inflammation that coincides with an increased activation of platelets and leukocytes. Cellular interact ions may contribute to the systemic responses observed. Women have differen t patterns of cellular activation than men, indicating differences in patho genetic mechanisms. (C) 2001 Elsevier Science Ltd. All rights reserved.