Increased leukocyte activity as a predictor for flow-limiting coronary lesions in patients with angina pectoris

Myocardial ischemia initiates an acute inflammatory response, in which poly morphonuclear leukocytes (PMNs) are major participants. We investigated whe ther increased PMN activity in the peripheral blood is a marker for high-gr ade coronary artery stenosis in patients with angina pectoris. PMN activity was examined in 45 patients by measuring the luminol-dependent chemilumine scence (CL) response of the peripheral blood upon addition of phorbol myris tate acetate (PMA). The CL of patients with angiographic filling delay was 1.6-fold higher than in patients without delay (480 +/- 54 vs. 302 +/- 33 c ounts/PMN, P < 0.01). The CL of patients with a filling delay of the left a nterior descending artery (LAD) was 1.7-fold higher than in patients withou t an LAD filling delay (537 +/- 79 vs. 317 +/- 27 counts/PMN, P < 0.01). Wi th the CL cut-off at 400 counts/PMN, the sensitivity and specificity for de tecting an angiographic filling delay of the LAD were 69 and 75%, respectiv ely. These data indicate that PMN activity in the peripheral blood is incre ased with the presence of a flow-limiting coronary lesion showing an angiog raphic filling delay. Measuring PMN activity may be a useful approach to as sess indications for and timing of angiography and/or adjunctive invasive t herapies in patients with angina pectoris. (C) 2001 Elsevier Science Irelan d Ltd. All rights reserved.