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Stability of atherosclerotic plaque is determined by multiple factors, as are immunological and inflammatory ones. Natural killer cells (NK) have proinflammatory property and ability of direct contribution to vascular lesion. Immunoglobulin E (IgE) could be involved in late atherosclerotic phases, improving plaque unstability and clinical events. Increased values of IgE are in different cardiovascular disease, especially in patients with unstable angina pectoris and ACS.
To determine CRP, IgE, NK cell values in patients with CAD proven by elective coronary angiography. Methods and patients: It was prospective study with 150 patients divided in 3 groups based on coronarography findings according to severity of coronary artery stenosis severity. I group includes patients with significant coronary artery stenosis >70%, II group included patients with coronary artery stenosis <70%, and the III group included patients without verified stenosis of coronary artery All patients, admitted on elective coronary angiography, with previous diagnosis of angina pectoris. From the study were excluded all the patients with diagnosis of acute inflammation, Diabetes mellitus, allergic, chronical inflammatory and atopic and malignant disease.
In our study in I patien t group with coronary significant stenosis > 70% (meaning that atherosclerotic plaque includes 70% of artery lumen), concentration of CRP in serum was significantly higher according to II patient group with stenosis of <70%, and III group without verified stenosis of artery. Serum concentration of CRP between II (stenosis <70%) and III group without coronary artery stenosis proved by coronary angiography was almost equal. CRP value range in I group (>70% significant coronary artery stenosis) was 1,0-14,9 mg/dl, in II group (<70% coronary artery stenosis) was 0,4-5,5, and in III group (no verified coronary artery stenosis) was 0,2-3,7 mg/dL. Also in our study we found out IgE being higher in patient group >70 % with significant coronary artery stenosis, comparing it with patient group <70% of coronary artery stenosis, and with patient without verified stenosis. In our study NK cell representation in no verified coronary artery stenosis group of patient was significantly lower than in group with stenosis >70% or <70%.
Serum concentration of CRP implies fact of CRP being predictor of acute inflammation, and active atherosclerotic process. IgE could be hint of acute myocardial infarction, but in the same time high values could have protective role. NK cells has specific role in process of atherosclerosis, since being higher in coronary artery stenosis. CRP test has the best sensitivity and specificity, and therefore is the most beneficial and applicable in diagnostics.