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Clinical Chemistry and Laboratory Medicine (CCLM)

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Volume 42, Issue 10 (Oct 2004)


Time course of systemic markers of inflammation in patients presenting with acute coronary syndromes

Martina Brueckmann
  • First Department of Medicine, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany
/ Thomas Bertsch
  • Institute of Clinical Chemistry and Laboratory Medicine, Clinic Nuremberg, Nuremberg, Germany and Institute of Clinical Chemistry and Institute of Clinical Chemistry, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany
/ Siegfried Lang
  • First Department of Medicine, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany
/ Tim Sueselbeck
  • First Department of Medicine, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany
/ Christian Wolpert
  • First Department of Medicine, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany
/ Jens J. Kaden
  • First Department of Medicine, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany
/ Carlos Jaramillo
  • First Department of Medicine, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany
/ Guenter Huhle
  • First Department of Medicine, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim; Eli Lilly and Company, Lilly Germany GmbH, Bad Homburg, Germany
/ Martin Borggrefe
  • First Department of Medicine, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany
/ Karl K. Haase
  • First Department of Medicine, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany
Published Online: 2005-06-01 | DOI: https://doi.org/10.1515/CCLM.2004.232


Inflammation within coronary plaques may cause an acute coronary syndrome by promoting rupture and erosion. It was the aim of this study to examine whether markers of inflammation derive from a cardiac or extracardiac source and how their levels develop over time.

Blood samples were taken from patients with acute coronary syndromes (ACS) with proven atherosclerotic lesion(s) of the left coronary artery (n = 13) and from control patients without coronary artery disease (n = 13). Blood was taken from the femoral vein and the coronary sinus vein before and after coronary angioplasty (day 0) and on days 1 and 120.

Levels of tumor necrosis factor-α (TNF-α), interleukin- 6 (IL-6), interleukin-1-receptor antagonist (IL-1 ra) and soluble CD40 ligand (sCD40L) were higher in ACS patients as compared to controls and remained elevated up to day 120. In the long-term time course these markers of inflammation and plaque remodeling slightly decreased in ACS patients. There were no statistically significant differences detectable in the levels of TNF-α, IL-6, IL-1 β, IL-10, IL-1 ra, sCD40L and monocyte chemoattractant protein-1 (MCP-1) in the blood of ACS patients taken from a cardiac source as compared to an extracardiac source (coronary sinus vs. femoral vein).

This study demonstrates the importance of a systemic inflammatory condition in patients with ACS, in whom markers of inflammation are increased as compared to controls. During long-term follow-up the pro-inflammatory activity remains elevated in ACS patients, supporting the concept of a systemic rather than a local vascular inflammation contributing to the development of atherosclerosis.

Keywords: acute coronary syndrome; coronary sinus; inflammation; time course


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About the article

Corresponding author. Martina Brueckmann, MD, First Department of Medicine, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. Phone/Fax: +49-621-383-2875, E-mail:

Received: 2004-05-28

Accepted: 2004-08-23

Published Online: 2005-06-01

Published in Print: 2004-10-01

Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2004.232. Export Citation

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