Neutrophilic intracellular metabolic changes and fatal outcome in coronary heart disease
Kratnov, A.E.; Khabarova, I.V.
Klinicheskaia Laboratornaia Diagnostika 1: 20-22
2009
ISSN/ISBN: 0869-2084 PMID: 19256017 Document Number: 635596
An association of neutrophilic intracellular metabolic changes with the occurrence of a fatal outcome was studied in 121 patients with coronary heart disease (CHD). On admission, all patients with CHD were found to have higher relative counts of neutrophils, C-reactive protein, and malonic dialdehyde in blood and that of lactate in neutrophils than those in the controls; their cellular activity was, on the contrary, lowered. The deceased patients were significantly older; they had more frequently a history of myocardial infarction and a lower left ventricular ejection fraction. These patients, as compared to the survivors, were observed to have a higher myeloperoxidase activity and suppressed neutrophilic glutathione reductase with increases in the blood levels of malonic dialdehyde and circulating immune complexes (CIC). It is believed that in patients with CHD and left ventricular systolic dysfunction with activated lipid free radical oxidation, the evident CIC-dependent activation of oxygen-dependent neutrophilic metabolism is able to deplete antioxidative defense of phagocytes, by favoring their mass intravascular death, followed by endothelial damage and hemostatic disorder.