Role of serum neopterin level in unstable angina

ABSTRACT

Coronary artery disease is the most common form of heart disease and the important single cause of death. Unstable angina is a life threatening disorder and a major cause of emergency medical care. Disruption of vulnerable atheromatous plaque is the most common pathogenic mechanism in unstable angina. Macrophage and T cell lymphocytes are critical in the growth and changes of plaques through the secretion of growth factors, cytokines and extracellular matrix digesting enzymes, which weaken fibrous cap. Neopterin, which is a byproduct of guanosine triphosphate degradation in macrophages activated by interferon gamma being a marker of macrophage activation, is a more direct measurement of immune system activation. Immune system activation may play a pathogenic role in acute coronary syndrome. Neopterin can be used as a marker for activity of coronary disease. The purpose of this study to evaluate the neopterin level in patients had unstable angina and complex coronary artery disease lesions vs. patient with chronic stable angina. Prospective study was performed in 50 patients divided in three groups. Group1 [30 patients with unstable angina class IIIb according to Braunwald classification. Group2 10 patients with chronic stable angina. Group3 10 patients with normal coronary angiography. The neopterin level was high significantly in group 1 in compare to both other two groups. There was correlation between the neoperin level and the number of angiographically complex lesion. Neopterin level was not correlated vessel score or stenosis score