Acute local elevation in monocyte chemoattractant protein-1 (MCP-1), distal to the culprit lesion in acute ST elevation myocardial infarction

摘要

Monocyte chemoattractant protein-1 (MCP-1), also known as CC chemokine ligand 2 (CCL2), plays a role in myocardial remodelling and dysfunction after infarction, through its effects on macrophage recruitment [1]. Its use as a marker for outcome following ST elevation myocardial infarction (STEMI) as measured in peripheral venous blood is however, unknown, with variable changes observed post STEMI [2-8]. We sought to examine acute local levels of MCP-1 in the distal coronary artery subtending acutely infarcting myocardium in humans presenting with STEMI, with the hypothesis that in this local environment, local elevations of MCP-1 would be observed. In 10 patients presenting acutely with STEMI, blood was drawn from the coronary artery, distal to the culprit coronary artery lesion immediately following re-establishment of flow and stenting during primary percutaneous coronary intervention. Blood sampling was performed using a multifunction probing catheter (Medtronic Inc, Minneapolis, MN, USA), a technique previously validated by ourselves as not causing ex vivo platelet activation [9]. The same techniques were used in 10 patients undergoing elective coronary stenting for stable angina as a control group. A second control group was provided by peripheral venous blood from 10 healthy volunteers.