Key result
Vasospastic angina is linked to elevated inflammatory cytokines alongside myocardial and pericoronary inflammation.
Why the study?
Patients with variant angina have poor clinical outcomes and an unclear etiology, prompting investigation into whether vasospastic angina is associated with inflammation of the heart.
Are plasma cytokine levels and myocardial inflammation elevated in patients with vasospastic angina compared to normal controls and patients with acute myocardial infarction?
Observational (n=224)
No
Are plasma cytokine levels and myocardial inflammation elevated in patients with vasospastic angina compared to normal controls and patients with acute myocardial infarction?
Vasospastic angina is associated with significantly elevated plasma cytokines and myocardial inflammation, suggesting a potential underlying link to myocarditis.
Answers are grounded in this paper and cite their sources.
May prompt inflammation evaluation in refractory vasospastic angina; hypothesis-generating for myocarditis association pending prospective trials.
Background: Vasospastic angina (VSA) is caused by severe diffuse or segmental coronary artery spasms. Patients with variant angina have poor clinical outcomes, although nitrates and calcium blockers help improve patient symptoms because there is no understanding of the etiology and causal treatment. The present study investigated whether VSA is associated with inflammation of the heart. Patients and Methods: A total of 109 patients with VSA diagnosed by the presence of recurrent angina pectoris, typical electrocardiography, and coronary angiography were recruited, and 61 normal participants and 61 patients with acute myocardial infarction (AMI) and coronary artery stenosis were recruited as controls. The plasma levels of 24 cytokines were measured using a magnetic Luminex assay, and endothelin-1 and histamine levels tested using enzyme-linked immunosorbent assay and mass-spectrometry, respectively, for all participants. Furthermore, four patients with VSA underwent 18-fluorine fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT). Results: The plasma levels of interleukin (IL)-12p70, IL-13, PDL-1, IL-10, IL-6, IL-15, macrophage inflammatory protein (MIP)-1α, and MIP-1β in patients with VSA were significantly higher than those in both normal controls and patients with AMI (p< 0.001) but did not differ between normal controls and patients with AMI. 18 F-FDG PET/CT showed that the left ventricle, coronary perivascular tissue volume, and coronary perivascular FDG uptake were significantly increased in all four patients. Conclusion: Our findings demonstrate that VSA patients have significantly elevated plasma cytokine levels and myocardial and pericoronary inflammation, suggesting that VSA is associated with myocarditis. This study provides novel insights into the etiology and treatment of VSA.
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Xu et al. (2022) conducted an observational in Vasospastic angina (VSA) (n=224). Vasospastic angina vs. Normal controls and patients with acute myocardial infarction was evaluated on Plasma levels of 24 inflammatory cytokines and chemokines (p=<0.001). Patients with vasospastic angina had significantly elevated plasma levels of multiple inflammatory cytokines and chemokines, as well as evidence of myocardial and pericoronary inflammation, suggesting an association with myocarditis.
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