C-reactive protein contributes to the hypercoagulable state in coronary artery disease

C. J. Song, A. Nakagomi, S. Chandar, H. Cai, I. G S Lim, H. P. McNeil, S. B. Freedman, Carolyn L. Geczy

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objectives: Elevated plasma C-reactive protein (CRP) levels predict coronary events, but it is unclear whether CRPplays a role in thrombosis associated with these events. We investigated tissue factor (TF) induction by CRP on peripheral blood mononuclear cells (PBMC) from patients with coronary disease. Patients and Methods: PBMC from 35 patients with stable angina (SA) in study 1, 10 male patients with SA, 10 with unstable angina (UA) and 10 matched controls in study 2, and 25 patients with in.ammatory disorders (ID) and 24 normal controls in study 3 were stimulated with CRP, interferon-c (IFN) or lipopolysaccharide (LPS), or their combination. PBMC from additional normal donors were also stimulated with CRP in adherent and non-adherent conditions, and TF activity, antigen andmRNA expression detected. Results: CRP (5-25 μg mL-1) dose dependently induced more TF on PBMC from SA patients than 42 contemporary controls (P = 0.001, study 1). Compared with controls, patients with SA or UA had higher basal, and much higher CRP- or CRP/LPS-induced monocyte TF activity although serum CRP levels were similar (study 2). IFN induced monocyte TF activity in patients with angina, but not in controls. Basal or CRP-induced TF levels did not di.er between controls and ID, even though ID patients had much higher serum CRP levels (study 3). CRP-induced monocyte TF activity correlated with serum CRP levels in controls (P = 0.005) and ID (P = 0.007) in study 3, but not in patients with angina (P = 0.84) in study 2. CRP induced more TF activity, protein and mRNA under adherent than nonadherent conditions implying that it may mainly target macrophages in lymphocyte-rich lesions. Conclusions: Our results indicate that monocytes from patients with angina are preactivated and express TF but CRP is unlikely to be a major priming factor in vivo. IFN and CRP further increase TF levels that may contribute to the hypercoagulable state in coronary disease.

Original languageEnglish
Pages (from-to)98-106
Number of pages9
JournalJournal of Thrombosis and Haemostasis
Volume4
Issue number1
DOIs
Publication statusPublished - Jan 2006
Externally publishedYes

Keywords

  • C-reactive protein
  • Coronary disease
  • Inflammation
  • Thrombosis
  • Tissue factor

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