Neutrophil count as the centerpiece in the joined association networks of inflammatory and cell damage markers, and neuroendocrine stress markers in patients with stable angina pectoris following stenting

About the Authors:

Tamás Horváth

Roles Conceptualization, Investigation, Methodology, Resources, Writing – review & editing

Affiliation: Invasive Cardiology Unit, Centre of Cardiology, Medical Faculty, University of Szeged, Szeged, Hungary

Gyöngyi Serfőző

Roles Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Writing – review & editing

Affiliation: Department of Biochemistry, Medical Faculty, University of Szeged, Szeged, Hungary

Ádám Györkei

Roles Formal analysis, Visualization, Writing – review & editing

Affiliations Synthetic and Systems Biology Unit, Biological Research Centre, Szeged, Hungary, PhD School of Biology, Faculty of Sciences, University of Szeged, Szeged, Hungary

Imre Földesi

Roles Data curation, Investigation, Resources, Writing – review & editing

Affiliation: Department of Laboratory Medicine, Medical Faculty, University of Szeged, Szeged, Hungary

Tamás Forster

Roles Resources, Supervision, Writing – review & editing

Affiliation: Centre of Cardiology, Medical Faculty, University of Szeged, Szeged, Hungary

Margit Keresztes

Roles Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Supervision, Visualization, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

Affiliation: Department of Biochemistry, Medical Faculty, University of Szeged, Szeged, Hungary

ORCID logo http://orcid.org/0000-0001-5208-9682

Introduction

Mainly due to advanced interventional cardiology and improved prevention, the mortality rate of coronary artery disease (CAD) decreased considerably in the last decade. Still, myocardial infarction probably remains a major obstacle to human longevity also in the coming decade [1]. According to a recent model, development and progression of CAD are determined mostly by the atherosclerotic inflammatory events and by the subsequent arterial repair [2]. Following percutaneous coronary intervention (PCI) with stent implantation, a secondary inflammatory response is initiated, which is triggered by endothelial denudation and disruption, in addition to plaque rupture and myocardial ischemia-reperfusion injury [3, 4]. Peri-procedural myocardial injury still represents a frequent complication of PCI (even in uneventful cases) [5]. It is mostly related to myocardial ischemia, that is elicited primarily by plaque disruption (leading to side branch occlusion or distal embolization) or by coronary vasoconstriction; ischemia and reperfusion are associated with inflammatory reactions [5–6].

Neutrophils and monocytes/macrophages have fundamental roles not only in the process of coronary atherosclerosis but in the post-PCI inflammatory events and in reperfusion wound healing responses as well [3–4, 6–7]. Elevated counts of monocytes were observed after stenting [8]. In a biobank study, the monocyte-to-lymphocyte ratio (MLR) correlated best with cardiovascular...