OBJECTIVE: This study was undertaken to investigate
troponin and lymphocyte subset changes in acute myocardial
infarctions (AMI) and to correlate these changes with disease
variables.
METHODS: Forty-five patients with AMI admitted to the
Coronary Care Unit, Jordan University Hospital and
Queen Alia Heart Institute at King Hussein Medical Center,
Amman, Jordan during the period November 1999 through to
April 2000 were included in the study. Forty-five patients with
non cardiac conditions were selected as a control group. Tests
performed include; determination of the percentages of
B-lymphocytes, T-lymphocytes and T-lymphocyte subsets by flow
cytometry, measurements of serum cardiac troponin I (cTnI) by
microparticle enzyme immunoassay and determination of minor
blood groups by the gel test.
RESULTS: A significant increase in the percentages of
CD8+ and CD19+ cells combined with a significant decrease in the
percentages of CD3+ and CD4+ cells as well as a decrease of
CD4+/CD8+ ratio were documented in patients with AMI 24 hours
after admission to the hospital. Except for CD19+ cells, all of
cell types assayed for returned to their normal percentages
before discharge of patients. Very low CD4+ cell percentages and
CD4+/CD8+ ratio were found to be poor prognostic signs of AMI.
Serum cTnI levels which were elevated in all patients correlate
very well with the decreased CD4+ cell percentages, and the
decreased CD4+/CD8+ cell ratio and they seem to correlate with
the extensiveness of infarction. Troponin and lymphocyte subset
changes, on the other hand, did not correlate with the number of
vessels diseased or the risk factors for AMI. Finally, a
statistically significant association was observed between the
Le (a-b-) phenotype and AMI.
CONCLUSION: Immunologic change seem to accompany or
follow AMI and changes in T-lymphocyte subsets and cTnI can be
regarded as prognostic markers in AMI but these changes are
independent of risk factors and the number of vessels diseased.
Institution
Department of Pathology, Microbiology and Forensic Medicine,
Faculty of Medicine, University of Jordan, Amman,
Jordan. |