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13 August 2019 : Clinical Research  

Increased Ratio of Circulating T-Helper 1 to T-Helper 2 Cells and Severity of Coronary Artery Disease in Patients with Acute Myocardial Infarction: A Prospective Observational Study

Chang Li1B, Wenxia Zong1CD, Ming Zhang1E, Yanming Tu1E, Qiyu Zhou1F, Mingke Ni1D, Zhiyong Li1A, Haizhen Liu1AE, Jingyi Zhang1ACE*

DOI: 10.12659/MSM.913891

Med Sci Monit 2019; 25:6034-6042

Abstract

BACKGROUND: This study aimed to determine the association between CD4-positive T-helper (Th) cell subsets, T-helper 1 (Th1) and T-helper 2 (Th2) in patients with acute myocardial infarction (AMI) and the severity of coronary artery disease (CAD) determined by coronary artery angiography.

MATERIAL AND METHODS: Three groups of patients with AMI who underwent coronary angiography and percutaneous coronary intervention (PCI) included patients with stable CAD (n=35), ST-segment elevation myocardial infarction (STEMI) (n=30), and non-STEMI (NSTEMI) (n=35), and controls (n=33). Measurement of high-sensitivity cardiac troponin T (hs-cTnT) was performed. The numbers of circulating CD4-positive Th1 and Th2 cells were measured using flow cytometry. Plasma levels of interferon-γ (IFN-γ) and interleukin-4 (IL-4) were measured using enzyme-linked immunosorbent assay (ELISA).

RESULTS: An increase in the Th1 lymphocyte population was associated with more CAD, and an increased Th1/Th2 ratio was found in patients with NSTEMI and STEMI (controls 7.27±2.98; stable CAD 7.58±2.52; NSTEMI 16.62±2.74; and STEMI 22.32±7.35) (P<0.001). The proportion of Th1 cells and the Th1/Th2 ratio increased as the number of affected arteries, the degree of stenosis, and the lesion length increased. At a median follow-up of 18.2 months, patients with CAD and an increased Th1/Th2 ratio had a significant increase in adverse cardiac events compared with patients with a reduced Th1/Th2 ratio (log-rank, P=0.042).

CONCLUSIONS: An increased ratio of circulating Th1 to Th2 cells in patients with AMI was associated with the severity of CAD determined by angiography.

Keywords: adaptive immunity, atherosclerosis, Interleukin-1, Myocardial Infarction, Aged, Coronary Angiography, Coronary Artery Disease, Coronary Vessels, Middle Aged, percutaneous coronary intervention, Prospective Studies, ST elevation myocardial infarction, Severity of Illness Index, T-Lymphocytes, Helper-Inducer, Th1 Cells, Th2 Cells

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750