A standardized stimulus augment CRP similarly in patients with a history of stable or unstable

Objective: To compare the CRP response to a standardized inflammatory stimulus in patients with history of stable or unstable CHD Methods: Adjuvanted influenza sc vaccination (Inflexal y®) was given to 60 adult male patients with quiescent CHD and well-controlled CV risk factors who had presented at onset of CHD as stable CHD: silent or inducible ischemia (group 1, n=26) or acute coronary syndromes (group 2; n=34). hsCRP was determined by ELISA on plasma samples collected at baseline and 48 hours after vaccination, according to the results of a pilot time-course study performed in 5 volunteers. Results: The patients were non diabetic, non-smokers, free of inflammatory or other conditions that might presumably influence the immune response. The groups were similar in prevalence of non-coronary atherosclerosis, history of allergies, infections. CV risk factors and current use of CV drugs, including aspirin (100%) and statins (90%), as well as age, BP, BMI and mean levels of LDL-C, TG, HDL-C and median [25•75th perc] baseline hsCRP (group 1: 0.47 µg/ml [0.21-0.86] vs. group 2: 0.64 µg/ml [0.21-1.09]). Vaccination significantly augmented hsCRP in both groups (Wi1coxon test, p<0.01), without significant differences between groups in terms of absolute (0.12 µg/ml [0-0.29] vs 0.16 µg/ml [-0.02 - 0.41 ]) or percent (29% [0 - 81 %] vs 36% [-6 - 72%] changes (Mann-Whitney tests, both NS). Conclusion: CHD patients with history of stable or unstable disease respond similarly to a defined standardized inflammatory stimulus (influenza vaccination) in terms of CRP change. Funding: Centro Cardiologico Monzino. Italian Ministry of Health