Cellular Immunity, Neuroendocrine, and Inflammatory Factors for Clinical Prognosis in Acute Coronary Syndrome

Summary

In acute coronary syndrome (ACS), there is an increase in cortisol levels, as an expression of the stress response, and C-reactive protein, as an expression of the inflammatory response, which are in turn associated with changes in the components of cellular immunity, and ultimately are predictors of clinical events. The objective of this study is to demonstrate that, within the frame of reference of ACS, beyond the thrombotic phenomenon that leads to ischemia and myocardial necrosis, there is an activation of an inflammatory and stress response, evidenced by an elevation of CRP and cortisol, respectively, and sequentially modifications in the components of cellular immunity in peripheral blood that convey prognostic value during hospitalization and after discharge. A prospective, observational, analytical, unicentric study of consecutive patients with ACS, with telephone follow-up to 6 months, will be carried out. For 2 years, all eligible patients admitted with a diagnosis of ACS to the Coronary Care Unit of the Hospital de Clínicas José de San Martín in Buenos Aires will be registered consecutively.

Eligibility

Inclusion Criteria:

* Are over 21 years of age and admitted to the Coronary Unit of the Hospital de Clínicas with a diagnosis of Acute Coronary Syndrome (ACS).
* Agree to participate in the study through informed consent.

Exclusion Criteria:

* Concomitant diagnosis of chronic neoplastic or inflammatory disease.
* Diagnosis of allergic disease, parasitic disease, asthma, or hypereosinophilic syndrome.
* Severe associated valvular disease.
* Acute myocardial infarction (AMI) in the previous month.
* Chronic corticosteroid treatment.
* Creatinine clearance \<30% by MDRD (Modification of Diet in Renal Disease).
* Severe hepatic insufficiency.
* Pregnant women.
* Known disease that limits their life expectancy to 6 months.
* Refuse to participate in the study either by their own will or unable to understand its characteristics due to their clinical condition.

Conditions6

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