Sulfido-peptide leukotrienes in coronary heart disease - relationship with disease instability and myocardial ischaemia

Eur J Clin Invest 2010; 40 (3): 258–272 Background Urinary excretion of leukotriene (LT) E4 is an index of LTC4 biosynthesis and platelet–neutrophil interactions, which may occur in coronary heart disease and contribute to myocardial ischaemia. Enhanced LTC4 biosynthesis may be a consequence of myocardial ischaemia or be linked to its pathogenetic substrate. Methods and results Overnight urine collections were obtained from 17 patients with chronic stable angina, three patients with Prinzmetal’s angina, 16 patients with non ST‐elevation acute coronary syndromes (NSTE‐ACS) and six patients with acute ST‐elevation myocardial infarction (STEMI). LTE4 excretion was measured by enzyme immunoassay after HPLC separation. Compared with healthy controls (51·1 ± 21·3 pg mg−1 creatinine, mean ± SD, n = 11) and with non‐coronary cardiac controls (36·6 ± 9·8 pg mg−1 creatinine, n = 9), LTE4 excretion was unchanged in stable angina (40·5 ± 25·8 pg mg−1 creatinine), but significantly (P