Assessment of lymphocyte populations and their subsets in the patients with acute coronary syndrome

We examined 23 patients aged 40 to 65 years (mean age 54.52±6.72) with a diagnosis of acute coronary syndrome (ACS) at admission, who underwent emergency or delayed coronary stenting a day later. All patients had arterial hypertension as a concomitant disease. Upon additional examination, blood troponin levels were determined, ECG was performed in the time dynamics. Acute myocardial infarction with ST elevation was diagnosed in 7 patients, infarction without ST elevation, in 6 patients, the unstable angina rest, in the rest of this group (Grace risk from 75 to 150 points, on average, 107.7±27.16 points). To assess the immune status, especially, lymphocyte populations and subsets we used standardized techniques, i.e., flow cytometric assays with Navios cytofluorimeter (Beckman Coulter, USA). The following subpopulations were determined: CD45⁺ (panleukocyte marker for gating lymphocytes), CD45⁺, CD3⁺ (T cells), CD45⁺, CD3⁺, CD4⁺ (helper inducers), CD45⁺, CD3⁺, CD8⁺ (cytotoxic T cells), CD45⁺, CD3⁺CD16⁺, CD56⁺ (TNK cells) CD45⁺, CD3^-, CD16⁺, CD56⁺ (natural killer cells), CD45⁺, CD3^-, CD19⁺CD5⁺ (B cells), CD45⁺, CD3⁺, CD4⁺, CD25⁺ (activated helpers, early activation phase), CD45⁺, CD3⁺, HLA-DR (activated T lymphocytes – late activation phase). The data obtained indicate that the relative indices of T helper subpopulations, T cells at early and late activation step, and B lymphocytes were increased in the patients with acute coronary syndrome, compared with control group. At the same time, there is a trend for increasing absolute values of these indexes. The subpopulation of TNK lymphocytes proved to be significantly increased both in relative and absolute values, whereas percentages of CD45⁺CD3⁺CD19^- (p < 0.01) and T cytotoxic lymphocytes (p < 0.001) were decreased and showed the same trend in absolute terms. The ratio of CD4/CD8 lymphocytes was almost doubled (p < 0.001), due to increased content of T-helpers and decrease in cytotoxic T lymphocytes. In clinical blood analyses of ACS patients a tendency for leukocytosis was shown, (10.15±5.22), with a shift to the band forms.