Prevalence of Allergic Diseases and Atopy in Subjects With Coronary Artery Disease
Prevalence of Allergic Diseases and Atopy in Subjects With Coronary Artery Disease
The purpose of this study is to estimate the prevalence of allergic diseases and atopy among
 patients with angiographically confirmed coronary artery disease as well as to assess levels
 of serum allergic inflammation markers in this population.
Cardiovascular disease (CVD) is one of the leading causes of death, disability and medical
 resources use worldwide. Atherosclerosis remains the basic pathology found in CVD. Based on
 theoretical knowledge and animal experimental models it can be hypothesized that allergic
 inflammation affects atherosclerotic plaque formation/disruption. The exact nature of such
 interaction remains unknown.

 The process most probably takes place at the molecular level and involves both: specific
 interleukin formation and mast cells recruitment. On the one hand some pro-allergic
 interleukins have been found to inhibit atherosclerotic plaque formation in experimental
 animal models. However, other hypothesis conclude that mediators released by mast cells might
 encourage hypoxemia of the heart muscle cells and thus promote their necrosis. Mast cells and
 eosinophils -typically associated with allergy - are both found in human heart muscle, cross
 sections of coronary arteries and atherosclerotic plaques.

 Atopic patients who are prone to IgE-mediated mast cell activation seem to run a lower risk
 of sudden cardiac death after myocardial infarction. It may be associated with the fact that
 atopy produces a mild haemostatic imbalance similar to that typical of aspirin - moderately
 long bleeding time, depressed platelet aggregability and delayed generation of thrombin in
 clotting blood. Tryptase, one of the mediators released from mast cells widely used marker of
 anaphylaxis, has recently been shown to be increased in sera of patients with
 angiographically significant narrowings in coronary arteries. These results are in accordance
 with the previous finding of increased total IgE (antibody involved in type I allergic
 reaction) post myocardial infarction. Allergic myocardial infarction (also known as Kounis
 syndrome) - a condition in which heart muscle ischemia results from allergic insult sometimes
 even in the absence of permanent coronary artery lesions - is another hint supporting the
 hypothesis of possible interaction between allergy and cardiovascular diseases.

 Despite relatively many reports studying the association at molecular, in vitro and clinical
 level, the research investigating the problem as a whole, connecting laboratory data with
 clinical picture, is scarce. Our research aims at providing epidemiological evidence on the
 prevalence of allergy and atopy as well as serum allergy markers profile in subjects with
 coronary artery disease.

 Our study is dedicated to post-coronary angiography subjects willing to express informed
 consent for study participation.

 Coronarography has been chosen as a verification tool for several reasons:

 -  it gives more accurate diagnosis of clinically relevant coronary narrowings than basic
 ECG, ECG exercise test or coronary angioCT

 -  it enables the distinction between typical angina pectoris and Prinzmetal's angina

 -  it has become a common procedure in Poland giving a relatively large and diverse cohort
 of patients undergoing the procedure whom we could address
Inclusion Criteria:

 -  available result of coronary angiography

 -  able to express written informed consent for study participation

 -  able to perform forced expiratory manoeuvre for spirometry

 Exclusion Criteria:

 -  ongoing infection

 -  exacerbation of chronic disorder (e.g. asthma, COPD, CVD, chronic kidney disease,
 neoplasm<10 years from complete remission)