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Cross-Talk Between Primary Percutaneous Coronary Intervention, Arterial Inflammation, and Light/Dark Patterns

Recent research has shown that inflammation plays a key role in coronary artery disease and other manifestations of atherosclerosis. Immune cells dominate early atherosclerotic lesions, their effector molecules accelerate progression of the lesions, and activation of inflammation can elicit acute coronary syndromes (2). The implication or association of physiological rhythms with peak activity at a certain time of day or night may be suspected, given that the onset of cardiovascular accidents follows a circadian pattern (3). Likewise, we have previously reported that in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention, day/night rhythms of inflammatory markers may be abnormal (4–6). A reciprocal link exists between inflammation and thrombosis. A better understanding of arterial inflammation will enhance our ability to prognosticate risk and effectively design therapy. Therefore, the presence of variability during the 24 h of inflammatory and immunologic functions, would, hypothetically, have a profound effect on the practice of primary percutaneous coronary intervention.

^_* Coronary Care Unit, Department of Cardiology, University Hospital of Canarias, Ofra s/n La Cuesta E-38320, Tenerife, Spain (Email: adrvdg{at}hotmail.com).

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