CD14+CD16+ monocytes in coronary artery disease and their relationship to serum TNF-α levels

Monocytes play a central role in the inflammatory disease atherosclerosis. CD14+CD16+ monocytes are considered proinflammatory monocytes, as they have an increased capacity to produce proinflammatory cytokines, such as TNF-alpha, and are elevated in various inflammatory diseases. We hypothesized that :patients with coronary artery disease (CAD) have increased levels of CD14+CD16+ monocytes, and that CD14+CD16+ monocytes are associated with inflammation markiers.We investigated CD14+CD16+ monocytes in 247 Patients with CAD and 61 control subjects using flow cytometry. In addition serum concentrations of TNF-alpha IL-6, and Hs-CRP w ere assessed. Patients with CAD had higher levels of CD 14+CD 16+ monocytes than controls (13.6% versus 11.4%; p<0.001). Logistic regression analysis including quartiles of CD 14+CD 16+ monocytes showed that CD 14+CD 16+ monocytes were associated with prevalence of CAD (OR 4.9,95% Cl 2.5-19.1, for subjects in the fourth quartile in comparison to subjects in the first quartile). The association between CD14+CD16+ monocytes and CAD remained independently significant after adjustment for most potential confounders (OR 5.0, 95% Cl 1.2-20.0). Serum concentrations of TNF-alpha were elevated in subjects within the highest cluartiles of CD 14+CD 16+ monocytes (p=0.018). Our study showed that increased numbers of CD 14+CD 16+ monocytes are associated with coronary atherosclerosis and TNF-alpha. In accordance, recent animal studies suggest a possibly important role of these monocytes in the development of atherosclerosis.