Summary

Monocytes play a central role in the inflammatory diseaseatherosclerosis. CD14+CD16+ monocytes are consideredproinflammatory monocytes, as they have an increased capacityto produce proinflammatory cytokines, such as TNF-α, andare elevated in various inflammatory diseases.We hypothesizedthat patients with coronary artery disease (CAD) haveincreased levels of CD14+CD16+ monocytes, and thatCD14+CD16+ monocytes are associated with inflammationmarkers. We investigated CD14+CD16+ monocytes in 247patients with CAD and 61 control subjects using flow cytometry.In addition serum concentrations of TNF-α, IL-6, andHs-CRP were assessed. Patients with CAD had higher levels ofCD14+CD16+ monocytes than controls (13.6% versus 11.4%;p<0.001). Logistic regression analysis including quartiles of CD14+CD16+ monocytes showed that CD14+CD16+ monocyteswere associated with prevalence of CAD (OR 4.9, 95% CI2.5–19.1, for subjects in the fourth quartile in comparison tosubjects in the first quartile). The association betweenCD14+CD16+ monocytes and CAD remained independentlysignificant after adjustment for most potential confounders(OR 5.0, 95% CI 1.2-20.0). Serum concentrations of TNF-αwere elevated in subjects within the highest quartiles ofCD14+CD16+ monocytes (p=0.018). Our study showed thatincreased numbers of CD14+CD16+ monocytes are associatedwith coronary atherosclerosis and TNF-α. In accordance,recent animal studies suggest a possibly important role of thesemonocytes in the development of atherosclerosis.