PT  - JOURNAL ARTICLE
AU  - A Abbate
AU  - D Santini
AU  - G G L Biondi-Zoccai
AU  - S Scarpa
AU  - F Vasaturo
AU  - G Liuzzo
AU  - R Bussani
AU  - F Silvestri
AU  - F Baldi
AU  - F Crea
AU  - L M Biasucci
AU  - A Baldi
TI  - Cyclo-oxygenase-2 (COX-2) expression at the site of recent myocardial infarction: friend or foe?
AID  - 10.1136/hrt.2003.010280
DP  - 2004 Apr 01
TA  - Heart
PG  - 440--443
VI  - 90
IP  - 4
4099  - http://heart.bmj.com/content/90/4/440.short
4100  - http://heart.bmj.com/content/90/4/440.full
SO  - Heart2004 Apr 01; 90
AB  - Background: Cyclo-oxygenase-2 (COX-2) is induced in cardiomyocytes only in response to stress, such as ischaemia.Objective: To assess COX-2 expression at the site of recent myocardial infarction.Methods: COX-2 expression was evaluated by specific immunostaining in cardiomyocytes from 23 subjects who died 10–60 days after acute myocardial infarction. The relation between COX-2 myocardial expression and apoptotic rate was investigated. Cardiomyocyte apoptotic rate was defined as the number of cells co-expressing in situ end labelling of DNA fragmentation (TUNEL) and immunostaining for activated caspase-3.Results: COX-2 expression was found in cardiomyocytes at the site of infarction in nine of 23 cases (39%). It was associated with fivefold higher apoptotic rates (median 17.9% (interquartile range 11.0–25.4%) v 3.7% (0.6–12.8%); p  =  0.016), and apoptotic rate increased progressively from mild to intense COX-2 staining (p for trend 0.009). COX-2 expression co-localised with TUNEL nuclear staining in myocytes, and there was a high concordance between COX-2 and hypoxia induced factor 1-α staining (78%, p  =  0.021) and between COX-2 and bax (83%, p  =  0.014). Subjects showing myocardial COX-2 expression were more likely to have enlarged hearts (p  =  0.050), and intense COX-2 staining was strictly associated with symptomatic heart failure (p  =  0.035).Conclusions: COX-2 is expressed in cardiomyocytes in nearly 40% of cases at the site of recent acute myocardial infarction, even late after the index event. Its expression was associated with extremely high apoptotic rates. These findings suggest a potential cause–effect link between COX-2 expression and enhanced myocardial apoptosis in ischaemic cardiomyopathy.