The Role of Neutrophils, Lymphocytes and Monocytes in Ischemic Heart Disease: Friend or Foe?

Ischemic heart disease (IHD) remains a leading cause of morbidity and mortality globally. In recent years research has increasingly focused on the interplay between the white blood cells and the development and progression of IHD. Neutrophils, lymphocytes, and Monocytes play an important role in the immune system and were found to have dual roles in both protective mechanisms and harmful effects. Neutrophils are traditionally viewed as first responders to tissue injury. Their rapid infiltration aids in the clearance of cellular debris and pathogens, while the release of reactive oxygen species and inflammatory mediators can exacerbate tissue damage. Additionally, neutrophils participate in intercommunication with endothelial cells and platelets, influencing the progression of atherosclerosis and thrombosis. Lymphocytes, a key player in adaptive immune response, similarly exhibit a dual role in IHD. Their involvement extends beyond immune surveillance. Monocytes contribute to phagocytosis and tissue repair while some of their actions cause atherosclerotic plaque instability. This review provides an overview of IHD, covering its prevalence, pathogenesis, risk factors, clinical manifestations, diagnosis, and the involvement of white blood cells, including neutrophils, lymphocytes, and monocytes, in the disease process.