Initial Study on Coronary Arterial Remodeling of Patients with Coronary Artery Disease

Objective To initially evaluate the coronary arterial remodeling of the patients with coronary artery disease by use of intravascular unltrasound(IVUS).Methods 28 consecutive patients with coronary artery disease were randomly divided into the acute coronary syndrome(ACS)group(n=18)and stable angina group(n=10).The area of plaques,the area of extra-elasticity membrane(EEM)of vascellum and plaque burden as well as remodeling index(RI)of coronary arteries were measured by IVUS in two groups.The plasma levels of high sensitivity C-reactive protein(hs-CRP),matrix metalloproteinase(MMP,including MMP-2 and MMP-9),CD40 ligand(CD40L)and pregnancy associated plasma protein-A(PAPP-A)were measured by ELISA.Results The area of plaques(P=0.000),the area of EEM(P=0.003)and plaque burden of criminal lesions(P=0.037)in the patients of the ACS group increased more significantly than that of the control group.The incidence of high-risk plaques(P=0.028)and RI(P=0.015)in the ACS group increased more significantly than that of the control group.The positive remodeling was more common in the ACS group(P=0.040),while negative remodeling in the control group(P=0.039).The plasma levels of MMP-2(P=0.011),MMP-9(P=0.001)and CD40L(P=0.034)in the high-risk plaques group were significantly higher than those in the non-high-risk plaques group.There were no significant differences of the plasma levels of hs-CRP(P=0.190),MMP-2(P=0.255),MMP-9(P=0.574),CD40L(P=0.342),PPAP-A(P=0.403)and the incidence of high-risk plaques(P=0.566)in the positive and negative as well as none remodeling groups.Regression analysis showed that only the regression coefficient of ACS and stable angina by RI were significant(P0.05),the regression equation was RI=0.179-0.131 group(group stands for ACS group and stable angina group).Conclusion The clinical types of coronary artery disease may be an independent predictor of the coronary arterial remodeling measured by IVUS.