[Associations between the plasma inflammatory markers and plaque morphologies of coronary artery lesions].

OBJECTIVE: To evaluate the vulnerability of coronary artery plaque with coronary angiography (CAG), intravascular ultrasound (IVUS) and the levels of plasma inflammatory markers. METHODS: 58 consecutive patients with lesion of a single blood vessel demonstrated successfully by CAG were randomly divided into 3 groups based on the angiographic morphology of the the lesions: type I lesion group (n = 16), type II lesion group (n = 25), type III lesion group (n = 17). Meantime, a control group of stable angina (n = 17) was established. A subgroup of 28 patients (including 18 acute coronary syndrome (ACS) patients and 10 stable angina control patients) who underwent IVUS study were analyzed. Then the plasma levels of high sensitivity CRP (hs-CRP), matrix metalloproteinase (MMP, including MMP-2 and MMP-9), CD(40) ligand (CD(40)L) and pregnancy associated plasma protein-A (PAPP-A) were measured with ELISA. Analyses were performed by statistical package SPSS 11.0. RESULTS: The plasma levels of MMP-2, MMP-9 and PAPP-A in type II lesion group were significantly higher than the other groups (P < 0.05, 0.05, 0.001, respectively). In type II lesion group, linear correlation analysis manifested significantly positive correlation between levels of hs-CRP and MMP-2 (r = 0.508); MMP-2 and MMP-9, CD(40)L, PAPP-A (r = 0.647, 0.704, 0.751, respectively); MMP-9 and CD(40)L, PAPP-A (r = 0.491, 0.639, respectively); CD(40)L and PAPP-A (r = 0.896). IVUS subgroup analysis showed that the area of plaques and plaques burden in culprit lesion, the incidence of high-risk plaques, remodeling index (RI) and positive remodeling percentage in ACS patients were significantly greater than those in the control group (P = 0.000, 0.037, 0.028, 0.015, 0.040, respectively). Compared with the control group, the plasma levels of hs-CRP, MMP-2, MMP-9 and PAPP-A were markedly elevated (P = 0.033, 0.000, 0.000, 0.027, respectively). CONCLUSIONS: CAG and IVUS combined with the study on plasma levels of inflammation mediators were helpful in judging the vulnerability of coronary artery plaques.