Clinical Study On Relationship Between Nuclear Factor-κB And Acute Coronary Syndrome

[Objective] Acute coronary syndromes (ACS), which range from ST segment elevation myocardial infarction (STEMI) to non-ST-segment elevation MI (NSTEMI) to unstable angina(UA), are deficient of early sensitive and specific index to detect in clinic. It has been demonstrate that most of ACS onsets are related to coronary plaque instability and disruption. It has been reported that the activation of NF-KB in the plaque significantly rose and the expression of genes regulated by NF-KB significantly increased in patients with ACS, NF-KB in mononucleus cells in peripheral blood was selectively and markly activated in patents with UA. In this study, the activations of NF-KB in peripheral blood mononucleus cells were measured to find the relationship between NF-kB and serum CRP and stability of plaques, and to investigate its determinant value to ACS.[Methods] Two milliliter peripheral blood was drawed from 22 patients with ACS(11 patients with AMI and 11 patient with UA ) , 10 patients with SA and 11 patients with HT on admission. After two weeks, two milliliter peripheral blood was drawed from 20 patients with ACS again (2 of 22 patients died). Mononucleus cells were separated from two milliliter peripheral blood by density gradient centrifugation, then the nucleoprotein was extracted, and the concentration of the nucleoprotein was measured.Using TransFactor NF-KB Kits, OD of NF-KB p50 in mononucleus cells were measured by ELISA. Serum CRP, blood glucose, serum total cholesterol and triglyceride, blood routine were measured in all patients. Relationship between NF-KB p50 in mononucleus cells and those indexes were investigated and acute coronary events were instantaneously observed in two weeks.[Results] OD of NF-KB p50 in mononucleus cells in ACS group (AMI group and UA group) on admission was significantly higher than that in SA group and HT group(P<0.01), OD of NF-KB p50 in mononucleus cells in AMI group on admissionwas significantly higher than that in UA group(P<0.05). OD of NF-kB p50 in mononucleus cells in SA group were no difference from that in HT group. After two weeks, OD of NF-KB p50 in mononucleus cells in ACS group was significantly decreased compared with that on admission (P<0.01). Serum CRP level in ACS group (AMI group and UA group) was significantly higher than that in SA group and HT group (P<0.01), respectively. The serum CRP level in AMI subgroup was higher than that in UA subgroup (P<0.01), however there was no difference between SA group and HT group. The cases of the patients with diabetes mellitus were no statistical difference between AMI, UA, SA and HT group, but the blood glucose level in AMI group was markedly increased than that in other three groups (P<0.01), and there was a positive correlation between OD of NF-KB p50 in mononucleus cells and blood glucose level (r=0.512,P<0.01) in ACS group. OD of NF-KB p50 in mononucleus cells also had a positive correlation with serum CRP level(r=0.771, P<0.01). OD of NF-KB p50 in mononucleus cells and serum CRP level in patient with acute coronary events in two weeks were on high level.[Conclusion] OD of NF-KB p50 in mononucleus cells in ACS group was higher than that in SA group or HT group, but there was no statistical difference between SA group and HT group. OD of NF-KB p50 in mononucleus cells in ACS group markedly decreased with time going on. It is speculated that the activation of NF-KB in mononucleus cells in peripheral blood may be a predictor of the coronary plaque instability and disruption, and it might be helpful in the diagnosis of ACS.There was a positive correlation between OD of NF-KB p50 in mononucleus cells and blood glucose level, so it can be supposed that blood glucose control may partly inhibit the activation of NF-KB.Serum CRP level and activation of NF-KB in mononucleus cells in peripheral blood can be used to estimate the prognosis of ACS patients.