The Study Of Correlation Between The Levels Of Serum CRP,sCd40L,MMP-2 And Coronary Heart Disease

Objective This study is designed to investigate the difference of peripheral serum CRP, sCD40L, MMP-2 levels in different subtype of coronary heart disease(CHD),and to explore the value of inflammatory markers in the risk stratification of CHD,the relationship between them and the severity of coronary stenosis,and the correlation between them and the incidence of acute coronary syndrome(ACS). Methods 65 patients with CHD were divided into stable angina pectoris (SAP) group(21 patients) unstable angina pectoris(UAP) group(22 patients) acute myocardial infarction(AMI) group(22 patients), SAP and UAP were documented by coronary angiography,the severity of coronary stenosis was graded with Gensini score, 16 subjects who underwent coronary angiography but showed no evidence of CHD served as normal control.All these people whom we studied had no history of infection systemic immunologic disease serious liver or renal disease tumor wound operation in recent months.peripheral serum CRP, sCD40L and MMP-2 levels were measured by ELISA.Results Compared with the control and SAP,serum CRP level was markedly increased in UAP and AMI patients (P<0.01), and no significant difference was found between SAP group and the control,in the patients with AMI,the level of CRP was higher than the patients with UAP;Serum sCD40L was increased stepwise according to the sequences of the control, SAP, UAP and AMI,the patients with UAP and AMI had significantly raised serum levels of sCD40L when compared with the patients with SAP and the control (P<0.01), but no significant difference was found between AMI groupand UAP group,in addition ,there was also no difference between SAP group and the control;The concentrations of MMP-2 were elevated stepwise according to the sequences of the control, SAP, UAP and AMI,there were also marked differences among all groups (P<0.05) . There was no correlation between the severity of coronary stenosis and the levels of the inflammatory mediators.There were positive correlation among the three inflammatory mediators (P<0.05) .Logistic stepwise regression analysis revealed that the odds ratio(OR) of both CRP and MMP-2 was>l (P<0.05) indicating that CRP and MMP-2 were important risk factors.Conclusions Our study support the theory that the atherosclerosis in CHD patients is closed to inflammation .Serum levels of CRPm sCD40Lm MMP-2 may reflect the severity of CHD and reflect the activities of plaque indirectly. The severity of CHD was decided by the stability of plaque rather than the degree of coronary stenosis.CRP and MMP-2 are the important risk factors in incidence and development of ACS.