| Background and Objective: In acute coronary syndrome there is an unexpected and sudden development of ischemia which has been attributed to plaque rupture and subsequent thrombosis, not to the structure of coronary arteries. The potential role of inflammation in plaque rupture in acute coronary syndrome has become increasingly recognized. From a clinical perspective, early detection of these plaques may prevent the occurrence of serious coronary events. Recent studies have suggested that markers of systemic inflammation may help in the detection of high risk patients. But which markers are helpful in acute coronary events are not verified. The aim of this study is to discuss whether or not soluble intercellular adhesion molecule-1 and pregnancy associated plasma protein-A are the markers of unstable plaques.Methods: We collected clinical data and measured serum levels of PAPP-A and sICAM-1 in 20 patients with acute myocardial infarction, 26 with unstable angina, 22 with stable angina, and 20 controls with ELISA method. Values are expressed as means +SD. Statistical significance was evaluated by one-way analysis of variance followed by the One-Way ANOVA tests for multiple comparisons. All statistical tests were performed on raw data. The quantitative analysis was used to evaluate the concentration of PAPP-A and sICAM-1 by SPSS 12.0 process. And correlation analysis was used to evaluate the relationship among PAPP-A, sICAM-1, and blood sugar, TC, TG, LDL-C, HDL-C, apoAl, apoB, CK-MB, numbers of coronary vessel disease. P <0.05 was considered significant.Results: 1. sICAM-1 in ACS group was significantly higher than those in SA group (P <0.05) and control group (P <0.01) , sICAM-1 in SA group was also higher than that in control group (P <0.01), and sICAM-1 was higher in patients with AMI than that in patients withUA (PO.01) .2. PAPP-A in ACS group was significantly higher than those in SA group and control group (P <0.01), There were no significant difference between SA group and control group , AMI patients and UA patients (P>0.05) .3. sICAM-1 in 1-vessel-disease group , 2-vessel-disease group and 3-vessel-disease group were significantly higher than that in control group (.P <0.01) , sICAM-1 in 2-vessel-disease group and 3-vessel-disease group were higher than that in 1-vessel-disease group (P <0.05) , There were no significant difference between 2-vessel-disease group and 3-vessel-disease group (PX3.O5) .4. PAPP-A in 2-vessel-disease group and 3-vessel-disease group were significantly higher than those in 1-vessel-disease group and control groupiP <0.05, P <0.01), There were no significant difference between 2-vessel-disease group and 3-vessel-disease group , 1-vessel-disease group and control group (P >0.05) .5. There were no significant difference of sICAM-1 and PAPP-A between mild stenosis group and sever stenosis group of coronary artery (P >0.05 ) .6. In the AMI group there was no significant difference of sICAM-1 and PAPP-A when this group was divided into ^6 score group and >6 score group using Wagner's QRS scoring system.7. correlation analysis:(1) In patients with AMI, there was high correlative relationship between sICAM-1 andPAPP-A (r=0.737, .PO.OOl), there was moderate correlative relationship between sICAM-1and fibrinogen and the number of WBC (r=0.621, /> =0.013, r=0.582, P =0.023), there wasmoderate correlative relationship between PAPP-A and fibrinogen and the number of WBC(r=0.565, P =0.032, r=0.535, P =0.041) .(2) In patients with UA, there was high correlative relationship between sICAM-1 and PAPP-A (r=0.758, PO.001), there was moderate correlative relationship between sICAM-1and fibrinogen and the number of WBC (r=0.438, P =0.032, r=0.529, P =0.005), there was moderate correlative relationship between PAPP-A and fibrinogen and the number of WBC (r=0.446, P =0.020, r=0.541, P =0.004) .(3) In ACS group , there were no significant correlative relationship among sICAM-1. PAPP-A and age, blood sugar, TC, TG, LDL-C, HDL-C, apoAl, apoB, CK-MB, numbers of coronary vessel disease.Conclusion: Both PAPP-A and sICAM-1 were detected in patients with UA, and the circulating levels of them were elevated in patients with ACS; these increased levels may reflect the instability of atherosclerotic plaques and the severity of coronary heart disease. The elevated levels of PAPP-A and sICAM-1 in ACS suggested the possible relation of PAPP-A and sICAM-1 to the pathogenesis of acute coronary syndrome, which may be newly sensitive markers for indentifying patients with ACS.
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