The Clinical Implications Of Increased Serum Amyloid A Protein Levels In Patients With Acute Coronary Syndromes

Objective:We studied changes of level of serum amyloid A in patients with acute coronary syndrome, and the relationship of serum amyloid A, high sensitivity c-reactive protein, Interleukin-6and tumor necrosis factor-a level. We investigated whether serum amyloid A is an useful indicator of detection of vulnerable plaques.Method:We divided88cases of candidates into3groups with clinical observation based on history, clinical manifestations and secondary checks. These groups included patients with acute coronary syndrome(n=29, including acute ST-segment elevation myocardial infarction and acute non-ST-segment elevation myocardial infarction), patients with chronic stable angina pectoris(n=28) and normal controls(n=31, including patients with chest pain or hypertension excluded coronary heart disease). High sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-alpha and serum amyloid A protein were measured with enzyme-linked immunosorbent assay. We studied the correlation of4of these inflammatory markers and the influence of admission time on these4kinds of inflammatory markers. Result:High sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-alpha and serum amyloid A protein in patients with acute coronary syndrome were significantly higher than those in patients with chronic stable angina pectoris and controls (p<0.01). These4kinds of inflammatory markers had no significant group differences between patients with chronic stable angina pectoris and controls(p>0.05). High sensitivity C-reactive protein and interleukin-6in patients had no significant difference between the first day and the fifth day of admission(p>0.05). Serum amyloid A protein and tumor necrosis factor-alpha in patients of the first day were significantly higher than those in patients of the fifth day(p<0.05). Serum amyloid A protein correlated positively with high sensitivity C-reactive protein and tumor necrosis factor-alpha in all patients(r=0.372,0.229, p<0.05), but not with interleukin-6(p>0.05). Logistic regression analysis also demonstrated that serum amyloid A protein was an predictor factor for acute coronary syndrome((OR,70.655,95%CI6.274-795.683, p=0.001)Conclusion:Patients with acute coronary syndrome showed that increased concentrations of serum amyloid A protein may be a valuable marker for the detection of vulnerable plaques and predicting the severity of acute coronary syndrome.