| Objective: To investigate the relationship of increased serum levels of S100 B, S100A6 and S100 P,the ligands of receptor for advanced glycation endproducts(RAGE),to the presence of acute coronary syndrome(ACS),as well as the potential role of diabetes mellitus, and to evaluate their predictive value for short-term prognosis in patients with unstable angina pectoris.Methods: Eight hundred and eighty-two patients who were performed coronary artery angiography(CAG) in the cardiology department of Ruijin hospital affiliated to Shanghai Jiaotong University school of medicine from March 2014 to February 2014, were enrolled in our study.the patients were categorized as three groups:Controls(n=251,CAG showing to be normal or ≦ 30% luminal stenosis), stable angina(SA)(n=211), and ACS(n=420, with 70 UA,90 NSTEMI,260 STEMI);based upon their clinical presentation, EKG,results of CAG and laboratory findings;Patients with SA and ACS were then divided into three subgroups as single, double and three branch lesions according to the involved of coronary artery branches.No difference of age,gender,or weight index was found in the above groups.Five mililitters of peripheral blood were collected from radial venous during CAG surgery before heparin and nitroglycerin were injected. Serum levels of S100 B, S100A6, S100 P, s RAGE, CRP and TNF-a were examined by means of enzyme-linked immunosorbent(ELISA) kits.Patients were followed-up for three months. Major adverse cardiovascular events(MACE) were defined as(sudden cardiac death, severe heart failure, malignant arrhythmia, recurrent myocardial infarction, or revascularization). SPSS15.0 software was used for data analysis.Results:(1)No significant difference of age, gender, body mass index or the occurence of diabetes mellitus was found among three groups. ACS patients were more inclined to have multi-vessel lesions than SA patients(p<0.001).(2)Serum S100B、S100A6 and S100 P levels were higher in patients with ACS than those with SA or Controls,(all p<0.01), However,there was no statistically significant difference of the above three bio-measurements between the SA and the control group, In the following subgroup analysis for ACS, patients with ST-segment elevation myocardial infarction(STEMI) showed the highest levels of S100 B,S100A6, S100 P,CRP and TNF-a than those with unstable angina or non-ST-segment elevation myocardial infarction(UA/NSTEMI).(3) None of serum S100 B, S100A6 and S100 P protein levels was significantly different in all samples or each subgroup between diabetic and non-diabetic patients.(4) Serum levels of both S100 B and S100 P were positively linearly correlated with CK-MB and troponin I peak levels in ACS group(all p<0.05).(5)In multivariable regression analysis, serum levels of S100B(OR=1.273, 95%CI1.024-1.582,P<0.05),S100A6(OR=1.451, 95%CI1.099-1.915,P<0.01),S100P(OR=1.457,95%CI1.099-1.932,P<0.01),CRP(OR=1.843,95%CI1.398-2.429,P<0.001) and TNF-a(OR=1.453,95%CI1.176-1.795,P<0.01) were all independently associated with the presence of ACS.(6) During the followed-up of 70 UA patients for three months, 8 patients were lost, and 22 people had MACE, Patients with MACE had higher serum levels of CRP, S100 B, S100A6 and S100 P than those without..Moreover, higher levels of S100 B,S100A6,S100 P were independently associated with MACE in three months.Conclusion: 1 ACS patients showed increased level of serum S100 B, S100A6 and S100 P, which also independently associated with the risk for ACS.,High levels of S100 B and S100 P were also related to the severity of myocardial ischemia and predicted the short-term prognosis of ACS. 2 Diabetes environment had no significant effect on the expression of serum S100 B, S100A6 or S100 P. |
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