The Correlation Analysis Of Stability And Composition Of Coronary Atherosclerosis Plaque In Sudden Coronary Death

Part one Analysis the composition of coronary atherosclerosis plaque in sudden coronary deathObjective: To analyze the composition of coronary atherosclerosis(CAS)plaque in sudden coronary death(SCD).Methods: The subjects were divided into 3 groups,non coronary heart disease group(group A),coronary heart disease and non sudden death group(group B),sudden coronary death group(group C).The clinical data and autopsy data were analyzed retrospectively,and the relative content of the components(lipid,fiber and calcium salt)were further analyzed by special staining.Results: There were 59 cases in group A,with an average age of 39.54±11.16 years,and coronary artery was slight lesion.There were 59 cases in group B,with an average age of 55.64±14.11 years.The highest incidence of coronary artery stenoses was grade III and Left anterior descending(LAD)was the most vulnerable.There were were 56 cases in group C,with an average age of 53.36 ±13.91 years old.There are obviously predisposing factor for 30 cases.The incidence of coronary artery stenoses of grade IV was the highest,and LAD was the most prone to disease.HE staining and special staining showed that coronary artery intima only existed foam cells in group A,while there had different degrees of coronary artery lipid deposition and fibrous tissue hyperplasia in group B and group C,there were 38 cases in group B and 41 cases in group C for calcification.There was a significant difference for contents of lipid,fiber and calcium(53.53±16.23,27.07±9.78 and 19.39±13.46 in group B,44.00±12.00,31.63±9.29 and 24.37±10.08 in group C)between group B and group C(P < 0.05).There were different degrees of chronic inflammation in group A,group B and group C,most as chronic bronchitis and chronic pyelonephritis,and there were had the highest incidence of chronic inflammation in group C.Conclusion: The severe coronary artery stenosis is more likely to lead SCD and the composition of CAS plaque(especially calcium salt)affects the stability of plaque.Part two Relativity of stability and expression of bone related proteins in coronary atherosclerosis plaque with sudden coronary deathObjective: To investigate the relationship between inflammatory factors,such as C-reactive protein(CRP),calcium deposition and plaque stability in CAS plaques.Methods: The subjects were divided into 3 groups,non coronary heart disease group(group A),coronary heart disease and non sudden death group(group B),sudden coronary death group(group C).The detection of a-SM-actin,CRP,bone related proteins,such as bone morphogenetic protein 2(BMP2),matrix metalloproteinase 9(MMP9)and tissue inhibitor of matrix metalloproteinase 1(TIMP1)were taken by immunohistochemical staining and Western blot experiment.Results: There was positive expression for a-SM-actin in CAS plaques of group B and group C.The expression of CRP in group A,group B and group C increased gradually.BMP2,MMP9 and TIMP1 in group A were not significantly expressed,but all were expressed in group B and group C,and the expression of these three proteins in group C were significantly higher than that of group B(P < 0.05).CRP expression was positively correlated with BMP2,MMP9 and TIMP1(R values were 0.988,0.995,0.990,respectively,P < 0.01).Conclusion: It was destroyed instability of the plaque,which eventually leads to SCD by expressing of bone related proteins(BMP2)and calcification and high expressing of MMP9 and TIMP1 in chronic inflammation stress.