The Change Of Plasma TPA,PAI-1 Concentration Level In Patients With Unstable Angina Pectoris And Its Risk Stratification

Background: Unstable angina pectoris(UAP) is a complex> fast advance cardiovascular disease and tend to deteriorate to acute myocardial infarction or sudden cardiovascular death . The major cause of UAP is the instability of coronary atherosclerotic plaque . It has become a hot spot of studding coronary heart disease how to recognize unstable plaque and prevent plaque rupture . But there are less methods to recognize unstable plaque now . The coronary intravascular ultrasound and angioscopy can t be performed on a larger number of patients . Therefore , seeking a chemical marker related to unstable plaque has many clinical advantages . The relationship between plasma tissue plasminogen activator(t-PA) and UAP has been recognized gradually.Objective: By observing plasma t-PA concentration in patients with UAP , their significance in pathophysiologic process of UAP development has been explored .Methods: 18 patients with UAP , 21 patients with stable angina pectoris(SAP), and 16 normal persons as control group . Plasma t-PA -.plasminogen activator inhibitor l(PAI-l) concentration were measured using enzyme linked immunosorbent assay( ELISA) . The plasma t-PA -, PAI-1 concentration of three groups and three UAP classes were compared .Results: control group Plasma t-PA concentration was 7.91 ?.40 ng/ml> PAI-1 concentration was 109.51 ?6.44ng/ml, SAP group Plasma t-PA concentration was 9.59 + 2.13 ng/mK PAI-1 concentration was 96.37?4.88ng/ml, UAP group Plasma t-PA concentration was 16.72?.99 ng/mK PAI-1 concentration was 135.04 +25.lOng/ml, UAP group Plasma t-PA-, PAI-1 concentration were significantly higher (P<0.01) . UAP group I class Plasma t-PA concentration was 13.20 ?.50 ng/mK PAI-1 concentration was 136.85+ 17.68ng/ml, IIclass Plasma t-PA concentration was 14.73 ?.69 ng/mK PAI-1 concentration was 137.62 ?5.53ng/ml, Illclass Plasma t-PA concentration was 19.96 ?.62 ng/mK PAI-1 concentration was 144.71 ?5.82ng/ml, UAPIII class Plasma t-PA concentration were significantly higher (P<0.05)> there was not significant difference in PAI-1 concentration among each class of UAP (p>0.05) . By following up 3 months , three patients with UAP had acute myocardial infarction , two patients belong to UAP group III class, one belong to UAP group I class . Patients with SAP had not acute myocardial infarction .vConclusions: The plasma t-PA concentration level of UAP is significantly higher and with the increase of UAP severity class . The plasma t-PA concentration affect the stability of coronary atherosclerotic plaque .