| objective Inflammation plays a critical role in the mechanism of acute coronary syndrome(ACS), which acts through the progress of atherosclerosis,and is significantly related with prognosis of ACS.It has been confirmed that Aspirin can reduce inflammation by inhibiting COX-2, which turns arachidonic acid into prostaglandin endoperoxide that promotes synthetism and secretion of TXA2, so that inhibits the progress of atherosclerosis. Clopidogrel can prevent acceleration of platelets by combining with receptors of ADP, which combined with ADP can activate receptors of glycoprotein Ⅱb / Ⅲa , which can combine platelet and fibrinogen. It has been well known that clopidogrel can inhibit the acceleration of platelets. It is rarely known whether clopidogrel can reduce inflammation. This research investigates whether clopidogrel can suppress the inflammation to stabilize vulnerable plaque, and the significance of the usage of clopidogrel during perioperation, i.e. whether clopidogrel can suppress the inflammation of patients with ACS treated with PCI, by measuring the concentration of serum hs-CRP and tumor necrosis factor-alpha (TNF-α).method 65 patients, which were hospitalized for ACS between October 2003 and August 2004, were randomized into three groups: aspiringroup (group A) and clopidogrel added to aspirin group (group B), PCI group (group C). The patients in group A took 300mg aspirin for the first time, then 100mg aspirin every day. The patients in group B took 300mg aspirin and 300mg clopidogrel for the first time, then 100mg aspirin and 75mg clopidogrel every day. The patients in group C were treated with PCI and took the same doses of aspirin and clopidogrel as those of group B. The concentrations of hs-CRP and TNF-α for all patients were examined before administration, 7 days and 30 days after administration separately. 15 healthy volunteers without any treatment were also involved as controls (group D), and the concentrations of hs-CRP and TNF-α for them were examined contemporaneously. Alteration of the concentrations of hs-CRP and TNF-α were compared in three groups with ACS. All patients with ACS were treated with angiography. The software of SPSS was used for analysis of data.result The concentrations of hs-CRP and TNF-α in three groups with ACS were higher than those of group D before administration. 7 days after administration, the concentrations of hs-CRP in group A and group B decreased significantly( 6.53±1.50 mg/L vs 9.77±1.58 mg/L, 4.90±1.58 mg/L vs 10.06±1.53 mg/L, P<0.01 ) , and the same to TNF-ain both groups ( 92.4U29.32 pg/ml vs 118.16±37.22 pg/ml , 75.60±22.75 pg/ml vs 115.09±33.27 pg/ml, P<0.01 ) , but those in group C didnot decline significantly (9.93±2.22 mg/L vs 10.47±1.97 mg/L, 103.61+25.73 pg/ml vs 115.51±33.88 pg/ml, P>0.05) . 30 days after administration, the concentrations of hs-CRP and TNF-ain three groups with ACS decreased significantly, and these in group C were lower than those in group A andgroup B ( P<0.05 ) .conclusion Clopidogrel added to aspirin can reduce theconcentrations of serum hs-CRP and TNF-α more significantly than aspirin in patients with ACS, which demonstrates that clopidogrel can suppress the vasclular inflammation. PCI elevated the levels of inflammation markerstemporarily although clopidogrel added to aspirin was administrated contemporaneously, but inflammation markers in serum in group C decreased more significantly than those in group A and group B 30 days after administration of clopidogrel added to aspirin, which demonstrates PCI can improve reperfusion of culprit-lesions to suppress the vascular inflammation.
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