Effect Of Tongxinluo On Soluble CD40 Ligand,Matrix Metalloproteinase-2 And High-Sensitivity C-Reactive Protein In Acute Coronary Syndrome Patienta

Object: Acute coronary syndromes (ACS) concerned chiefly with the stability of atherosclerotic plaque. Increasing studies have suggested that soluble CD40 ligand (sCD40L),matrix metalloproteinases-2(MMP-2),high-sensitivity C-reactive protein(hsCRP) may reflect the stability of atherosclerotic plaque.We investigated the effect of Tongxinluo on sCD40L,MMP-2 and hsCRP in patients with ACS。Methods: 90 of 100 patients with ACS were divided into two groups randomly:Tongxinluo group and control group ,Tongxinluo group included 46 patients ( 32 men , 14 women ; mean age,65.7±11.5years) and was given Tongxinluo ( 4 capsules ,Tid ) and the period of treatment was 4 weeks ; control group included 44 patients (29 men , 15 women; mean age ,67.7±8.2 years ) and was given conventional therapy only for 4 weeks。The periphery serum levels of sCD40L,MMP-2 and hsCRP were measured by means of enzyme linked immunosorbent assay (ELISA) before and after therapy。 Result:(1) Compared with the patients with unstable angina ( UA ) ,the periphery serum levels of MMP-2 and hsCRP in patients with acute myocardial infarction (AMI) group were increase before therapy(MMP-2:77.15±29.84ng/ml vs.66.29±8.48 ng/ml; hsCRP: 8.30±3.73 mg/l vs. 6.73±2.86 mg/l, P <0.05)。sCD40L level was higher in AMI group than that in UA group before therapy, but it was no statistical significance between the two groups ( 6.33±2.52 ng/ml vs. 5.52±1.84 ng/ml, P﹥0.05)。(2) The serum level of sCD40L had not statistical difference between the two groups before therapy (5.83±2.20 ng/ml vs. 5.94±2.22 ng/ml,P =0.82 ),but it was decreased after therapy(Tongxinluo group vs. control group ;69% vs. 55%)。The serum level of sCD40L had statistical difference between the two groups after therapy(2.60±1.39 ng/ml vs 1.84±1.25 ng/ml,P <0.01)。(3)The serum level of MMP-2 had not statistical difference between the two groups before therapy(68.93±13.57 ng/ml vs. 73.45±27.24 ng/ml,P =0.32), but it was decreased after therapy( Tongxinluo group vs. control group ;53% vs. 48%)。The serum level of MMP-2 had statistical difference between the two groups after therapy( 32.57±10.85 ng/ml vs. 38.07±13.39 ng/ml, P <0.05)。(4)The serum level of hsCRP had not statistical difference between the two groups before therapy(7.25±3.36 mg/l vs. 7.65±3.38 mg/l,P =0.58), but it was decreased after therapy( Tongxinluo group vs. control group ;69% vs. 58%)。The serum level of hsCRP had statistical difference between the two groups after therapy(2.27±1.39 mg/l vs. 3.14±1.78 mg/l,P <0.05)。Conclusions: (1)The periphery serum levels of MMP-2 and hsCRP in patients with AMI were higher than that with UA。It shows sCD40L,MMP-2 and hsCRP levels may be bio-markers for risk stratification in ACS patients。(2) Tongxinluo can decrease serum levels of sCD40L,MMP-2 and hsCRP in various degrees. Because more and more studies have suggested that sCD40L,MMP-2 and hsCRP may reflect the stability of atherosclerotic plaque, Tongxinluo may increase the stability of atherosclerotic plaques in ACS patients。...