The Significance Of Nuclear Factor-κB,Matrix Metalloproteinase-9 And Its Promoter C-1562T Gene Polymorphism In Vulnerable Plaque Of Acute Coronary Syndrome

Objectives In order to investigate the pathological of acute coronary syndrome and its clinical detection methods,through detection nuclear factor-κB and matrix metalloproteinase-9 changes of patients,used polymerase chain reaction restriction fragment length polymorphism to identify all patients genotype of MMP-9 promoter C-1562T,to clear its pathogenesis and clinical significance in vulnerable plaque of acute coronary syndrome.Some patients underwent 64-slice spiral computed tomography coronary artery imaging,to evaluate the clinical value of 64-slice spiral computed tomography combined hs-CRP and MMP-9 to detect the vulnerable plaque of acute coronary syndrome.Methods 163 patients were enrolled in our study,all patients underwent the Coronary Arlgiography(CAG) and were confirmed to have or not CHD,of which CHD group were 103 cases,60 cases in the control group.According to the clinical property,CHD group was further divided into stable angina pectoris(SAP) group (n=32) and acute coronary syndrome(ACS) group(n=71).In addition,according to the extent of coronary lesion,CHD group was further divided into single,double, three blood vessels lesions group;meanwhile according to the degree of coronary lesion,CHD group was further divided into mild,moderate,severe disease group, according to the standard of ACC/AHA coronary changes in 1988,CHD group was divided into A-type,B-type,C-type disease group.Based on Gensini score standards to quantitative assess the extent of coronary artery disease.To detect the plasma concentration of NF-κB,MMP-9 with the ELISA.Used polymerase chain reaction restriction fragment length polymorphism to identify all patients genotype of MMP-9 promoter C-1562T.72 cases coronary heart disease patients,of which ACS group were 43 cases,SAP group were 29 cases,25 cases in the control group,all patients underwent 64-slice spiral computed tomography coronary artery imaging.Results(1) Soft plaque incidence of ACS group was significantly higher than SAP,the difference was statistically significant(P = 0.001).(2)Compared with control group,the NF-κB,MMP-9,hs-CRP concentration in ACS,SAP group increased,and ACS was higher than SAP group,there were statistically significant difference(P＜0.001).(3)Compared the NF-κB,MMP-9 concentration between single,double,three lesions group,control group were statistically significant difference(P＜0.001),in which NF-κB between single lesions group and control group was no statistically difference.(4)Compared the NF-κB,MMP-9 concentration between mild,moderate, severe lesions group,control group were statistically significant difference(P＜0.001),in which NF-κB between mild lesions group and control group was no statistically difference.(5)Compared the NF-κB,MMP-9 concentration between A-type,B-type,C-type disease group,control group were statistically significant difference(P＜0.001),in which NF-κB between A-type disease group and control group was no statistically difference.As the lesions extent,degree and type increased complexity,boths level increased more obvious.(6) In CHD patients,compared with the fibrous plaque,calcified plaque group,hs-CRP,MMP-9 plasma levels of soft group were significantly increased(P≤0.001).(7)MMP-9 was correlated positively to NF-κB.(8)To multiple linear regression analyze between Gensini score and non-traditional risk factors of CHD,suggested that hs-CRP,MMP-9,NF-κB were risk factors for CHD.(9)Compared with SAP group,control group,MMP-9 promoter-1562C/T genotype frequency and -1562T allele frequency increased in ACS group,there were statistically difference.(10)The distribution of T-allele in CHD patients between single,double,three lesions;mild,moderate,severe lesions were no significant difference.(11)In CHD patients,MMP-9 concentration increased in T-allele patients compared with no T-allele,there were statistically difference.(12)To logistic regression analyze between CHD and its risk factors,suggested that hypertension, hyperlipidemia,age＞60y,male were risk factors for serious coronary artery disease.Conclusions1.The activity of NF-κB increases in patients with CHD,which may regulate a variety of cells,inflammation factor,play an important role in the occurrence of CHD.2.Combined hs-CRP and MMP-9,to raise the accuracy of 64-slice spiral computed tomography detection coronary artery plaque in patients with ACS,know stability of the plaque,improve the diagnosis rate.3.Both NF-κB and MMP-9 are a risk factor for CHD,especially in ACS patients, with the NF-κB to increase the level of MMP-9 level increased even more significantly,NF-κB may be through regulation MMP - 9 in the course of the advancement in ACS.4.The present findings suggest that genetic poly- morphism in MMP-9 promoter C-1562T is associated with ACS,T-allele may be one of signs of genetic susceptibility genes in patients with CHD,-1562T allele may increase expression of MMP-9. However,-1562T allele was not related to the severity and range of coronary artery disease.