The Correlation Between Plasma Level Of Inflammatory Cytokines And Fibrinolytic Capacity In Patients With Acute Coronary Syndrome

ObjectiveTo explore the the relationship between fibrinolytic activity and inflammation in patients with acute coronary syndrome and the clinical correlation between these markers and ACS by measuring tPA,PAI-1 antigen and Hs-CRP,TNF-α.MetheodsAll cases were divided into four groups:⑴acute myocardial infarction group (AMI group) 32 cases,⑵unstable angina pectoris group (UAP group) 32 cases,⑶stable angina pectoris group (SAP group) 17 cases,⑷control group (CO group) 15 cases. Detect the plasma level of tPA, PAI-1 antigen and the concentration of Hs-CRP, TNF-a, also the concentration of cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C).Compare plasma markers level among four groups. explore the the relationship between fibrinolytic activity and inflammation, explore the the relationship between lipid and fibrinolytic activity,inflammation, explore the the relationship between the two different inflammatory cytokines Hs-CRP and TNF-α.All data were analyzed by SPSS11.5 software.Results⑴tPA: The plasma levels of tPA increased significantly in patients with AMI and UAP than with SAP(P<0.01,P<0.05)and controls(P<0.01,P<0.05),but the difference of tPA level between AMI and UAP was not found. PAI-1: The plasma level of PAI-1 increased significantly in patients with AMI,UAP and SAP than in controls(P<0.01, P<0.01,P<0.05),PAI-1 was higher in patients with AMI than with UAP(P<0.05)⑵HsCRP:The plasma concentration of HsCRP had a significant increase in patients with AMI and UAP comparing to SAP(P<0.01,P<0.05)and controls (P<0.01,P<0.05), HsCRP was higher in patients with AMI than with UAP(P<0.01). TNF-α: The plasma concentration of TNF-αhad a significant increase in patients with AMI and UAP comparing to SAP(P<0.01,P<0.05)and controls (P<0.01,P<0.01), TNF-αwas higher in patients with AMI than with UAP(P<0.01).⑶The plasma level of PAI-1 positively correlated with Hs-CRP and TNF-α(P<0.01, P<0.05),but not correlated with tPA ( P>0.05). ⑷The concentration of TG positively correlated with Hs-CRP,TNF-αand PAI-1(P<0.05, P<0.05,P<0.01). The concentration of HDL-C negatively correlated with TNF-αand PAI-1(P<0.05, P<0.05).⑸The concentration of TG positively correlated with Hs-CRP(P<0.05).Conclusions⑴When the coronary arterial thrombosis occurred,the fibrinolytic activity decreased and the plasma levels of tPA and PAI-1 increased,especially PAI-1. and they increased with the severity of coronary artery lesions.⑵When the coronary arterial thrombosis occurred, The plasma concentration of HsCRP and TNF-αincreased and they increased with the severity of coronary artery lesions.⑶HsCRP and TNF-αpromoted the expression of PAI-1.Thus it disturbed the dynamic equilibrium between coagulation and fibrinolysis.⑷The plasma level of TG positively correlated with Hs-CRP,TNF-αand PAI-1. The concentration of HDL-C negatively correlated with TNF-αand PAI-1. so, In the body TG probably promote the occurrence of ACS by inducing inflammation status, and inhibiting fibrinolysis activity, and HDL-C may have a protective effect for coronary artery also by the same mechanism.⑸The concentration of TG positively correlated with Hs-CRP, the mechanism of Inflammatory cytokines promoting ACS are not independent, they form a complex network systems, influence each other, jointly promote the occurrence of ACS.