| BackgroundAtherosclerosis (AS) is a chronic inflammatory disease. Inflammatory events have been implicated at all stages in the evolution of atherosclerotic plaque, from the early development of endothelial dysfunction, to the formation of the mature atheroma and its subsequent rupture. Recent studies have demonstrated that tumor necrosis factor-α(TNF-α),interleukin-8(IL-8) is relative to atherosclerosis (AS) and CHD, which can make plague vulnerable and lead to ACS. It is not clear that the relation between neutrophil-activating peptide-2(NAP-2) and CHD.ObjectiveThrough investigating the relationship between the leves of TNF-α, IL-8, NAP-2 and the severity of clinical manifestations, the Gensini score of coronary artery, the morphology of atherosclerotic plaque and the correlation analysis the leves of NAP-2 and TNF-α, IL-8,to search new biomarkers with high sensitivity and specificity that can reflect the vulnerable plaque characteristic. With the help of these markers, we can evaluate the risk degrees of patients with CHD to outbreak ACS and interfere with vulnerable plaque earlier.Materials and MethodsAll subjects came from the in-patients of the department of cardiology , the first affiliated hospital of Zhengzhou University during Mar 2008 and Jun 2008. 1.Sixty-two patients with CHD diagnosed by CAG, were divided into two sub-groups according to clinical type. Among them, there were 33 patients in ACS group, 22 men and 11 women, mean age (68.7±16.5) years; 29 patients in stable angina pectoris (SAP)group, 20 men and 9women, mean age(67.5±14.3) years. Twenty -five normal subjects as the control group, 17 men and 8 women, mean age (65.2±14.2) years. 2.The severity scale of coronary artery stenosis was quantitatively assessed according to CAG by Gensini scoring system. The coronary artery lesions was divided into typeⅠ,ⅡandⅢplaque group by the morphology of atherosclerotic plaque. Enzyme linked immuoserbent assay (ELISA) was used to measure the serum levels of TNF-α,IL-8,NAP-2 in the patients with CHD and control group.Results1. In ACS, SAP and the control groups, the mean level of TNF-αwas 114.91±29.31ng/L,61.95±14.26ng/L,49.76±6.63ng/L respectively; In ACS, SAP and the control groups, the mean level of IL-8 was 85.99±20.58ng/L, 70.98±18.77ng/L, 57.78±13.93ng/L respectively; In ACS, SAP and the control groups, the mean level of NAP-2 was 34.16±15.12ng/L, 23.54±11.31ng/L, 15.78±6.85ng/L respectively. The serum levels of TNF-α,IL-8,NAP-2 were obviously higher in ACS group than that in SAP and control groups(P<0.01); Compared with that in control group, the mean level of serum TNF-αin SAP group was significantly(P<0.01). The serum levels of IL-8,NAP-2 were obviously higher in SAP group than that in control groups(P< 0.05).2. Compared with that in SAP group, the incidence of typeⅡplaque was increased, and typeⅠand typeⅢplaque decreased in ACS. The difference was significant (P<0.01).3. In typeⅡ,Ⅲ,Ⅰplaque and control groups, the mean level of TNF-αwas 116.50±31.13ng/L,69.18±21.20ng/L,67.40±19.62ng/L,49.76±6.63ng/Lrespectively;In typeⅡ,Ⅲ,Ⅰplaque and control groups, the mean level of IL-8 was 91.54±17.13ng/L,73.79±14.00ng/L,63.42±10.86ng/L,57.78±13.93ng/Lrespectively;In typeⅡ,Ⅲ,Ⅰplaque and control groups, the mean level of NAP-2 was 36.27±13.08ng/L,26.32±13.44ng/L,19.43±8.43ng/L,15.78±6.85ng/Lrespectively. The serum levels of TNF-α,IL-8,NAP-2 were obviously higher in typeⅡgroup than that inⅢ,Ⅰplaque and control group(P<0.05); The serum levels of TNF-α,IL-8,NAP-2 were obviously higher in typeⅢgroup than that control groups(P<0.05); The serum levels of IL-8 were obviously higher in typeⅢgroup than that I plaque groups(P<0.05).The serum levels of TNF-α,IL-8,NAP-2 in typeⅠplaque group were higher than that in control groups, the difference was significant only in the serum levels of TNF-α(P<0.05).4. The Gensini score of coronary artery in the ACS and the SAP group was (88.18±41.15), (44.57±32.95) respectively and there were significant differences among them(P<0.05).5. A significant correlation was found between the serum levels of TNF-αand the Gensini score(r=0.345, P=0.006); No correlation was found between the serum levels of IL-8 and the Gensini score(r=0.141, P=0.257); No correlation was found between the serum levels of NAP-2 and the Gensini score(r=0.060, P=0.644); No correlation was found between the serum levels of NAP-2 and the TNF-α(r=0.173,P=0.178); No correlation was found between the serum levels of NAP-2 and the IL-8(r=0.220,P=0.086).Conclusion1 The serum levels of TNF-αas a new inflammatory factor like IL-8,NAP-2 in patients with CHD may evaluate the prognosis of patients with coronary heart disease and can provide basis for risk stratification of CHD.2 TypeⅡplaque is more commonly in patients with ACS, but typeⅠandⅢplaque are more in patients with SAP. The serum levels of TNF-α,IL-8,NAP-2 in typeⅡplaque group are higher than that in typeⅠandⅢplaque groups, which suggests that typeⅡplaque is more vulnerable plaque. The serum levels of TNF-α,IL-8,NAP-2 may act as the biomarkers of vulnerable plaques.3 The fact that there was no correlation between NAP-2 and TNF-αor IL-8 suggests that they promote the inflammatory response of the coronary heart disease through different pathways or different stages of the same pathways. |
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