Correlation Between Atherosclerotic Plaques By Optical Coherence Tomography And Inflammatory Makers In Patients With Coronary Heart Disease

Background:Abundant studies have found that inflammation play an important role in both atherosclerosis and vulnerability of plaque. There are robust correlations between acute cardiovascular events and the stability of atherosclerotic plaque. However, the thickness of cap fibroatheroma is the critical factor affects the stability of atherosclerotic plaque. Intravascular optical coherence tomography provides us with a high resolution cross-sectional images of tissue. Therefore, unrevalling the levels of serum inflammatory factors and identifying the correlation between inflammatory factors and different state of coronary artery disease may eventually furnish the discrimination of dangerous CAD patients.Objective:1. To detecte the serum levels of highly sensitive C-reactive protein (hs-CRP), leptin, visfatin and adiponectin in patients and to identify the correlation between inflammatory factors and different state of CAD.2. To investigate the morphologic character of culprit lesion in patients with CAD.3. To assess the correlations between the morphologic character of culprit lesion and inflammatory factors.Methods:Plasma levels of highly sensitive C-reactive protein (hs-CRP), leptin, visfatin and adiponectin were measured by commercially available ELISA(enzyme linked immunosorbent assay), according to the protocols of the manufacturer. The identified culprit lesion was visualized using the M2OCT system.Results1. The plasma hs-CRP, leptin and visfatin were significantly higher in UAP and SAP group compared with the control group(P<0.05), while adiponectin was lower in UAP and SAP group compared with the control group(P<0.05).2. The plasma hs-CRP, leptin and visfatin were significantly higher in UAP and SAP group compared with the control group(P<0.05), while adiponectin was lower in UAP and SAP group compared with the control group(P<0.05).3. There wa a significant inverse linear relationship between fibrous cap thickness and plasma levels of hsCRP and leptin(r=-0.932, P<0.001; r=-0.564, P=0.001), positive correlation between fibrous cap thickness and plasma level of adiponectin(r=0.459, P=0.006), none relationship between the thickness and visfatin.4. There was no relationship between inflammatory factor concentrations and the presence of thrombus formation. Although we could find a trend towards higher levels of hs-CRP, leptin and visfatin in plaque with evidence of TCFA and fibrous cap rupture, inversely trend was adiponectin. Higher level of adiponectin was in plaque presenting calcification(P<0.05)5. Hs-CRP and adiponectin independently predicted the probability of TCFA by multiple regression analysis ROC curves for the concentration of hs-CRP was0.859. As the independent parameters for predicting the probability of TCFA, the hs-CRP concentration of1.23ng/ml would detect TCFA with a sensitivity of81.2%and a specificity of72.2%,Conclusion:1. Inflammatory factors may participate the pathogenesis and progression of CAD. The serum levels of hs-CRP, leptin and visfatin will contribute to the assessment of the patheogenetic condition with CAD. So would adiponectin as an anti-inflammatory factor.2. Culprit lesion in SAP group is apparently different from that in UAP group, the former has more evidence of calicification while the latter has more evidence of TCFA and fibrous cap rupture.3. Both inflammatory factor and anti-inflammatory factor has correlation with the thickness of fibrous cap. There was a significant inverse linear relationship between fibrous cap thickness and plasma levels of hsCRP and leptin, positive correlation between fibrous cap thickness and plasma level of adiponectin.4. The plasma hs-CRP concentration is the strongest independent predictor of TCFA.