The Research Of Evaluation Of Coronary Artery Plaque By Dual Source Computed Tomography And Serum Biomarkers

ObjectiveThe research is mainly to detect serum biomarkers(hsCRP,MIF,CXCL12,WISP-1,Galectin-3)of acute coronary syndrome(ACS)patients,and analyze the DSCT characteristics of coronary artery vulnerable plaque of them,so as to evaluate the plaque characteristics of coronary artery in ACS from both serum and morphology aspects.MethodsFrom July 2012 to March 2016,the clinical data of 149 patients diagnosed coronary heart disease(CAD)with coronary angiogram(CAG)examination in Peking Union Medical College Hospital were retrospectively analyzed.All subjects received DSCT examination within 30 days before CAG.75 subjects diagnosed non-CAD with approximately normal results of CAG were matched for age,sex and BMI as controls.They were divided into three groups,ACS(n=92),stable angina pectoris(SAP,n=57)and control(n =75)group.The serum levels of hsCRP,MIF,CXCL12,WISP-1 and Galectin-3 of three groups were measured.Meanwhile,in combination with the analysis of DSCT characteristics of coronary artery culprit lesions in ACS patients and target lesions in SAP patients,the correlation between serum biomarkers and DSCT vulnerable plaque was evaluated.Results1.Compared with controls,ACS patients had significant higher serum levels of hsCRP(1.84mg/L,interquartile range[IQR]0.79-4.84mg/L in ACS vs 0.84mg/L,IQR 0.46-1.91mg/L in controls,p=0.001),lower CXCL12(0.33ng/ml,IQR 0.14-0.48ng/ml vs 0.36ng/ml,IQR 0.27-0.50ng/ml,p=0.037),WISP1(1.62ng/ml,IQR 1.50-1.73ng/ml vs 1.70 ng/ml,IQR 1.58-1.77ng/ml,p =0.021)and Galectin-3(0.83ng/ml,IQR 0.43-1.04ng/ml vs 0.96ng/ml,IQR 0.70-1.17ng/ml,p =0.032),and elevated MIF whereas without significant difference.Compared with controls,SAP patients had statistical tendency of lower serum levels of CXCL12(p=0.058),but hsCRP WISP1 and Galectin-3 were unchanged.Compared with SAP,ACS patients had higher serum levels of hsCRP but lower WISP1.2.In three groups,serum levels of CXCL12 and WISP1,CXCL12 and Galectin-3 were positively related when marching age,sex,serum lipid and other CAD risk factors.3.The incidence of fibrous plaques,spotty calcifications and positive remodeling are higher than that in SAP group,but without significant difference.4.The serum level of hsCRP is higher in ACS with noncalcified plaques than in SAP with calcified plaques,and higher in ACS without large calcifications than in SAP with large calcifications.But the serum level of MIF,CXCL12,WISP1 and Galectin-3 were not related to plaque characteristics by DSCT evaluation.5.It is suggested hsCRP is the risk factor of ACS and CAD by logistic regression analysis.Conclusions1?Elevated serum level of hsCRP,decreased WISP1 and GLA3 may be related to ACS.The serum level of CXCL12 may have effects of anti-atherosclerosis,but can' t reflect stability of plaques.2.Low density plaques?spotty calcifications and positive remodeling may be morphological characteristics of vulnerable plaques in ACS03.HsCRP in combination with DSCT may be related to vulnerable plaques of coronary artery,and can better evaluate plaque characteristics compared with other serum biomarkers.