The Relationship Between Thrombomodulin, High Sensitive C-Reactive Protein And The Ischemic Events Of Coronary Artery Disease

Objectives: The aim of this study was to investigate the levels of thrombomodulin and high-sensitive C-reactive protein of patients with acute coronary syndrome and stable angina pectoris so as to explore the relationship between levels of TM, CRP and the recurrent acute coronary events in the coming 18 months.Methods: Fasting blood samples were collected from one hundred and nine hospital-based patients with documented coronary heart disease (CHD) and 63 healthy controls, respectively. The patients with CHD were divided into two subgroups: acute coronary syndrome(n=53) and stable angina pectoris(n=56). Plasma TM was measured by enzyme-linked immunosorbent assay(ELISA) in all groups. Plasma hs-CRP of CHD patients was measured by immunoturbidimetry. The Patients with CHD were followed for 18 months. The correlation of the recurrent cardiovascular events and the levels of TM and hs-CRP of patients with CHD were analyzed by multiple variable logistic regression.Results:1. The plasma level of TM in patient with CHD was significantly higher than that in the control group(259.89±86.29ng/mlVS 204.44±65.83 ng/ml, P＜0.05).2. The plasma level of TM in the stable CHD subgroup was significantly higher than that of the control group(234.68±75.73ng/ml VS 204.44±65.83ng/ml, P＜0.05). The plasma level of TM in the ACS subgroup(286.53±89.39 ng/ml) was significantly higher than in the stable CHD subgroup(234.68±75.73ng/ml) and the control group (204.44±65.83ng/ml). The plasma level of TM from the SAP subgroup was significantly higher than that from the control group.3. Significantly higher plasma level of hs-CRP was observed in the ACS patients compared to the stable CHD subgroup[32.10(2.19～28.12) mg/L VS 14.40 (2.07～20.34), P=0.039].4. There were positive correlations between the plasma level of TM and hypertension and the pack-years of cigarette smoking, while there was a negative correlation between the plasma level of TM and high density lipoprotein cholesterol.5. The plasma level of TM(b-2.260, P=0.000, OR=9.586) and CRP (b-1.032, P=0.002, OR=2.806) were strongly correlated with the acute events of CHD (b=1.93, P=0.000, OR=6.86) respectively. The correlation between the TM level and acute events was stronger than the hs-CRP level。6. The plasma level of TM(b=2.674, P=0.009, OR=14.492) and CRP (b=1.030, P=0.045, OR=2.801) were strongly correlated with the acute events of the ACS subgroup respectively. The correlation between the TM level and acute events was stronger than the hs-CRP level. Nevertheless, TM and hs-CRP had no significant correlation with the SAP subgroup. Conclusions:(1) The plasma level of TM in patient with CHD is significantly higher than that in the control group.(2) There is a positive correlation between the plasma level of TM and hypertension and smoking respectively, while there is a negative correlation between the plasma level of TM and high density lipoprotein cholesterol.(3) The plasma level of TM and hs-CRP can reflect the extent and severity of CHD respectively.(4) Both TM and hs-CRP may have positive correlations with the acute events of CHD, especially of the ACS patients. Moreover, TM may have a stronger correlation with the acute events of CHD than hs-CRP.