The Serum Levels Of Activin A And Its Role In Patients With Coronary Heart Disease

OBJECTIVES: We sought to investigate serum levels of activin A in patients with coronary heart disease, observe whether activin A could be involved in the risk stratification of coronary heart disease , and then discuss the role of activin A.METHODS: Sixty angina patients undergoing clinically indicated diagnostic coronary angiography were recruited into the study. We examined the role of activin A in patients with stable (n=28) and acute coronary syndrome (n =32)and healthy control subjects (n = 20) by Enzyme Linked-Immuno-Sorbent Assay(ELISA) and immune turbidimetry methods(ITM).RESULTS :1) Both patients with stable angina (411.98±175.48pg/ml) and acute coronary syndrome(549.42±291.90pg/ml) had significantly increased serum levels of activin A, compared with healthy controls (125.32±66.98 pg/ml ), also with significant differences between the two groups of CHD.2) Compared with healthy control subjects, both patients with stable angina and acute coronary syndrome had significantly increased levels of CRP(3.36±1.21 mg/l , 6.25±3.52mg/l) and IL-6(95.69±35.72 pg/ml, 141.28±89.46pg/ml ), also with significant differences between the two groups of CHD.3)As for activin A, there was a decrease in the concentration, reaching significantly lower levels after 24 h PCI(421.50±224.36 pg/ml) than before PCI(531.61±250.45 pg/ml), but an opposite effect was found in CRP (5.03±2.63 mg/l vs 7.97±3.55 mg/l )and IL-6(140.94±75.97 pg/ml vs 171.32±79.89 pg/ml).4) Compared with single coronary stenosis, both patients with double and triple coronary stenosis had significantly increased levels of Activin A (418.53±228.48 pg/ml,611.79±236.73 pg/ml,647.05±343.09 pg/ml),CRP(4.16±1.67 mg/l , 5.61±2.53 mg/l , 5.85±3.70 mg/l) and IL-6 (104.23±68.63 pg/ml,164.03±82.48 pg/ml,166.50±79.90 pg/ml) ; but with no significant differences between the two groups of patients with double and triple coronary stenosis.5)Compared with healthy control subjects, patients with heart failure had significantly elevated ACT- A(468.73±235.52 pg/ml,533.72±290.96 pg/ml),CRP(4.49±2.12 mg/l,5.77±4.00 mg/l ) and IL-6(110.86±53.78 pg/ml ,138.84±94.55 pg/ml) concentrations in those with NYHA classesⅡand III; but with no significant differences between the two groups of patients in those with NYHA classesⅡand III. CONCLUSIONS: Similarly to the two important inflammatory factors CRP and IL-6, patients with coronary heart disease had increased serum levels of activin A, especially increased in patients with vulnerable plaque. ACT-A probably involved in the process of atherosclerotic progress as a inflammatory mediator. And may probably be used as a predictor of plaque stability.