Relationship Between The Changes Of NF-κB Activation In The Peripheral Blood Mononuclear Cells And Prognosis In PCI

Objective To investigate the relationship betwen the changes of nuclear factor kappaB(NF-κB) activation in the peripheral blood mononuclear cells and the cardiac and vascular events and restenosis after percutaneous coronary intervention. In order to illuminate it's role in the development of CHD and to provide the related theoretical evidence for whether it can be used as one of the main prognosticate indexes for the development of the coronary artery diseases.Methods Total 90 patients with CHD coincidence with the testing standard is classified three groups: acute myocardial infarction(AMI) group(30patients), unstable angina (UA) group(30patients), stable angina (SA) group(30patients). Three group collects 2ml venous blood in the EDTA anticoagulation test tubes before PCI and 24h after PCI. In addition, 30 normal persons confirmed by coronary angiography(CAG) as control (Ctrl)group,and collects 2ml venous blood in the EDTA anticoagulation test tubes before PCI. NF-κB activation in PBMC is detemined quantificationally by flow cytometer with the NF-κB Kit. To analysis the NF-κB activation in every groups and the relations between the NF-κB activation and their clinical characteristic and complications. The cardiac and vascular events (angina,AMI,sudden cardiac death,revascularization etc)and stent restenosis were observed intraprocedural in 6 months after the procedures.Result The patients of coronary heart diseases have more risk factors such as the history of hepertension and/or diabete,the family history of cardial-cerebrovescular diseases, smoking than Ctrl group(P<0.001). There is no difference in age, sex and lipid etal(P>0.05).The activity of NF-κB in PBMC in UA group and AMI group is significantly higher than that in SA group and Ctrl group before PCI(P<0.001). The activity of NF-κB in PBMC in AMI group is higher than that in UA group(P<0.001). The activity of NF-κB in PBMC 24 hours after PCI were significantly higher than those before PCI in SA group,UA group and AMI group (P<0.01). There are no relations between the NF-κB activation and TnI,CK or CK-MB at the same time in AMI group (P>0.05). The cardiac and vascular events rate and stent restenosis rate were significantly higher in higher NF-κB level group than that in lower group in 6 months (P<0.01).Conclusion The NF-κB activation is closely bound up with the serious degrees of the pathological changes in CHD . This indicates PCI is likely to trigger and exacerbate coronary artery inflammation in a short time period. It can be used for the criticality estimation of CHD. It may be a predictor in 6 month prognosis of patients undergoing coronary stent implantation. It indicates that the complications and clinical restenosis in 6 months are markedly influenced by the preprocedual degree of inflammatory cell activation.