| Objective Acute coronary syndrome(ACS) include unstable angina pectoris(UAP), acute myocardial infarction(AMI) and cardiac sunden death, all the ACS share common pathophysiological processes characterized by coronary plaque disruption with superimposed thrombus formation. Inflammation plays a pivotal role in the pathogenesis of atherosclerosis and mediates many of the stages of atheroma development from initial leukocyte recruitment to eventual rupture of the unstable atherosclerotic plaque. Matrix metalloproteinase promote weakening of the fibrous cap and trigger plaque cell apoptosis by degrading extracelluar matrix(ECM), which results in plaque erosion and rupture. Recent reports demonstrate that macrophage migration inhibitory factor(MIF) and matrix metalloproteinase-9(MMP-9) have intimate relation with formation of atherosclerotic plaque, but their roles aren't clarified utterly in ACS. The study investigates change of MIF and MMP-9 serum levels in patients with UAP and AMI, their relationship with coronary artery vessels and lesion degree and influence of PCI. Whether MIF and MMP-9 can be predictive factors of ACS.Method:One hundred thirty patients with coronary heart disease were selected according to the results of coronary angiography and clinical manifestation. They were divided into three groups:SAP group(n=44), UAP group(n=46) and AMI group(n=40).35 patients with negative CAG results were selected as normal control group. The blood samples with 5 mL were drown from venous in morning of the following day after hospitalization. In addition, the blood samples were drown from venous of patients undergoing PCI operation on 6h,24h and 30d after PCI. The serum levels of MIF and MMP-9 were delected by enzyme-linked immunosorbent assay (ELISA). They were compared in each group, before and after PCI, different coronary artery vessels and different coronary artery lesion degree. At the same time correlation was analyzed between MIF and MMP-9 in patients with ACS.Results1. Serum levels of MIF and MMP-9 in each group:The serum levels of MIF and MMP-9 in AMI group and UAP group were significantly higher than those in SAP and control group (P<0.05), but there was no difference between UAP group and AMI group(P>0.05). There was no significant difference between SAP group and control group(P>0.05).2. MIF and MMP-9 serum levels among different coronary artery vessels in patients with ACS:According to the results of coronary angingraphy in patients with ACS, neither MIF nor MMP-9 was statistical difference among one-vessel, two-vessel and three-vessel group(P>0.05).3. MIF and MMP-9 serum levels among different coronary artery lesion degree in patients with ACS:Neither MIF nor MMP-9 was statistical difference among mild, middle and serious stenosis group in patients with ACS(P>0.05).4. Correlation analysis between MIF and MMP-9 in patients with ACS:Serum MIF level was positively relative to serum MMP-9 level in ACS group (r=0.78, P<0.05)5. Change of MIF and MMP-9 before and after PCI:Compared with before PCI, MIF and MMP-9 serum levels were significantly increased after 6h and 24h PCI (P<0.05), however there was no difference between after 30d PCI and before PCI(P>0.05).conclusion1.Serum MIF and MMP-9 levels are related to the unstability of coronary artery plaque. They are no relation with the degree of coronary artery stenosis. There is positive correlation between MIF and MMP-9.2. MIF and MMP-9 serum levels were markedly higher after 6h and 24h PCI than before PCI, but there was no difference between after 30d PCI and before PCI. It indicates they participate in the earlier inflammation reaction of coronary artery after PCI.
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