Serum Level And The Implications Of A Disintegrin-Like And Metalloproteinase With Thrombospondin Type 1 Motifts In Patients

Objective Coronary atherosclerotic heart disease (CAD) is now thought to be a great threat to human health all over the world. The end phase of CAD would be acute coronary syndrome (ACS). Rupture of plaques with superimposed thrombosis is now considered to be the main cause of ACS. It would usually cause serious angina symptoms when ACS was triggered, even cause death. Therefore, ACS is such kind of a disease of great risk.Versican is a kind of extracellular matrix (ECM) protein. It is mainly produced by the arterial smooth muscle cells. As the major ECM protein during the process of vessel injury, versican get involved in many vascular disease, such as atherosclerosis, aneurysms, etc. A disintegrin and metalloprotease with thrombosponding type 1 motifs (ADAMTS-1) is a member of the ADAMTS family, which is recently discovered to be a new kind of metalloproteinase. It is assumed to have played an important part in accelerating the process of atherosclerosis, therefore promoted the onset of ACS, by cleaving the versicans and many other proteoglycans in vessel ECM. In this current study, we set up to explore the circulating level of ADAMTS-1 in the CAD patients. Thus we can discuss the value of ADAMTS-1 testing in predicting the occurrence of ACS.Methods Selected from the patients of Shandong Provincial Hospital during December 2009 to November 2010, a total number of 130 patients and 32 healthy subjects were enrolled in this study. They were separated into 4 groups of 40 patients in acute myocardial infarction (AMI) group, 50 patients in unstable angina pectoris (UAP) group,40 patients in stable angina pectoris (SAP) group and 32 patients in control group. Gather all patients'basic information such as age, gender, weight, height, medical history, routine blood test result and body examine result, etc. Blood were drawn from all patients'median cubital veins to measure their ADAMTS-1 level by using Enzyme Linked Immunosorbent Assay (ELISA) kit.Result Patients with CAD had a higher level of ADAMTS-1 in contrast to those without CAD. Serum ADAMTS-1 in patients with and without CAD were (100.71±37.06 ng/ml) and (47.04±11.79 ng/ml). The difference was significant (P<0.05). In addition, we found a stepwise increase in ADAMTS-1 level in patients with SAP, UAP and AMI. Serum ADAMTS-1 level in patients with SAP, UAP and AMI were 69.33±15.87 ng/ml,93.43±21.36 ng/ml and 141.18±31.01 ng/ml. The difference was also significant (P<0.05).By bivariate analysis, ADAMTS-1 was found correlated with HSCRP, HDL-C, UA. In patients with CAD, the correlation between ADAMTS-1 and HS-CRP remained significant. Moreover, an statistically significant association between ADAMTS-1 and the number of complex stenoses was also observed. Ordinal regression revealed that ADAMTS-1 increase with the increase of the clinical severity of CAD. Among 162 studies subjects, higher ADAMTS-1 levels was found to be the independent factor associated with ACS. Even among the 130 patients with CAD, such association remained to be significant. Furthermore, a ROC curve analysis showed a good discriminatory power of serum ADAMTS-1 in predicting the onset of ACS.Conclusion1. Patients with CAD had a higher level of ADAMTS-1.2. Serum ADAMTS-1 level may serve as a novel biomarker of atherosclerosis plaque vulnerability. It may also involved in the process of plaque destabilization.3. Serum ADAMTS-1 level can be used as a significant biomarker to predict the occurrence of ACS.