| Background and Objective:Dynamic instability of coronary atherosclerotic plaque is seen as the foundation ofthe development of the acute coronary syndromes (ACS). A complex intravascularinflammatory response is an integral component of this dynamic instability. Comparingto patients with stable angina, coronary plaque of patients with ACS contains excessivemonocyte-macrophages. Activated macrophages produce a range of pro-inflammatorycytokines which induce the aggravation of the inflammatory responses and lead to onsetof coronary events. It is demonstrated that the instability of atherosclerotic plaque isassociated to activated the receptor for advanced glycation end products (RAGE).Experimental evidence indicates that in the atherosclerotic animal models, theintervention of RAGE antagonist can decrease lipid, the number ofmonocyte-macrophage cells, the expression of inflammatory factors and enhance thestability of atherosclerotic plaque. Presently the investigation of the relationshipbetween the expression of RAGE on peripheral blood mononuclear cells and clinicalmanifestations of coronary heart disease is rare. Therefore, this study aims to analyzethe relationship between the level of RAGE and the clinical manifestations of coronaryheart disease and the severity of angiographic lesion. Further investigation should bemade to discuss whether RAGE can play a guiding role in the prediction and assessmentof the risk of coronary heart disease.Methods:80study participants were scheduled to undergo elective cardiaccatheterization for suspected coronary artery disease (from July2011to December2011)at the Department of Cardiology, the Second Affiliated Hospital of Dalian MedicalUniversity. Baseline data (age, gender, height, weight and smoking history, history ofdiabetes mellitus and hypertension, etc) was recorded. According to clinical manifestations of coronary heart disease, Gensini scores of coronary angiographicstenosis and the number of diseased coronary artery, all subjects were divided intodifferent groups. Expression of RAGE on peripheral blood mononuclear cells wasdetected by flow cyto-metric analysis. We compared the levels of RAGE in differentgroups. The data was analysed with SPSS17.0for windows. P <0.05are statisticallysignificant.Results:1. RAGE of peripheral blood mononuclear cells and HsCRP level of patients withAMI group and UAP group were apparently higher than those in the group of stableangina and control group (P＜0.05). RAGE level was positively correlated with HsCRPlevel.（R=0.476， P=0.01）2. With increasing the number of diseased coronary vessels, the RAGE level ofperipheral blood mononuclear cells gradually increased. RAGE in muti-vessel CADgroup was higher than that in single-vessel CAD group and double-vessel CAD group(P<0.05). RAGE in double-vessel CAD group was higher than that in single-vesselCAD group (P<0.05).3. Among groups divided by Gensini score, the level of RAGE of peripheral bloodmononuclear cells gradually increased with the coronary artery disease exacerbation.Statistic differences existed among groups. Both the level of RAGE and the level ofHsCRP showed positve correlation to Gensini score（R=0.376，P=0.007；R=0.407，P=0.003）.4. Logistic regression analysis showed that high level of RAGE is the independentrisk factor of the severity of clinical manifestation in patients with CHD（OR=1.180,P=0.02）.Conclusion:1. The RAGE level on peripheral blood mononuclear cells increases significantlyin patients with coronary artery disease and is in positive correlation with the severity ofclinical manifestation of coronary heart disease.2. The RAGE level on peripheral blood mononuclear cells is correlated withcoronary artery lesion. It is of certain value on prediction for the severity of coronaryartery lesion.3. The RAGE level on peripheral blood mononuclear cells could be regarded as anindependent risk factor for the severity of clinical manifestation in patients with CHD. |
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