The Correlation Study Of RANTES And Coronary Plaque Vulnerability

Objective:Coronary heart disease, especially acute coronary syndrome (ACS) is a life-threatening disease, with high incidence, acute onset, high risk, accurate diagnosis to save the lives of patients, reduce risk, improve the prognosis of critical. The degree of risk of coronary heart disease and related local local vulnerable plaque, plaque rupture, platelet aggregation and thrombus formation, leading to serious coronary stenosis, occlusion or vasospasm, which led to the occurrence of acute cardiovascular events. Therefore, early identification of vulnerable plaque has important significance for prevention and treatment of acute cardiovascular events. At present, most domestic and foreign scholars,95%vulnerable plaque fibrous cap thickness less than65um. In imaging technology at present, optical coherence tomography (optical coherence tomography OCT) is the highest spatial resolution, the minimum resolution of10um, not only can clearly show the atheromatous plaque lipid content, the thickness of fibrous cap and the fibrous cap cell components (macrophages、Smooth Muscle Cells), but also to identify heterogeneous, eccentric or mixed plaque, science has highly consistency in the results and the plaque tissue. Therefore, we can through the OCT to observe plaque fibrous cap thickness in patients with coronary artery disease, early identification of vulnerable plaque. But at present, But the present conditions, OCT technology because of its invasive, expensive, technology characteristics, limits its wide application in clinical. The main clinical detection of serum inflammatory markers of risk, ECG and coronary angiography and identification of coronary heart disease, we can through the OCT to observe the thickness of fibrous cap plaque and other histological features and some inflammatory markers expression, found with the high sensitivity, specific serum inflammatory strong markers, as soon as possible identification of plaque vulnerability, risk assessment. Chemokines are essential mediators of inflammation mediated inflammatory immune response, At present the domestic and foreign research shows, there are close relationships between the form factor RANTES with the trend, the rupture of vulnerable plaques, In this study, the thickness of fibrous cap recognition using OCT technology of coronary artery plaque, combined with serum RANTES in different groups monitoring the expression level, to discover the relation of chemokine RANTES and coronary plaque vulnerability.Methods:All149patients including acute myocardial infarction emergency PCI (AMI group, n=49),unstable angina pectoris (UAP group, n=50),and stable angina (SAP group, n=50).Using double antibody sandwich enzyme liked immunosorbent assay (ELISA method) to detect the serum levels of chemokine RANTES. Twenty patients (11in UAP group and9in SAP group) were determined the plaque fibrous cap thickness by optical coherence tomography (OCT).Results:Chemokine RANTES concentration and coronary heart disease risk is proportional to the degree of serum, there was statistical significance between the groups (P<0.01); The RANTES area of ROC was higher than hs-CRP in judging ACS [(0.951±0.022):(0.916±0.030),(P<0.05)]. Group UAP plaque fibrous cap thickness lower than SAP group,(P<0.05), in UAP group, levels of chemokine RANTES was negatively correlated with the plaque fibrous cap thickness (r=-0.821, P<0.01).Conclusion:1. Chemokine RANTES are closely related with dangerous degree of coronary heart disease, confirmed its participation in the process of coronary atherosclerosis occurrence, development.2. Chemokine RANTES serum levels and plaque fibrous cap thickness was negatively correlated, explains its relationship with atherosclerotic plaque vulnerability.3. Chemokine RANTES is an independent, to predict the biological marker of coronary artery plaque vulnerability, compared with hs-CRP for early diagnosis and prognosis of higher value.