| Aims:To measure the Rho kinase activity in patients with ACS and the NT-proBNPserum leveland to discusse the application of combined two indicators to evaluate itsrecent prognostic value in patients with ACS.Methods:The research objects included118inpatients who were hospitalized because of chestpain or chest discomfort and underwent diagnostic coronary angiography from June2012to December2012in Department of Cardiovascular Diseases of the second affiliatedhospital university of south china.They were divided into Acute CoronarySyndrome(ACS) group with98patients and Dnon-CHD control group with20patients.The Acute Coronary Syndrome group was also divided into threegroups,including52cases of ST-elevation myocardial infarction (STEMI),26cases ofNon-ST-elevation myocardial infarction (NSTEMI) and20cases of unstable anginapectoris(UAP).ROCK activity was determined by Western blot analysis of leukocytelysates and expressed as the ratio between phospho-Thr696in the myosin-bindingsubunit (P-MBS) of myosin phosphatase and myosin-binding subunit (MBS) in each caseand control.The number of lesion vessel was calculated by international general Judkinsmethod and Gensini Score estimated coronary lesion’s degree according to the results ofCAG.In the Acute Coronary Syndrome group,there are43patients were treated by PCItreatment.All the adverse cardiac events occurring during hospital stay and within12months after discharge including congestive heart failure (CHF),cardiacdeath,readmission with ACS. Results:ROCK activity in the ACS group was significantly higher than non-CHDgroup(P<0.05).ROCK activity in AMI group was significantly higher than UAPgroup(P<0.05),but the difference of ROCK activity between STEMI group and NSTEMIgroup was meaningless（P＞0.05）.There were8deaths,16readmissions with ACS and9admissions with CHF within12months.In the ACS group,ROCK activity as dependent variables,while gender, age, smokinghistory, BMI, symptoms of heart failure on admission, CRP, FBS, TG, TC, LDL, HDL,the WBC count, CTnT and coronary lesions as independent variable for single factor andmulti-factor linear regression analysis,symptoms of heart failure on admission, the WBCand LDL, the coronary artery lesion count ws an independent predictor of ROCKactivity.Compared to no-cardiovascular events group, the ROCK activity,NT-proBNPserum levels in the cardiovascular events group were significantly higher,there wasstatistical significance between them(P<0.001);in hospitalization and after discharge forcardiovascular events as the dependent variable, in gender, age, smoking history, diabetesmellitus and hypertension, FBS, TG, TC, LDL, HDL, the WBC, ROCK activity, NT-proBNP serum levels and coronary artery lesion counts, CTnT and treated by PCI afteradmission, the use of statins for the independent variable COX regression analysisshowed that on admission PCI therapy (HR=0.24,95%CI:0.07~0.76), after dischargeusing statins (HR=0.26,95%CI:0.08~0.84), Rho kinase activity (HR=2.67,95%CI:1.52~4.68), the NT-proBNP (HR=1.00003,95%CI:1.00002~1.00005) is anindependent predictor of cardiovascular events.4. Patients with a high N-terminal pro-B-type natriuretic peptide (NT-proBNP)and high ROCK activity on admission had a four-fold risk of a cardiovascular event (RR:3.68;95%CI:1.26–10.78) when compared to those with low NT-proBNP and lowROCK activity. Conclusions:1.Rho kinase activity is increased in patients with ACS, particularly in those patientswith myocardial infarction.2.Rho kinase activity is higher, the risk of cardiovascular events in patients withACS is higher.3.The combined usage of both ROCK activity and NT-proBNP might identify asubset of ACS patients at particularly high risk. |
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