Study On Correlation Between PDGF,hs-CRP And The Property Of Coronary Plaque In NSTE-ACS Patients

Objective The aim of this study was to investigate the different levels of the serum platelet-derived factor(PDGF)and plasma hypersensitive C-reactive protein(hs-CRP)among the patients with non-ST-elevation myocardial infarction(NSTE-ACS),with stable angina pectoris(SAP),and without coronary heart disease(CHD);also to investigate the correlation and predictive value between blood PDGF,hs-CRP levels and the property of coronary plaque in NSTE-ACS patients,by coronary angiography(CAG)and intravascul-lar ultrasound(IVUS)examination.Suject and Method:1.Subgroups: Our study included 256 patients who underwent coronary angiography(CAG)examination at Tianjin Chest Hospital,from May 2016 to February 2018.There were 81 cases in the control group,69 casesin the stable angina(SAP)group,and 106 cases in the NSTE-ACS group.65 patients in the NSTE-ACS group with degree of coronary artery stenosis between 50% to 90% were able to do IVUS examination and divided into divided into vulnerable plaque group(46 cases)and non-vulnerable plaque group(19 cases).2.Data Collection: Patients were collected general clinical data,laboratory indicators and coronary angiography and IVUS test results.Serum levels of PDGF were measured by ELLSA.Resuult1.Compared with the control group,the difference in diabetes and TG,LDL-C,FFA,AIP was statistically significant in the SAP group(P<0.05).And the gender,smoking history,drinking history,history of diabetes mellitus(DM),family history,TG,LDL-C,FFA,hs-CRP,lipoprotein a,non-HDL-C,AIP in the NSTE-ACS group was significant too,comparing with SAP group and control group(P<0.05).2.There was a statistically significant difference between the non-vulnerable plaquegroup and the vulnerable plaque group in gender,smoking history,history of DM,family history of CHD,TG,LDL-C,FFA,hs-CRP,lipoprotein a,non-HDL-C and AIP(P<0.05).Combined with the results of IVUS examination,plaque characteristics of vulnerable plaque group and non-vulnerable plaque group were compared,and there was a significant difference in MLA,plaque area and plaque burden(P<0.05).Further study found that hs-CRP(R=0.521),HBA1c%(R=0.472)was associated with plaque burden(P<0.05);hs-CRP was associated with NC(R=0.481,P<0.05).3.Analysesing the correlation of PDGF and plaque burden,plaque area,MLA and plaque composition,finding that PDGF correlated with plaque burden(R=0.428,P<0.05)and NC(R=0.669,P<0.05).PDGF was found to be associated with non-HDL-C and FFA(P<0.05).4.Logistic regression analysis showed that hs-CRP(OR=2.651,95%CI 0.682 to 10.564),non-HDL-C(OR=3.802,95%CI 1.105 to 13.078)and PDGF(OR=4.751,95%CI1.534 to 29.543)were independent risk factors of vulnerable plaques(P<0.05).5.In ROC curve,PDGF(ACU=0.876,95% CI 0.804 to 0.948)and hs-CRP(ACU=0.80295% respectively CI 0.638 to 0.965)had a higher predictive value for vulnerable plaques(P<0.05).Conclusion The levels of blood PDGF,hs-CRP were significantly elevated in patients with NSTE-ACS,and correlated with plaque burden,NC in patients with NSTE-ACS.They were independent risk factors of vulnerable plaques,also had higher predictive value for vulnerable plaques,might have great significance to guide the intervened treatment for NSTE-ACS patients.