Abstract
The aim of this study was to investigate the correlation between the severity of coronary artery lesions in patients with acute coronary syndromes (ACS) and levels of estrogen, high-sensitivity C-reactive protein (hs-CRP) and matrix metalloproteinase-9 (MMP-9). A total of 65 patients with ACS, 33 patients with stable angina pectoris (SAP) and 36 healthy controls were randomly enrolled. Patients with ACS were subdivided into two groups: Acute myocardial infarction (AMI; n=30) and unstable angina pectoris (UAP; n=35). Serum levels of estrogen, hs-CRP and MMP-9 were detected in the four groups of subjects. Serum estrogen levels in patients with AMI, UAP and SAP were significantly lower than those in the control group (P<0.05). Estrogen levels were also significantly different among the AMI, UAP and SAP groups (P<0.05), with a progressive increase across the three respective groups. Compared with healthy subjects, patients with AMI had the highest levels of hs-CRP and MMP-9, followed in descending order by those with UAP and SAP (P<0.05). Levels of hs-CRP and MMP-9 were also significantly different among the AMI, UAP and SAP groups (P<0.05). Serum estrogen levels were negatively correlated with hs-CRP and MMP-9 levels (r=−0.6634 and −0.6878, respectively; both P<0.05). hs-CRP and MMP-9 levels correlated positively (r=0.7208, P<0.05). The number of stenosed coronary vessels was negatively correlated with estrogen levels (r=−0.6467, P<0.05), and positively correlated with hs-CRP and MMP-9 levels (r=0.6519 and 0.6835, respectively; both P<0.05). In conclusion, serum estrogen, hs-CRP and MMP-9 levels were significantly correlated with the severity of coronary artery lesions. There was also a significant correlation between serum estrogen, hs-CRP and MMP-9 levels. These data indicate that serum estrogen, hs-CRP and MMP-9 have the potential to be used as biomarkers for evaluating the severity of coronary artery lesions and the stability of coronary artery plaques.
Highlights
Acute coronary syndrome (ACS), one of the most common severe cardiovascular diseases, is a type of severe coronary heart disease that is associated with high rates of mortality and disability [1]
ACS is classified as either acute myocardial infarction (AMI) or unstable angina pectoris (UAP), and the classification is based on vulnerable plaque rupture accompanied by complete or incomplete artery occlusion [2]
Serum estrogen levels were significantly lower in patients with AMI (52.31±8.94 ng/l), UAP (58.72±8.21 ng/l) and stable angina pectoris (SAP) (61.93±8.69 ng/l) compared with the control group (82.16±9.85 ng/l; P
Summary
Acute coronary syndrome (ACS), one of the most common severe cardiovascular diseases, is a type of severe coronary heart disease that is associated with high rates of mortality and disability [1]. Evaluation of the characteristics of coronary atherosclerotic plaques and the extent of coronary artery lesions can enable early diagnosis of ACS. Intracoronary ultrasound and coronary angiography can be used for the detection of coronary atherosclerotic plaques. These two methods are not widely applied in the clinic as they are expensive and invasive, and require improvements [3]. Clinical studies have demonstrated that hs‐CRP levels can be used as predictors of cardiovascular disease [5]. The aim of the present study was to explore an economic, convenient and non‐invasive method to evaluate the extent of coronary artery lesions and to analyze the correlation between estrogen, hs‐CRP and MMP‐9 levels and the severity of coronary artery lesions
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