Relationships between intima-media thickness, carotid artery plaque total score, P-selectin and coronary artery lesions of acute coronary syndrome patients

Abstract

Objective To analyze the relationships between carotid artery intima-media thickness (IMT), carotid plaque score (Crouse score), P-selectin (PS) levels and coronary artery stenosis, major adverse cardiac events (MACEs) in patients with acute coronary syndrome (ACS) during 6 months. Methods From June 2012 to January 2013, 282 cases with chest pain in the department of cardiology, affiliated hospital of Hebei united university were selected. All the subjects underwent coronary angiography and were divided into control group (non-CHD group, n=78), unstable angina group (UAP, n=117) or acute myocardial infarction group (AMI, n=87), according to angiographic results, ECG and cardiac enzymes results. PS levels were tested for all subjects on admission. Carotid artery IMT and Crouse scores were determined for all subjects within 72 hours. The coronary artery stenosis was evaluated by Gensini score according to coronary angiography. ACS patients were followed up for 6 months with MACEs recorded. Parameters were compared among groups statistically using SPSS 13.0 software for carotid artery IMT, Crouse score and PS levels. Results IMT, Crouse score and PS levels in control group were significantly lower than those in ACS group [(0.90±0.29)mm vs. (1.38±0.25)mm, 3.88±1.45 vs. 8.98±2.92, and (14.79±3.15)ng/L vs. (42.21±11.71)ng/L, all P<0.01]. Both UAP group [(1.33±0.18)mm, 8.29±2.78, (38.95±10.31)ng/L] and AMI group [(1.44±0.31)mm, 9.92±2.86, (46.57±12.09)ng/L] had higher IMT, Crouse score and PS levels than control group (all P<0.01). IMT, Crouse score and PS levels in ACS patients with single-vessel coronary artery disease, double vessel disease and three-vessel disease were (1.18±0.26)mm, 6.13±1.89, (32.51±8.96)ng/L and (1.39±0.17)mm, 9.15±1.84, (43.76±9.64)ng/L and (1.57±0.17)mm, 11.99±2.11, (50.79±9.65)ng/L, all P<0.01. IMT, Crouse score and PS levels were all positively correlated with coronary Gensini score in ACS patients (r=0.83, 0.75 and 0.84, respectively, all P<0.01). IMT, Crouse score and PS levels in patients with or without MACEs were (1.56±0.19) mm vs. (1.28±0.29)mm, 11.93±2.61 vs. 7.68±2.86, and (52.28±8.45)ng/L vs. (36.47±13.41)ng/L, all P<0.01. Conclusions IMT, Crouse score and PS level can be used as predictors of ACS, they may help to evaluate coronary artery disease severity and prognosis in ACS patients. Key words: Acute coronary syndrome; Intima-media thickness of carotid artery; Carotid artery plaque score; P-selectin