UAP Group Research Articles

Efficacy of atorvastatin in the management of atherosclerotic cardiovascular disease (ASCVD)

Purpose: To investigate the efficacy of atorvastatin in the treatment of atherosclerotic cardiovascular disease (ASCVD) Methods: A total of 158 patients who underwent coronary angiography in the Department of Cardiology, First Affiliated Hospital of Hebei North University, China were divided into acute myocardial infarction (AMI, n = 42), unstable angina pectoris (UAP, n = 70), and control (n = 46) groups. Atorvastatin (40 mg) was administered to the patients in AMI and UAP groups for 40 days. Triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), non-HDL-C, phospholipase A2 (PLA2), YKL40, and clinical efficacy were evaluated after treatment. Results: Acute myocardial infarction group (AMI) had significantly higher TC, LDL-C, non-HDL-C, PLA2, and YKL40 levels compared to UAP and control (p < 0.05). Also, HDL-C, TG, and TG/HDL-C were significantly higher in AMI and UAP compared to control group (p < 0.05). In coronary heart disease, TG/HDL-C had the highest sensitivity, and LDL-C had the highest specificity. Furthermore, TC, LDL-C, and TG significantly decreased in both AMI and UAP groups (p < 0.05), while HDL-C remained unchanged (p > 0.05). Conclusion: Atorvastatin effectively improves lipid profiles in ASCVD patients, and markers such as PLA2 and YKL40 effectively predict ASCVD risk. Further larger-scale, long-term studies are needed to validate the effectiveness of combining lipid and inflammatory biomarkers for ASCVD risk prediction and management.

Fermented Astragalus Powder, a New Potential Feed Additive for Broilers to Improve the Growth Performance and Health.

A total of 320 1-day-old broilers were randomly divided into five groups. The control group (CON) received a basal diet, while the FAP4, FAP2, and FAP1 groups were provided with the basal diet supplemented with 4%, 2%, and 1% fermented Astragalus powder, respectively. The unfermented Astragalus powder (UAP2) group was fed the basal diet supplemented with 2% UAP. Each group contained eight replicates of eight chicks each. The results revealed that the final BW and ADG in the FAP 1 and FAP2 were higher than those in the UAP2 and CON groups, while reducing F/G from day 14 to day 42. On day 42, the thymus index in the UAP and FAP groups as well as the bursa index in the FAP4 group showed significant increases compared to those in the CON group. Supplementation with 2% FAP elevated serum IgA levels in broilers on day 28 and day 42, and it also increased serum IgG levels on day 42. Furthermore, supplementation with 2% FAP elevated serum albumin (ALB) levels in broilers, while supplementation with 4% FAP increased serum (glucose) GLU levels in broilers on day 28. The serum biochemical parameters and pathological observation of the liver and kidney in the groups did not show any adverse effects on broilers' health. In addition, the serum total antioxidant capacity (T-AOC) level significantly increased in the FAP4 and FAP2 groups on day 28, and the malondialdehyde (MDA) level in both serum and liver tissue decreased in the FAP2 group on day 28 and day 42. Compared to the CON group, 2% FAP and 2% UAP supplementation reduced the relative abundance of Bacteroides and supplementation with 2% FAP increased the relative abundance of Alistipes on day 42. In conclusion, the dietary supplementation of FAP can enhance the growth performance, immune function, and antioxidant capacity and regulate microflora in broilers, of which 2% FAP is more effective. It indicates FAP exhibits significant application potential as a promising feed additive for broilers.

Alteration of circulating miRNAs during myocardial infarction and association with lipid levels.

Increasing mortality and morbidity of coronary artery disease (CAD) highlight the emerging need for novel noninvasive markers such as circulating microRNAs (miRNAs). To evaluate the circulating levels of miR-126-3p, miR-210-3p, let-7g-5p, and miR-326, and their associations with known contributors to CAD, in CAD subgroups. We divided the cohort into 4 groups: non-CAD controls (≤30% stenosis; n = 55), and patients with stable angina pectoris (SAP; n = 48), unstable AP (UAP; n = 46), and myocardial infarction (MI; n = 36). The circulating levels of miR-126-3p, miR-210-3p, let-7g-5p, and miR-326 were determined using TaqMan Advanced miRNA Assays in serum specimens. Circulating miR-126-3p levels were lower in the MI and UAP groups, compared with the non-CAD group, whereas miR-210-3p circulating levels were lower in the MI group than others. The levels of circulating let-7g-5p were shown to be useful for distinguishing UAP from MI, and there were substantial differences in circulating let-7g-5p levels between the UAP and MI groups. Moreover, lipid levels and ratios were lower in individuals with high circulating miR-126-3p and miR-210-3p levels. The study results suggest that circulating miR-126-3p, miR-210-3p, and let-7g-5p are differentiated between different clinical presentations of CAD and associated with lipid levels, which are important risk factors and determinants of CAD.

Retrospective Evaluation of In-Hospital and Thirty-Month Mortality Parameters in Cases of Acute Coronary Syndrome

Objectives: The aim of this study is to retrospectively assess, from the hospital records of patients, the clinical data of patients and the treatment strategies practiced on patients who were diagnosed as Acute Coronary Syndrome (ACS) and hospitalized and treated in the Hospital of Faculty of Medicine to research the effect of these data on occurrence of cardiovascular events and 30 months mortality. 
 Methods: It is a retrospective screening study in which patients hospitalized with the diagnosis of ACS between June 2007 and December 2008 in the Hospital of Faculty of Medicine Cardiology Clinic are evaluated by using patient file information and electronic data recording system information, and by calling patients. In-hospital and long-term follow-up deaths were the endpoints of the study. Statistical analysis was performed using SPSS (Version 15.0).
 Results: 985 patients were included in the study who were diagnosed as ACS, hospitalized and treated in the hospital. The categorization of the patients subjected to the analysis (n:901) according to their diagnosis is as follows: 339 (38%) cases diagnosed as UAP, 206 (23%) cases diagnosed as NSTEMI, and 356 (39%) cases diagnosed as STEMI. 78,4 % of cases were male while 21,6 % were female. It was found that cases with hypertension, hyperlipidemia, obesity risk factor, and with a history of cardiovascular disease fall into the NSTEMI and UAP groups with a larger proportion. Among the groups, the UAP diagnosed cases have the largest and the STEMI diagnosed cases have the smallest ratio of using medicine groups such as beta blocker, calcium-canal blocker, ACE inhibitor, ARB, diuretic, statin, fibrate and nitrate before being hospitalized. In-hospital mortality was frequently encountered with a percentage of 7.6 % in STEMI cases, 2.4 % in NSTEMI cases, and 0.6 % in UAP cases. 30-months of follow-up data were obtained in all diagnosis groups for long-term mortality assessment. 70 (7.8 %) deaths were observed within the follow-up. According to diagnosis groups, death was observed in 22 (6.5 %) of UAP cases, 22 (10.7 %) of NSTEMI cases, and 26 (7.3 %) of STEMI cases. Correlation between long-term survival (30 months) and in-hospital statin usage and statin usage in discharge was not significant (p value respectively 0.1 and 0.16). Correlation between an approximate 30-months-survival and in-hospital ACE inhibitor/ARB inhibitor usage and ACE inhibitor/ARB inhibitor usage during discharge was significant (p = 0.007 and p = 0.004). It is also found that there was a significant correlation between survival in the same period of time and in-hospital beta blocker usage (p = 0.01). There was not a significant correlation between beta blocker usage during discharge and long-term survival (p = 0.779). 
 Conclusion: Results of the unicentral retrospective scanning study which involves 901 ACS diagnosed patients prove to be similar to the ones obtained from GRACE and Euro Heart Survey prospective studies which were carried out in multi-central environment and among outnumbered patients.

Correlation of serum ADAMTS13 and TSP1 levels with myocardial injury and prognosis in patients with acute coronary syndrome

To investigate serum levels of von Willebrand factor lytic protease (ADAMTS13) and thrombospondin-1 (TSP1) in patients with different types of acute coronary syndrome (ACS) and their correlation with the patients' clinical prognosis. According to their disease history, results of angiography and clinical biochemical tests, a total of 405 patients undergoing coronary angiography, were divided into unstable angina (UAP) group (n=215), acute myocardial infarction (AMI) group (n=96), and angiographically normal group (n=94). Serum ADAMTS13 and TSP1 levels were detected in all the patients, who were followed up for 15 months to evaluate the occurrence of long-term major cardiac adverse events (MACE). Serum ADAMTS13 level was significantly lower and TSP1 level was significantly higher in AMI group and UAP group than in the normal group (P < 0.001). Serum ADAMTS13 and TSP1 levels were negative correlated in ACS patients (R=-0.577, P < 0.001). The patients experiencing MACE had significantly different serum TSP1 level from those without MACE (P < 0.05). Cox proportion regression model analysis showed that TSP1 was a risk factor affecting the occurrence of MACE in ACS patients; Kaplan-Meier survival analysis showed that the patients with high levels of TSP1 had a higher incidence of longterm MACE than those with low TSP1 levels. A lowered serum ADAMTS13 level and an elevated TSP1 level can support the diagnosis of ACS. An elevated TSP1 level may serve as an indicator for predicting the risk of MACE in patients with ACS.

Correlation between the Serum Platelet-Derived Growth Factor, Angiopoietin-1, and Severity of Coronary Heart Disease.

Background The expression of the platelet-derived growth factor (PDGF), angiopoietin-1 (Ang-1) in patients with coronary artery disease of different studies was inconsistent. This study was to investigate the expression of the PDGF and Ang-1 in peripheral blood and coronary artery in patients with acute coronary syndrome (ACS) and the relationship between the expression of the PDGF and Ang-1 and the severity of coronary artery disease. Methods A total of 81 patients with acute coronary syndrome undergoing coronary angiography were enrolled from September 2012 to December 2013. Patients with ACS included 61 patients with acute myocardial infarction (AMI group) and 20 patients with unstable angina pectoris (UAP group). The 29 patients who were hospitalized for chest pain undergoing coronary angiography without stenosis and with TIMI level 3 blood flow were selected as the control group. During coronary arteriography (CAG) or percutaneous coronary intervention (PCI), blood in the peripheral artery and in the local coronary artery was collected from all the patients. Serum PDGF and Ang-1 levels were measured by ELISA. We calculated the Gensini score of each patient with CHD according to the result of CAG. Patients with ACS were followed up, and the major adverse cardiovascular and cerebrovascular adverse events were recorded. Results In peripheral blood, the concentration of the PDGF was significantly elevated in the ACS group than that of the control group. The level of the PDGF in the AMI group was significantly higher than that in the UAP group. In coronary artery blood, the level of the PDGF in the ACS group was significantly higher than that of the UAP group. There was no significant difference in the concentration of Ang-1 in peripheral blood between patients with coronary heart disease and the control group. The concentration of Ang-1 in the coronary artery was significantly lower than that in peripheral blood. The coronary Ang-1 concentrations in the ACS group were significantly higher than those in the UAP group. The concentrations of the PDGF and Ang-1 in peripheral and coronary artery blood were positively correlated with the severity of coronary lesions. Patients with MACCE had higher PDGF and Ang-1 levels in the coronary sinus. Conclusion The serum PDGF concentration in patients with acute coronary syndrome was significantly increased, especially in the local coronary artery. The serum Ang-1 in the coronary artery was significantly increased in patients with acute myocardial infarction and was related to the degree of coronary artery stenosis. Coronary sinus PDGF and Ang-1 levels can reflect the severity of lesions in patients with acute coronary syndrome.

Changes in plasma levels of RIPK1, RIPK3, and MLKL in patients with coronary atherosclerotic heart disease and its clinical predictive value.

Coronary atherosclerotic heart disease (CHD) is caused by coronary atherosclerosis, which leads to stenosis and even occlusion of the lumen, resulting in myocardial ischemia, and necrosis subsequently. Its prevalence has been high for a long time. The prevention and treatment of CHD are important. The study aimed to investigate the role of plasma levels of receptor-interacting protein kinase 1 (RIPK1), receptor-interacting protein kinase 3 (RIPK3), and mixed-lineage kinase domain-like protein (MLKL) in patients with CHD and its clinical predictive value. A total of 190 patients with CHD who were diagnosed by coronary angiography and 70 healthy subjects in cardiovascular department from September 2015 to May 2017 were enrolled in this study. Patients with CHD were assigned into 4 groups: Patients with stable angina pectoris (SAP, n=46), patients with unstable angina pectoris (UAP, n=56), patients with non-ST-segment elevation myocardial infarction (NSTEMI, n=42), and patients with ST-segment elevation myocardial infarction (STEMI, n=46). Patients with CHD were assigned into a single-vessel lesion group, a double-vessel lesion group, and a multi-vessel lesion group according to the results of coronary angiography, and the severity of coronary artery stenosis was determined by Gensini score. Plasma levels of RIPK1, RIPK3, and MLKL were measured by enzyme-linked immunosorbent assay (ELISA). The plasma levels of RIPK1, RIPK3, and MLKL in patients with CHD were significantly higher than those in the controls (P<0.05). The plasma levels of RIPK1, RIPK3, and MLKL in the UAP group were significantly higher than those in the SAP group (P<0.05). The plasma levels of RIPK1, RIPK3, and MLKL in NSTEMI and STEMI group were significantly higher than those in the UAP group (P<0.05). There was no significant difference between the NSTEMI group and STEMI group (P>0.05). The plasma levels of RIPK1, RIPK3 and MLKL were significantly increased with numbers of coronary artery lesions (P<0.05), which were positively correlated with Gensini scores. The multivariate logistic regression analysis showed that plasma levels of RIPK1, RIPK3, and MLKL were independent risk factors for severe coronary artery stenosis.The average period of follow-up was 24 months after hospital discharge. The patients were divided into 2 groups according to whether they had major adverse cardiovascular events (MACE). Compared with patient without MACE, patient with MACE had higher levels of RIPK1, RIPK3, and MLKL (P<0.05). Receiver operator characteristic (ROC) curve analysis showed that the area under curve of RIPK1 was 0.72 (P<0.001), the area under curve of RIPK3 was 0.83 (P<0.001), and the area under curve of MLKL was 0.75 (P<0.001). Plasma levels of RIPK1, RIPK3, and MLKL are closely related to CHD, and they have predictive value for the prognosis evaluation for patients with CHD.

Inflammation-Related MicroRNAs Are Associated with Plaque Stability Calculated by IVUS in Coronary Heart Disease Patients.

Objectives This study aimed to investigate the association between inflammation-related microRNAs (miR-21, 146a, 155) and the plaque stability in coronary artery disease patients. Methods The expression of miR-21, 146a, and 155 was measured by real-time PCR in 310 consecutive patients. The level of hs-CRP, IL-6, and IL-8 was measured by ELISA. The plaque stability of coronary stenotic lesions was evaluated with intravascular ultrasound (IVUS). Results (1) The levels of hs-CRP, IL-6, and IL-8 were significantly increased in the UAP and AMI groups compared with the CPS group (P < 0.01). (2) The expression of miR-21 and miR-146a in peripheral blood mononuclear cells (PBMCs) and plasma was significantly higher in CAD patients compared with non-CAD patients, whereas the miR-155 expression in PBMCs and plasma was significantly lower in patients with CAD. (3) The miR-21 expression in PBMCs was higher in UAP and AMI groups compared with CPS group. The miR-146a expression in PBMCs was higher in SAP, UAP, and AMI groups than in CPS group. Although the level of miR-155 in PBMCs was lower in SAP, UAP, and AMI groups than in CPS group. The expression patterns of miR-21, miR-146a, and miR-155 in plasma were consistent with those of PBMCs. (4) The expressions of miR-21 and miR-146a in PBMCs and plasma were significantly higher in the vulnerable plaque group than those in stable plaque group. While miR-155 in PBMCs and plasma was significantly lower in vulnerable plaque group compared with stable plaque group. (5) The levels of miR-21 and miR-146a in PBMCs and plasma were significantly higher in soft plaque group than in fibrous plaque group and calcified plaque group. However, miR-155 in PBMCs and plasma was significantly lower in soft plaque group. Conclusions The expression of miR-21 and miR-146a are associated with the plaque stability in coronary stenotic lesions, whereas miR-155 expression is inversely associated with the plaque stability.

The Effect of Traditional Chinese Mind-Body Exercise (Baduanjin) and Brisk Walking on the Dorsal Attention Network in Older Adults With Mild Cognitive Impairment.

A growing number of studies have shown that mind-body exercise is beneficial to cognitive function, especially memory, in elderly MCI patients. However, few studies have explored the effect of mind-body exercise on the attention of MCI population. We recruited 69 participants and divided them equally into Baduanjin, brisk walking (BWK) exercise or usual physical activity (UAP) control groups. The two exercise groups performed 60 min of exercise three times per week for 24 weeks. All subjects underwent whole-brain functional MRI and assessment of attentional abilities, including selective, divided, and sustained attention, and processing speed at baseline and after 24 weeks. The results show that: Baduanjin exercise significantly increased the selective attention of MCI patients, and Dorsal attention network (DAN) of Baduanjin exercise group exhibited functional connectivity decreased in right rolandic operculum (ROL. R), right middle temporal gyrus (MTG. R), right supramarginal inferior parietal, angular gyri (IPL. R), right precuneus (PCUN. R), and right fusiform gyrus (FFG. R) regions compared with the other two groups. The BWK exercise group had obviously functional connectivity increased in IPL. R and decreased in the MTG. R region compared to that in the UAP group. But no significant association between the changes of functional connectivity of DAN and the change of attentional ability test was observed. Thus, our data indicated Baduanjin exercise may be a potential beneficial intervention to improve the attention of the elderly with MCI. Further study with more samples is necessary to elucidate its imaging mechanism.

Interleukin-32 increases in coronary arteries and plasma from patients with coronary artery disease

Interleukin-32 increases in coronary arteries and plasma from patients with coronary artery disease

Endothelial Nitric Oxide Level as a Predictor of Coronary Complexity in Patients With Unstable Angina Pectoris

Endothelial Nitric Oxide Level as a Predictor of Coronary Complexity in Patients With Unstable Angina Pectoris

The changes and clinical significance of plasma lipoprotein-associated phospholipase A2, C-reactive protein and cardiac troponin I in patients with acute coronary syndrome

Objective To investigate the relationship between lipoprotein associated phospholipase A2 (Lp-PLA2) and atherosclerotic plaque instability in patients with acute coronary syndrome (ACS), and to provide theoretical basis for diagnosis and treatment of ACS. Methods From September 2015 to February 2016, 80 patients with ACS in Shidao People's Hospital of Rongcheng were selected as the study group, including 38 cases in unstable angina group(UAP group), 24 cases in non ST segment elevation myocardial infarction group (NSTEMI group), 18 cases in ST segment elevation myocardial infarction group(STEMI group). Forty patients with stable angina pectoris(SAP group) and 40 healthy subjects(healthy group) were selected as control group.Each group was collected 8 hours fasting morning blood sample, the levels of Lp-PLA2, C reactive protein(CRP), troponin I, and low density lipoprotein were detected, in order to compare the differences among the groups and the correlation between Lp-PLA2 and ACS plaque instability was analyzed. Results The levels of Lp-PLA2, CRP, troponin I and low density lipoprotein in the ACS group were (312.63±11.14)ng/mL, (21.98±7.83)mg/L, (0.720±0.490)μg/L, (174.76±30.82)mg/dL, respectively, which were significantly higher than those of the healthy group [(141.14±12.30)ng/mL, (2.38±1.68)mg/L, (0.010±0.003)μg/L, (79.24±17.80)mg/Ml], and stable angina pectoris group[(176.42±12.44)ng/mL, (4.22±3.68)mg/L, (0.010±0.004)μg/L, (96.54±19.41)mg/mL]. There were statistically significant differences among all groups(F=3.07, 1.99, 2.43, 3.25, all P<0.01). The levels of CRP, Lp-PLA2 and cTnI in ACS patients with different types of the STEMI group, NSTEMI group, UAP group had statistically significant differences, which of the STEMI group were higher than those of the NSTEMI group, which of the NSTEMI group were higher than those of the UAP group(F=5.15, 3.47, 2.43, all P<0.05). Correlation analysis showed that the level of Lp-PLA2 was positively correlated with low density lipoprotein(r=0.625, P<0.01) and lipoprotein a(r=0.532, P<0.01). logistic regression analysis showed that Lp-PLA2 and CRP were significant independent risk factors of ACS, Lp-PLA2(OR=1.613, 95%CI: 1.292-1.992, P<0.01), CRP(OR=1.452, 95%CI: 1.210-1.782, P<0.01). Conclusion Lp-PLA2 is independent risk factor of ACS.Lp-PLA2 is involved in the inflammatory reaction of ACS, and is strongly associated with the stability of atherosclerotic plaque. Key words: Acute coronary syndrome; Lipoprotein-associated phospholiase A2; C-reactive protein; cardiac troponin I; Regression analysis

Correlation between serum inflammatory cytokine levels and fibrous cap thickness of fibrofatty plaque in coronary culprit lesions

Objective: To identify the correlation between serum inflammatory cytokine levels including high sensitive C reactive protein (hs-CRP) and lipoprotein associated phospholipase (Lp-PLA2) and the fibrous cap thickness of fibrofatty plaque in coronary culprit lesions. Methods: Clinical data of 117 patients with selective coronary artery angiography diagnosed coronary artery disease admitted to our hospital from January 2015 to January 2016 were retrospective analyzed. According to type of coronary disease, patients were divided into 3 subgroups: SAP group (containing 47 stable angina patients), UAP group (containing 52 unstable angina patients), and NSTEMI group(containing 18 acute non ST segment elevation myocardial infarction patients). Serum hs-CRP and Lp-PLA2 levels were measured before subsequent procedures. The characteristics of the culprit lesions were detected by optical coherence tomogarpgy(OCT) before interventional treatment, and the correlation between hs-CRP and Lp-PLA2 and the fibrous cap thickness of fibrofatty plaque in coronary culprit lesions were analyzed. Results: (1) The serum levels of hs-CRP (2.13(1.04, 4.75)μg/L vs. 1.02(0.60, 1.29)μg/L and 1.30(1.03, 1.96)μg/L, all P<0.05) and Lp-PLA2 ((394.8±61.4)mg/L vs. (140.1±40.4)mg/L and (284.5±93.6)mg/L, all P<0.05) were significantly higher in NSTEMI group than in SAP group and UAP group, and serum levels of hs-CRP and Lp-PLA2 were significantly higher in UAP group than in SAP group (all P<0.05). (2)The fibrous cap thickness of fibrofatty plaque in coronary culprit lesions were smaller in NSTEMI group and UAP group than in SAP group(50(50, 60)μm and 60(50, 90)μm vs. 130(80, 190)μm, all P<0.05), and there was no significantly difference between NSTEMI group and UAP group(P>0.05). Proportion of thin-cap fibroatheroma plaque(82.35%(14/18) vs. 19.15%(9/47) and 63.46%(33/52), all P<0.05), plaque rupture(55.56%(10/18)vs. 6.38%(3/47) and 28.85%(15/52), all P<0.05) and thrombosis(33.33%(6/18) vs. 4.26%(2/47) and 9.26%(5/52), all P<0.05) were significantly higher in NSTEMI group than in SAP group and UAP group. Proportion of calcifiacation in plaque was lower in NSTEMI group than in SAP group (11.11%(2/18)vs. 42.55%(20/47), P<0.05), and there was no significantly difference between NSTEMI group and UAP group(P>0.05). (3) Pearson correlation analysis showed that serum levels of hs-CRP(r=-0.233, P<0.05) and Lp-PLA2(r=-0.465, P<0.01)were negatively correlated with fibrous cap thickness of fibrofatty plaques. Spearman correlation analysis showed that serum levels of hs-CRP were positively correlated with plaque rupture(r=0.409, P<0.01) and thrombosis (r=0.227, P<0.05), and serum levels of Lp-PLA2 were also positively correlated with plaque rupture(r=0.499, P<0.01) and thrombosis(r=0.263, P<0.01). (4)Multiple logistic regression analysis showed that serum levels of Lp-PLA2 at baseline was independently related to thin-cap fibroatheroma plaque(OR=1.017, P<0.01). Conclusions: The serum levels of hs-CRP and Lp-PLA2 in NSTEMI patients are much higher than that in SAP and UAP patients, higher in UAP patients than in SAP patients. Prevalence of thin-cap fibroatheroma plaque, plaque rupture and thrombosis was significantly higher in the NSTEMI patients, while the prevalence of calcification in plaque is more often in SAP patients. Increased serum levels of Lp-PLA2 are independent risk factor of thin-cap fibroatheroma plaque formation.

Clinical prediction value of chemokine CCL21 level for acute coronary syndrome

Objective To investigate the clinical prediction value of chemokine CCL21 level for acute coronary syndrome. Methods Totally 212 patients receiving coronary arteriography were divided into acute myocardial infarction group(AMI, n=72), unstable angina pectoris group(UAP, n=76), and stable angina pectoris group(SAP, n=64). The serum level of chemokine CCL21 was detected by double-antibody sandwich enzyme-linked immunosorbent assay(ELISA)and the pathological changes of coronary artery were measured by Gensini scoring system.All patients were followed up for six months and the cardiovascular adverse events were recorded. Results The serum level of CCL21 was(169.72±14.64)ng/L in AMI group, (154.42±16.50)ng/L in UAP group, and(143.87±9.80)ng/L in SAP group, with statistically significant differences(F=99.818, P=0.000). Serum levels of CCL21 in ACS group and SAP group were positively correlated with Gensini score(r=0.474, P=0.000; r=0.350, P=0.049). Binary Logistic regression analysis revealed that chemokine CCL21 was an independent risk factor for predicting acute coronary syndrome(OR=1.049, P=0.022). The CCL21-judged area under the ROC curve in acute coronary syndrome group was 0.887±0.028(P=0.000), with diagnostic point of serum level of chemokine CCL21 at 159.15 ng/L, sensitivity of 0.635, specificity of 0.981.Serum level of CCL21 was higher in the patients with cardiovascular adverse events than in the patients without cardiovascular adverse events〔(168.57±7.24)ng/L vs.(156.92±6.53)ng/L〕, with statistically significant difference(t=16.100, P=0.000). Conclusions Serum level of chemokine CCL21 reflects the severity degree of coronary artery disease.The chemokine CCL21, as an independent and effective marker, can predict acute coronary syndrome. Key words: Acute coronary syndrome; Chemokine CCL21

A study in the correlation between vascular factors and plaque imaging morphology of coronary borderline lesions in patients with coronary heart disease

Objective To investigate the correlation between the levels of placenta growth factor (PLGF) , soluble angiopoietin receptor-2 (sTie-2) and critical coronary artery plaque imaging morphology of coronary borderline lesions in patients with coronary heart disease (CHD) . Methods In three consecutive years from April 2007 to September 2009, a cohort of 719 patients with borderline coronary lesions with stenosis in three main vessels with lumen diameter reduction varied all the way from more than 20% to less than 70% and with greater than 2.25 mm of the inner diameter were selected in this study from 4 teaching hospitals of tertiary class A in Beijing. These patients fell into three categories: unstable angina pectoris (UAP, n =292) , stable angina pectoris (SAP, n =219) and coronary arteriosclerosis (AS, n =208) . The vessels involved were analyzed using quantitative coronary angiography (QCA) . Plasma levels of PLGF and sTie-2 were measured by using protein chip. The relationship between plasma levels of vascular factors, sTie-2, PLGF and coronary artery plaque imaging morphology among three groups were analyzed. Results (1) Plasma level of PLGF was 80.33 ng/L in the UAP group, which was significantly higher than 54.29 ng/L in the SAP group and 45.16 ng/L in AS group (both P <0.05) . Plasma level of sTie-2 was 1353.06 ng/L in the UAP group, which was significantly higher than 1308.28 ng/L in the AS group (P =0.008) . (2) There was significantly statistical differences in QCA between the SAP group and the UAP group as well as the AS group (both P <0.05) in terms of the minimal lumen diameter, diameter stenosis rate, minimal lumen cross-sectional area and cross-sectional area of stenosis. The plaque area in the UAP group was larger than that in the AS group (P =0.013) . (3) The relationship between vascular factors and plaque imaging morphology was analyzed. There was significantly statistical difference in the involved lesions among the three groups (P <0.01) . (4) There was a positive correlation between plasma level of PLGF and minimal lumen cross-sectional area (r =0.493, P =0.009). Conclusions The plasma levels of PLGF and sTie-2 reflect the level of neo-vascularization in the plaque, and could be taken as predictive factors for potential pathogenesis of coronary plaque. Key words: Coronary heart disease; PLGF; sTie-2; Quantitative coronary angiography

Correlation of serum calprotectin level with the range of coronary lesion in patients with acute coronary syndrome

To examine the serum levels of S100 calcium-binding protein A8/A9 complex (S100A8/ A9) in patients with acute coronary syndrome (ACS) and to explore the relation between the serum levels of S100A8/A9 and the degree of coronary lesion. A total of 126 patients with coronary heart disease were enrolled from Xiangya Hospital of Central South University between September 2010 and January 2011, which included 51 patients with unstable angina pectoris (UAP group, n=51), 50 patients with acute myocardial infarction (AMI group, n=50), and 25 patients with stable angina pectoris (SAP group, n=25). Twenty-five healthy volunteers were served as a normal control group (NC group, n=25). According to the coronary artery lesion area, ACS patients were also divided into a single-branch group, a double-branch group and a triple-branch group. Serum levels of S100A8/A9 were measured by enzyme-linked immunosorbent assay on the day when the patients admitted to the hospital and on the day after one-week treatment (UAP group + AMI group). The serum levels were compared among the various branch groups. The short-term prognosis in patients with ACS was investigated by phone follow-up after 3 months. 1) The S100A8/A9 level in the SAP group was significantly higher than that in the normal control group (P<0.05). The serum levels of S100A8/A9 in the UAP group and the AMI group were significantly higher than that in the SAP group (all P<0.05); There was no significant difference in the S100A8/A9 level between the UAP group and the AMI group (P>0.05); 2) After one-week standard treatment, the serum levels of S100A8/A9 in patients with ACS were significantly reduced compared with that at the admission (P<0.01), but it was still elevated compared with that in the normal control group (P<0.01); 3) The serum level of S100A8/A9 in the triple-branch group was significantly higher than that in the single-branch group and the double-branch group (both P<0.05); 4) The short-term prognosis in patients with ACS was not correlated with the serum level of S100A8/A9 (r=0.012, P> 0.05). The serum level of S100A8/A9 is significantly elevated in patients with ACS, which might be positively correlated with the number of the coronary lesion branches.

Correlation between the severity of coronary artery lesions and levels of estrogen, hs-CRP and MMP-9.

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.

Clinical Significance of Leukotriene B4 and Extracellular Matrix Metalloproteinase Inducer in Acute Coronary Syndrome

Leukotriene B4 (LTB4) and extracellular matrix metalloproteinase (EMMPRIN) have been suggested as modulators of atherosclerotic plaque instability. This study sought to evaluate the potential diagnostic implication of LTB4 and EMMPRIN in patients with acute coronary syndrome (ACS). Patients (n=153) who underwent coronary angiography, including 105 patients diagnosed with ACS, were divided into four groups: stable angina pectoris (SAP, n=19), unstable angina pectoris (UAP, n=39), acute myocardial infarction (AMI, n=66) and control (with normal coronary angiography, n=29). EMMPRIN expression in peripheral blood mononuclear cells was determined by flow cytometry and serum LTB4 levels were measured by ELISA. To examine whether LTB4 can regulate the expression of EMMPRIN and matrix metalloproteinases (MMPs) in macrophages, differentiated THP-1 macrophages were stimulated with different concentrations of LTB4 (10-10-10-7mmol/L). Expression of EMMPRIN was evaluated by Western blotting. MMP-9 mRNA expression and enzymatic activity were determined by RT-PCR and SDS-PAGE gelatin zymography. Serum LTB4 concentration was significantly higher in AMI and UAP groups, compared with control and SAP groups (p < 0.01). Subgroups analysis showed that LTB4 was significantly higher in the AMI < 24h group, compared with the AMI > 24h group. Expression of EMMPRIN on circulating monocytes was significantly higher in patients with UAP and AMI (> 24h), compared with control, SAP and AMI (< 24h) groups (p < 0.05). In vitro study showed LTB4 up-regulated the expression of EMMPRIN, as well as the expression and activity of MMP-9, in cultured THP-1-derived macrophages (p < 0.05). LTB4 and EMMPRIN are associated with the pathogenesis of ACS and may be potential biomarkers for patients with ACS.

Endothelial microparticles exert differential effects on functions of Th1 in patients with acute coronary syndrome

Endothelial microparticles exert differential effects on functions of Th1 in patients with acute coronary syndrome

GW24-e1202 Relationship between levels of microalbuminuria and vascular endothelial function in patients with coronary atherosclerotic disease

ObjectivesTo investigate the relationship among the levels of microalbuminuria and high-sensitivity C-reactive protein (hs-CRP) in patients with coronary atherosclerotic disease, and the role of microalbuminuria in predicting the vascular endothelial...