Document Detail


Relationship between hs-CRP, proMMP-1, TIMP-1 and coronary plaque morphology: intravascular ultrasound study.
MedLine Citation:
PMID:  17097015     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Rupture of unstable plaque with subsequent thrombus formation is the common pathophysiological substrate of the acute coronary syndrome (ACS). It is of potential significance to explore the blood indexes predicting plaque characteristics. Little studies have focused on this field. Therefore we investigated the relationship between hypersensitive C-reactive protein (hs-CRP), pro-matrix metalloproteinase-1 (proMMP-1), tissue inhibitors of matrix metalloproteinase-1 (TIMP-1) and coronary plaque morphology. METHODS: Intravascular ultrasound (IVUS) examination was done in 152 patients with confirmed coronary heart disease before percutaneous coronary intervention from February 2003 to July 2005. Plasma samples of arterial blood were collected prior to the procedure. The level of hs-CRP, proMMP-1 and TIMP-1 were respectively measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: Unstable and ruptured plaque were found more frequently in patients with acute myocardial infarction and unstable angina. External elastic membrane cross-sectional area (EEM CSA), plaque area, lipid pool area and plaque burden were significantly larger in ruptured and unstable plaque group. Positive remolding, thinner fabric-cap, smaller minimal lumen cross-sectional area (MLA), dissection and thrombus were significantly more frequent in ruptured and unstable plaque group. The levels of plasma hs-CRP, proMMP-1 and TIMP-1 were higher in ruptured plaque group. hs-CRP > 8.94 mg/L was used to predict ruptured plaque with a ROC curve area of 0.76 [95% confidence interval (CI), 67.0% - 85.8%], sensitivity of 71.8%, specificity of 77.0% and accuracy of 69.2% (P < 0.01), similarly for proMMP-1 > 0.12 ng/ml with a ROC curve area of 0.69 [95% CI, 58.2% - 80.2%], sensitivity of 69.2%, specificity of 75.2% and accuracy of 66.2% (P < 0.01), and TIMP-1 > 83.45 ng/ml with a ROC curve area of 0.67 [95% CI, 56.2% - 78.3%], sensitivity of 66.7%, specificity of 61.9% and accuracy of 66.2% (P < 0.01). CONCLUSION: The plaque characteristics correlate with the clinical presentation. The elevation of hs-CRP, proMMP-1 and TIMP-1 are related to the plaque instability and rupture.
Authors:
Xing-wei Zhang; Jun-bo Ge; Jian-min Yang; Lei Ge; Ning-fu Wang; Yan Gao; Pei-zhang Li; Hao Pan; Guo-xin Tong; Liang Zhou; Xian-hua Ye; Jian Xu
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Chinese medical journal     Volume:  119     ISSN:  0366-6999     ISO Abbreviation:  Chin. Med. J.     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-11-13     Completed Date:  2006-12-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7513795     Medline TA:  Chin Med J (Engl)     Country:  China    
Other Details:
Languages:  eng     Pagination:  1689-94     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Hangzhou First Municipal Hospital & Hangzhou Hospital, Nanjing Medical University, Hangzhou 310006, China.
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MeSH Terms
Descriptor/Qualifier:
Aged
C-Reactive Protein / analysis*
Coronary Artery Disease / pathology
Coronary Disease / blood,  pathology
Coronary Vessels / pathology*,  ultrasonography*
Enzyme-Linked Immunosorbent Assay
Female
Humans
Male
Matrix Metalloproteinase 1 / blood*
Middle Aged
ROC Curve
Tissue Inhibitor of Metalloproteinase-1 / blood*
Ultrasonography, Interventional*
Chemical
Reg. No./Substance:
0/Tissue Inhibitor of Metalloproteinase-1; 9007-41-4/C-Reactive Protein; EC 3.4.24.7/Matrix Metalloproteinase 1

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