Otake Hiromasa, Shite Junya, Shinke Toshiro, Watanabe Satoshi, Tanino Yusuke, Ogasawara Daisuke, Sawada Takahiro, Hirata Ken-ichi, Yokoyama Mitsuhiro
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Am J Cardiol. 2008 Jan 1;101(1):1-7. doi: 10.1016/j.amjcard.2007.07.041. Epub 2007 Nov 26.
The present study investigated the relation between plasma high-sensitivity C-reactive protein (hs-CRP) and adiponectin and coronary plaque components in patients with acute coronary syndrome (ACS). Previous studies showed a pivotal role of inflammation in the progression of atherosclerosis and the prognostic value of several biomarkers. However, relations among inflammatory biomarkers and plaque characteristics were unknown. Ninety-three culprit plaques (ACS n = 50, non-ACS n = 43) and 56 nonculprit plaques (ACS n = 28, non-ACS n = 28) were analyzed using Virtual Histology intravascular ultrasound to examine relations among plasma hs-CRP, adiponectin, and ratios of each coronary plaque component. Plasma adiponectin was significantly lower and plasma hs-CRP was significantly higher in patients with than without ACS. Culprit plaques in patients with ACS had greater amounts of necrotic core plaque than those in patients without ACS. There was an inverse relation between serum hs-CRP and adiponectin with regard to necrotic core ratio in both culprit and nonculprit lesions in patients with ACS, but not those without ACS. In conclusion, increased plasma hs-CRP and hypoadiponectinemia might be related to the progression of ACS.
本研究调查了急性冠脉综合征（ACS）患者血浆高敏C反应蛋白（hs-CRP）和脂联素与冠状动脉斑块成分之间的关系。先前的研究表明炎症在动脉粥样硬化进展中起关键作用，并且几种生物标志物具有预后价值。然而，炎症生物标志物与斑块特征之间的关系尚不清楚。使用虚拟组织学血管内超声分析了93个罪犯斑块（ACS患者50个，非ACS患者43个）和56个非罪犯斑块（ACS患者28个，非ACS患者28个），以研究血浆hs-CRP、脂联素与各冠状动脉斑块成分比例之间的关系。ACS患者的血浆脂联素显著低于非ACS患者，而血浆hs-CRP显著高于非ACS患者。ACS患者的罪犯斑块比非ACS患者的罪犯斑块有更多的坏死核心斑块。在ACS患者的罪犯和非罪犯病变中，血清hs-CRP与脂联素在坏死核心比例方面呈负相关，但在非ACS患者中并非如此。总之，血浆hs-CRP升高和低脂联素血症可能与ACS的进展有关。
