Department of Medicine, University of Ulsan College of Medicine, Asan Medical Center, Korea.
Circ J. 2010 Feb;74(2):332-6. doi: 10.1253/circj.cj-09-0570. Epub 2009 Dec 14.
The relationship between plasma biomarkers and vulnerable plaque is not well understood.
The 188 patients who underwent 3-vessel virtual histology (VH) intravascular ultrasound (IVUS) with peripheral blood sampling were enrolled. Plasma levels of matrix metalloproteinase 2 and 9 (MMP-2, -9), tissue inhibitor of metalloproteinase-1, adiponectin, and macrophage migration inhibitory factor were measured. VH-IVUS-derived thin cap fibroatheroma (VH-TCFA) was defined as a necrotic core >10% of plaque area in the presence of >40% plaque burden. There were 38 patients with ruptured plaque and 150 patients without (107 patients with VH-TCFA, 43 patients without VH-TCFA) in culprit/target lesions. Among the biomarkers, only the MMP-9 level was significantly higher in patients with ruptured plaque (P=0.002). In the subgroup without ruptured plaque, significant differences in the levels of several biomarkers were not observed between patients with and without VH-TCFA. In both culprit/target and nonculprit/non-target vessels, the MMP-9 level showed a weak correlation with the total number of ruptured plaques (r=0.231, P=0.002).
Among the biomarkers tested in this study, the MMP-9 level was significantly higher in patients with ruptured plaque. However, measurement of several biomarkers, including MMP-9, was incapable of predicting the presence of VH-TCFA.
目前人们对血浆生物标志物与易损斑块之间的关系尚不完全了解。
共纳入 188 例行三血管虚拟组织学（VH）血管内超声（IVUS）检查并行外周血采样的患者。检测了基质金属蛋白酶 2 和 9（MMP-2、MMP-9）、金属蛋白酶组织抑制剂-1、脂联素和巨噬细胞移动抑制因子的血浆水平。VH-IVUS 检测到薄帽纤维粥样斑块（VH-TCFA）定义为存在>40%斑块负荷的情况下，斑块面积>10%的坏死核心。在罪犯/靶病变中，有 38 例患者为破裂斑块，150 例患者为非破裂斑块（107 例为 VH-TCFA，43 例为非 VH-TCFA）。在这些生物标志物中，只有 MMP-9 水平在破裂斑块患者中显著升高（P=0.002）。在没有破裂斑块的亚组中，有 VH-TCFA 和无 VH-TCFA 的患者之间，几种生物标志物的水平没有显著差异。在罪犯/靶血管和非罪犯/非靶血管中，MMP-9 水平与破裂斑块总数呈弱相关（r=0.231，P=0.002）。
在本研究检测的生物标志物中，破裂斑块患者的 MMP-9 水平显著升高。然而，包括 MMP-9 在内的几种生物标志物的测量无法预测 VH-TCFA 的存在。
