Division of Cardiology, Severance Cardiovascular Hospital & Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2012 May;53(3):508-16. doi: 10.3349/ymj.2012.53.3.508.
We investigated correlations of coronary plaque composition determined by virtual histology (VH) intravascular ultrasound (IVUS) and blood levels of biomarkers that represent the vulnerability of coronary plaques.
Pre- and postprocedural blood levels of high sensitivity C-reactive protein, soluble CD40 ligand (sCD40L), matrix metalloproteinase-9, and neopterin were measured in 70 patients with stable angina (SA) or unstable angina (UA) who were undergoing percutaneous coronary intervention (PCI) for single lesions. We evaluated the data for correlations between these biomarkers and necrotic core contents in PCI target lesions analyzed by VH.
Clinical characteristics, IVUS, VH, and biomarker blood levels were not different between the SA and the UA group except for more frequent previous statin use (52.3% vs. 23.1%, p=0.017) and lower remodeling index in the SA group (0.98±0.09 vs. 1.10±0.070, p<0.001). Among the biomarkers evaluated, only pre-PCI neopterin level showed a weakly significant correlation with the absolute volume of the necrotic core (r=0.320, p=0.008). Pre- and post-PCI blood levels of sCD40L (r=0.220, p=0.072; r=0.231, p=0.062) and post-PCI blood level of neopterin (r=0.238, p=0.051) showed trends toward weakly positive correlations with the absolute volume of necrotic core.
We found a weakly positive correlation between the pre-PCI neopterin level and necrotic core volume in the PCI-target lesion. The clinical implications of our findings need to be investigated in further studies.
我们通过虚拟组织学（VH）血管内超声（IVUS）检测冠状动脉斑块成分，并检测代表斑块易损性的生物标志物的血液水平，以研究两者之间的相关性。
70 例因单支病变而接受经皮冠状动脉介入治疗（PCI）的稳定性心绞痛（SA）或不稳定性心绞痛（UA）患者，在 PCI 术前和术后分别测定高敏 C 反应蛋白、可溶性 CD40 配体（sCD40L）、基质金属蛋白酶-9 和新蝶呤的血液水平。我们评估了这些生物标志物与 VH 分析的 PCI 靶病变中坏死核心含量之间的相关性。
SA 组和 UA 组的临床特征、IVUS、VH 和生物标志物的血液水平无差异，除了 SA 组中他汀类药物的使用率（52.3% vs. 23.1%，p=0.017）和再塑形指数（0.98±0.09 vs. 1.10±0.070，p<0.001）较高外。在所评估的生物标志物中，只有 PCI 前的新蝶呤水平与坏死核心的绝对体积呈弱显著相关性（r=0.320，p=0.008）。PCI 前和 PCI 后的 sCD40L 血液水平（r=0.220，p=0.072；r=0.231，p=0.062）和 PCI 后新蝶呤血液水平（r=0.238，p=0.051）与坏死核心的绝对体积呈弱正相关趋势。
我们发现 PCI 靶病变中 PCI 前新蝶呤水平与坏死核心体积之间存在弱正相关。我们研究结果的临床意义需要在进一步的研究中进行调查。
