Sakamoto Nobuo, Hoshino Yasuto, Misaka Tomofumi, Mizukami Hiroyuki, Suzuki Satoshi, Sugimoto Koichi, Yamaki Takayoshi, Kunii Hiroyuki, Nakazato Kazuhiko, Suzuki Hitoshi, Saitoh Shu-ichi, Takeishi Yasuchika
Department of Cardiology and Hematology, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan,
Heart Vessels. 2014 Mar;29(2):165-70. doi: 10.1007/s00380-013-0341-2. Epub 2013 Mar 27.
Tenascin-C, a large oligometric glycoprotein of the extracellular matrix, increases the expression of matrix metalloproteinases that lead to plaque instability and rupture, resulting in acute coronary syndrome (ACS). We hypothesized that a high serum tenascin-C level is associated with plaque rupture in patients with ACS. Fifty-two consecutive ACS patients who underwent emergency percutaneous coronary intervention (PCI) and, as a control, 66 consecutive patients with stable angina pectoris (SAP) were enrolled in this study. Blood samples were obtained from the ascending aorta just prior to the PCI procedures. After coronary guide-wire crossing, intravascular ultrasonography (IVUS) was performed for assessment of plaque characterization. Based on the IVUS findings, ACS patients were assigned to two groups according to whether there was ruptured plaque (ruptured ACS group) or not (nonruptured ACS group). There were 23 patients in the ruptured group and 29 patients in the nonruptured group. Clinical characteristics and IVUS measurements did not differ between the two groups. Tenascin-C levels were significantly higher in the ruptured ACS group than in the SAP group, whereas there was no significant difference between the nonruptured ACS and SAP groups. Importantly, in the ruptured ACS group, tenascin-C levels were significantly higher than in the nonruptured ACS group (71.9 ± 34.9 vs 50.5 ± 20.5 ng/ml, P < 0.005). Our data demonstrate that tenascin-C level is associated with pathologic conditions in ACS, especially the presence of ruptured plaque.
腱生蛋白-C是一种细胞外基质中的大型寡聚糖蛋白，它会增加基质金属蛋白酶的表达，而基质金属蛋白酶会导致斑块不稳定和破裂，进而引发急性冠状动脉综合征（ACS）。我们推测，ACS患者血清腱生蛋白-C水平升高与斑块破裂有关。本研究纳入了52例连续接受急诊经皮冠状动脉介入治疗（PCI）的ACS患者，作为对照，还纳入了66例连续的稳定型心绞痛（SAP）患者。在PCI手术即将开始前，从升主动脉采集血样。冠状动脉导丝穿过病变部位后，进行血管内超声检查（IVUS）以评估斑块特征。根据IVUS检查结果，ACS患者根据是否存在破裂斑块分为两组（破裂ACS组）或不存在破裂斑块（未破裂ACS组）。破裂组有23例患者，未破裂组有29例患者。两组患者的临床特征和IVUS测量结果无差异。破裂ACS组的腱生蛋白-C水平显著高于SAP组，而未破裂ACS组和SAP组之间无显著差异。重要的是，在破裂ACS组中，腱生蛋白-C水平显著高于未破裂ACS组（71.9±34.9对50.5±20.5 ng/ml，P<0.005）。我们的数据表明，腱生蛋白-C水平与ACS的病理状况有关，尤其是破裂斑块的存在。
