Tazaki Ryunosuke, Tanigawa Jun, Fujisaka Tomohiro, Shibata Kensaku, Takeda Yoshihiro, Ishihara Tadashi, Hoshiga Masaaki, Hanafusa Toshiaki, Ishizaka Nobukazu
Department of Cardiology, Osaka Medical College.
Int Heart J. 2016;57(1):18-24. doi: 10.1536/ihj.15-248. Epub 2015 Dec 17.
The role of pentraxin 3 (PTX3) has been implicated in the process of plaque vulnerability. However, few studies have addressed the direct relationship between plaque morphology and plasma PTX3. We evaluated the relationship between coronary vulnerable plaque, assessed by optical coherence tomography (OCT), and plasma PTX3 in patients with coronary artery disease (CAD).OCT was used to determine plaque vulnerability in 51 patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS; n = 17) and stable angina (SA; n = 34). Both highly-sensitive C-reactive protein and systemic plasma PTX3 were measured.Based on the OCT findings, patients were divided into 3 groups; a fibrous plaque (n = 18), thick-cap fibroatheroma (ThCFA) (n = 19), and thin-cap fibroatheroma (TCFA) (n = 14) groups. ThCFA was defined as a lipid-rich plaque (lipid content in ≥ 2 quadrant) covered with ≥ 65 μm thick fibrous cap, and TCFA was that with < 65 μm. There were no differences in patient characteristics between the 3 groups except for the presence of ACS and eicosapentaenoic acid levels. TCFA was more frequently observed with plaque rupture and intraluminal thrombus compared with the other 2 groups. Plasma PTX3 levels were higher in the TCFA group compared with the fibrous plaque and ThCFA groups, and showed weak correlation with cap thickness.Plasma PTX3 level was associated with plaque vulnerability assessed by OCT in patients with CAD.
五聚体蛋白3(PTX3)的作用已被认为与斑块易损性过程有关。然而,很少有研究探讨斑块形态与血浆PTX3之间的直接关系。我们评估了通过光学相干断层扫描(OCT)评估的冠状动脉易损斑块与冠心病(CAD)患者血浆PTX3之间的关系。
OCT用于确定51例非ST段抬高型急性冠状动脉综合征(NSTE - ACS;n = 17)和稳定型心绞痛(SA;n = 34)患者的斑块易损性。同时测量了高敏C反应蛋白和全身血浆PTX3。
根据OCT结果,患者分为3组:纤维斑块组(n = 18)、厚帽纤维粥样斑块(ThCFA)组(n = 19)和薄帽纤维粥样斑块(TCFA)组(n = 14)。ThCFA定义为脂质丰富的斑块(脂质含量在≥2个象限),覆盖有≥65μm厚的纤维帽,而TCFA是指纤维帽厚度<65μm的斑块。除了ACS的存在和二十碳五烯酸水平外,3组患者的特征没有差异。与其他2组相比,TCFA更常伴有斑块破裂和管腔内血栓形成。与纤维斑块组和ThCFA组相比,TCFA组的血浆PTX3水平更高,并且与帽厚度呈弱相关。
CAD患者的血浆PTX3水平与通过OCT评估的斑块易损性相关。