Department of Cardiology, Tianjin Chest Hospital, Tianjin, China.
Department of Cardiology, Tianjin Chest Hospital, Tianjin, China.
Am J Med Sci. 2021 Jun;361(6):759-764. doi: 10.1016/j.amjms.2020.10.029. Epub 2020 Nov 2.
Identifying a novel biomarker may contribute to detection of vulnerable plaque in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). The aim of this study was to investigate the relationship between serum platelet-derived growth factor (PDGF) and vulnerable plaque in patients with moderate and low risk of NSTE-ACS.
A total of 65 moderate- and low-risk NSTE-ACS patients with 50-90% coronary stenosis were divided into a vulnerable plaque group (n=46) and a stable plaque group (n=19) according to intravascular ultrasound (IVUS) examinations. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and serum PDGF were measured. Plaque characteristics and components were analyzed using gray-scale and iMap-IVUS. Correlation was performed between plaque characteristics and ACS markers. Logistic regression analysis was applied to determine risk factors. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value.
Patients with vulnerable plaque had visible higher levels of TG, LDL-C and PDGF (P < 0.05). There were significant differences in minimal lumen area (MLA), plaque area, plaque burden, fibrotic (FI), clipidic (LI) and necrotic core (NC) between the two groups (P < 0.05). PDGF was weakly correlated with plaque burden (R = 0.428, P < 0.05), as well as moderately correlated with NC (R = 0.669, P < 0.05). Multivariate analysis showed that serum PDGF (OR 4.751, [95% CI 1.534-9.543], P = 0.05) was an independent risk factor of vulnerable plaque. The area under the curve (AUC) was 0.876 (95% CI 0.804-0.948, P=0.001).
Serum PDGF could potentially predict vulnerable plaque in moderate and low risk of NSTE-ACS patients.
识别新的生物标志物可能有助于检测非 ST 段抬高型急性冠状动脉综合征（NSTE-ACS）患者的易损斑块。本研究旨在探讨中等和低危 NSTE-ACS 患者血清血小板衍生生长因子（PDGF）与易损斑块之间的关系。
根据血管内超声（IVUS）检查结果，将 65 例中等和低危 NSTE-ACS 患者（冠状动脉狭窄 50%-90%）分为易损斑块组（n=46）和稳定斑块组（n=19）。测量总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）和血清 PDGF。使用灰阶和 iMap-IVUS 分析斑块特征和成分。分析斑块特征与 ACS 标志物的相关性。应用 Logistic 回归分析确定危险因素。采用受试者工作特征（ROC）曲线评估预测价值。
易损斑块患者的 TG、LDL-C 和 PDGF 水平明显较高（P<0.05）。两组间最小管腔面积（MLA）、斑块面积、斑块负荷、纤维（FI）、脂质（LI）和坏死核心（NC）均有显著差异（P<0.05）。PDGF 与斑块负荷呈弱相关（R=0.428，P<0.05），与 NC 呈中度相关（R=0.669，P<0.05）。多变量分析显示，血清 PDGF（OR 4.751，95%CI 1.534-9.543，P=0.05）是易损斑块的独立危险因素。曲线下面积（AUC）为 0.876（95%CI 0.804-0.948，P=0.001）。
血清 PDGF 可能有助于预测中等和低危 NSTE-ACS 患者的易损斑块。
