Relationship among soluble CD105, hypersensitive C-reactive protein and coronary plaque morphology: an intravascular ultrasound study.
BACKGROUND
Rupture of unstable plaque with subsequent thrombus formation is the common pathophysiological substrate of acute coronary syndrome (ACS). It is of potential significance to explore the blood indexes predicting plaque characteristics. We investigated the relationship among soluble CD105, hypersensitive C-reactive protein (hs-CRP), and coronary plaque morphology.


METHODS
A clinical study from April 2004 to December 2006 was conducted in 130 patients who were divided into 3 groups: 56 patients (43.1%) in stable angina (SA) group, 52 patients (40.0%) in unstable angina (UA) group and 22 patients (16.9%) in acute myocardial infarction group. The concentrations of soluble CD105 and hs-CRP were measured in all of the patients by cardioangiography (CAG). Plasma samples of arterial blood were collected prior to the procedure. The levels of soluble CD105 and hs-CRP were measured by enzyme-linked immunosorbent assay (ELISA).


RESULTS
Unstable and ruptured plaque was found more frequently in patients with acute myocardial infarction and UA. External elastic membrane cross-sectional area (EEM CSA), plaque area, lipid pool area and plaque burden were significantly larger in the ruptured and unstable plaque group. Positive remodeling, thinner fabric-cap, smaller minimal lumen cross-sectional area (MLA), dissection and thrombus were significantly more frequent in the ruptured and unstable plaque group. Remodeling index (RI) was positively correlated with the levels of soluble CD105 in the UA group (r = 0.628, P < 0.01) and the acute myocardial infarction group (r = 0.639, P < 0.01). The levels of soluble CD105 and hs-CRP were higher in the ruptured plaque group. Soluble CD105 > 4.3 ng/ml was used to predict ruptured plaque with a receiver operating characteristic (ROC) curve area of 0.77 (95% confidence interval (CI), 66.8% - 87.2%), a sensitivity of 72.8%, a specificity of 78.0% and an accuracy of 70.2% (P < 0.01), similarly for hs-CRP > 5.0 mg/ml with a ROC curve area of 0.70 (95% CI, 59.2% - 80.2%), a sensitivity of 70.2%, a specificity of 76.2% and an accuracy of 67.2% (P < 0.01).


CONCLUSIONS
The plaque characteristics correlate with the clinical presentation. The elevation of soluble CD105 and hs-CRP is related to the plaque instability and rupture.
Cui
Song
S
Department of Cardiology, Anzhen Hospital Affiliated to Capital Medical University, Beijing 100029, China.
Lü
Shu-zheng
SZ
Chen
Yun-dai
YD
He
Guo-xiang
GX
Meng
Li-jun
LJ
Liu
Jian-ping
JP
Song
Zhi-yuan
ZY
Liu
Xian-liang
XL
Song
Xian-tao
XT
Ge
Chang-jiang
CJ
Liu
Hong
H
D000368:Aged; D000787:Angina Pectoris / Q000097:blood / Q000473:pathology; D015703:Antigens, CD / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis*; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology*; D000071063:Endoglin; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000473:pathology; D011956:Receptors, Cell Surface / Q000097:blood*; D018084:Ultrasonography, Interventional / Q000379:methods*
D015703:Antigens, CD; C064206:ENG protein, human; D000071063:Endoglin; D011956:Receptors, Cell Surface; D002097:C-Reactive Protein