Objective: To elucidate the relationship between serum inflammatory factors and intravascular ultrasound (IVUS) findings of atherosclerotic plaques in patients with stable and unstable angina.
Methods: Thirteen patients with stable angina (SA) in group A and nineteen patients with unstable angina (UA) in group B underwent study. Concentrations of hsCRP, sVCAM-1 and sICAM-1 were measured by means of Enzyme-Linked-Immunosorbent Assay (ELISA) and IVUS was used to analysis the coronary lesions. Their results were analyzed by correlate analysis.
Results: Concentration of hsCRP, sVCAM-1 and sICAM-1 were significantly higher in group B (4.7 mg/L +/- 2.6 mg/L, 789 micro g/L +/- 65 micro g/L and 365 micro g/L +/- 63 micro g/L) than in group A (2.4 mg/L +/- 1.8 mg/L, 544 micro g/L +/- 70 micro g/L and 264 micro g/L +/- 53 micro g/L, P < 0.01, respectively). IVUS found that 69.2% (18/26) patients in group B had soft lipid plaques, while patients in group A mainly had fibrous and mixed plaques, only 13.3% (2/15) had soft plaques. There were more eccentric plaques and EEMA in group B than in group A (P < 0.05, respectively), and PA and lumen area stenosis ratio (LAS) in group B were larger than those of group A (P < 0.01, respectively). Positive remodeling pattern was observed in 65.4% (17/26) lesions in group B while 66.6% (10/15) lesions in group A showed negative remodeling. sICAM-1 correlated well with RI (r = 0.475, P < 0.05) and C-RP with EEMA (r = 0.448, P < 0.05).
Conclusion: High levels of hsCRP, sVCAM-1 and sICAM-1 are sensitive predictors of unstable angina. The features of unstable atherosclerotic plaques are eccentric, soft plaques, with large plaque areas. The vessel at the lesion shows positive remodeling. Inflammatory reaction correlated well with vascular enlargement and remodeling.