Atherosclerosis is the most common type of arteriosclerosis.Vulnerable plaque is prone to rupture. Coronary vulnerable plaque rupture can lead to the occurrence of acute coronary syndrome (ACS ).This paper summarizes non-invasive detection and invasive detection of vulnerable plaque,as well as research on serological indexes of vulnerable plaque.It may provide a comprehensive basis for detecting vulnerable plaque.

Objective To investigate the relationship of high sensitivity C reactive protein (hs-CRP), interleukin-6 (IL-6)and soluble IL-6 receptor (sIL-6R)with the severity of clinical symptoms and coronary artery lesions in coronary heart disease (CHD)patients.Methods A total of 522 CHD patients were recruited and divided into three groups:stable angina pectoris (SAP),unstable angina pectoris (UAP)and acute myocardial infarction (AMI)groups.Another 102 healthy individuals served as normal controls (NCs).We calculated Gensini score according to the result of coronary angiography (CAG),collected clinical data and compared the groups. Multiple linear regression analysis was used to investigate the relationship of hs-CRP,IL-6 and sIL-6 R with Gensini score.Results The plasma hs-CRP,IL-6 levels were significantly higher and sIL-6R level was signficantly lower in SAP,UAP and AMI groups than in NC group (P<0 .0 5 ).There was a positive correlation between IL-6 level and Gensini score but a negative correlation between sIL-6 R and Gensini score presented by multiple linear regression analysis (P<0.05 ).Conclusion In CHD patients,plasma hs-CRP,IL-6 and sIL-6R levels are significantly related to the severity of clinical manifestations and coronary artery stenosis.These indicators may help predict the severity of CHD.

Objective To explore the role and relationship of N-terminal pro-brain natriuretic peptide (NT-proBNP) and matrix metalloproteinase-9 (MMP-9 ) in risk stratification and prognosis assessment of non-ST elevation acute coronary syndrome (NSTE-ACS).Methods We recruited 114 patients with NSTE-ACS and classified them into three groups according to the GRACE risk stratification:high-risk,intermediate-risk and low-risk groups.Another 5 8 patients were recruited as controls.Arterial blood was collected before angiography for the measurement of serum NT-proBNP and MMP-9 .Gensini score was used to evaluate the degree of coronary artery stenosis.All the patients were followed up for 6 months and MACE was observed and recorded.Results ① The levels of lg NT-proBNP and MMP-9 significantly differed between the groups (P<0.05).② ROC curve analysis showed that lg NT-proBNP could predict MACE of NSTE-ACS;area under the curve was 0.795,the cutoff value was 2 .0 6 9 ,corresponding to the NT-proBNP value of 1 1 6 .5 6 ng/L.MMP-9 could predict MACE of NSTE-ACS;area under the curve was 0 .6 9 6 ,the cutoff value was 3 2 .4 9 ng/ml;both of the abnormal indexes could predict MACE with the sensitivity of 80.41%,specificity of 82.19%,and Youden’s index of 0.63.③ Cox regression analysis showed that abnormal MMP-9 and NT-proBNP levels were independently related to the incidence of MACE by the value of OR as 3.751.Conclusion MMP-9 and NT-proBNP may be used as serological indicators in risk stratification of NSTE-ACS. The combined use of NT-proBNP and MMP-9 increases the power of predicting MACE.

Objective To investigate the correlation between arachidonate 15-lipoxygenase (ALOX15)gene polymorphism and its genetic predisposition to coronary heart disease (CHD)in Han population of Shaanxi Province so as to provide the basis for early diagnosis and prophylaxis of CHD.Methods The single nucleotide polymorphisms (SNPs)of ALOX15’s rs916055,rs2619112,and rs2664593 were measured by using matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF)method in 105 CHD patients (CHD group)and 75 non-CHD patients (control group)who were matched in age and sex.Results The frequencies of genotypes and alleles of SNPs rs916055A/G in CHD group were significantly different from those in control group (P=0.000 1,P=0.000 1).The frequencies of genotypes and alleles of SNP rs2619112A/G in CHD group did not significantly differ from those in control group (P=0.134 2,P=0.143 8).The frequencies of genotypes of SNP rs2664593C/G in CHD group significantly differed from those in control group (P=0.002 7),but the frequencies of alleles were not significantly different (P=0.537 1).Logistic regression analysis indicated that the A allele of SNP rs916055 was an independent risk factor for CHD.Conclusion SNP rs916055 may be related to CHD and its A allele may be the genetic susceptibility gene for CHD.

Objective To investigate the correlation of endothelial inflammation in patients with acute myocardial infarction (AMI)with no-reflow and severity of coronary lesion.Methods A total of 120 patients with AMI were all treated with percutaneous coronary intervention (PCI).The patients who had intraoperative no-reflow were in case group (n=40).The patients who were also treated by PCI but did not have no-reflow in the same period in our hospital served as the control group (n=80).According to the results of coronary angiography, no-reflow group patients were divided into three subgroups:single lesion group (n=14),two-lesion group (n=10), and three-lesion group (n=1 6 ).We monitored these patients’immediate postoperative endothelial microparticles (EMPs)and soluble intercellular adhesion molecule-1 (sICAM-1 )levels in both groups with flow cytometry and ELISA methods.Results In the case group,immediate postoperative EMPs and sICAM-1 levels in the blood circulation were significantly higher than those in the control group.EMPs area and sICAM-1 area under the curve in the case group were 0.755 and 0.701,which showed that EMPs and sICAM-1 levels had a good correlation with the occurrence of non-reflow in AMI patients after PCI.Gensini score and EMPs level rose with the increase of the lesion counts,and the level of EMPs was positively correlated with Gensini score.Conclusion In patients with AMI,the EMPs and sICAM-1 levels can well predict the occurrence of no-reflow and are of some value in predicting the severity of coronary lesion.

Objective To investigate the relationship of glycated hemoglobin (HbA1c),fibrinogen (Fbg)and cystatin C (Cys C)with the severity of coronary artery lesions in non-diabetic patients.Methods We enrolled 358 patients who received coronary angiography (CAG)in this study.They were divided into coronary artery disease (CAD)group and non-CAD group according to CAG results.Moreover,according to different clinical types of CAD,all the CAD patients were further classified into stable angina pectoris (SAP)group and acute coronary syndrome (ACS)group.We calculated Gensini score and divided CAD group into A,B and C subgroups by Gensini score.HbA1 c,Fbg,Cys C and other clinical data were measured and compared between groups,and the correlation analysis was used to find the relationship of HbA1c,Fbg and Cys C with Gensini score.Results The levels of HbA1 c,Fbg and Cys C were significantly higher in groups A,B and C than in non-CAD group.When Gensini score increased,the three indexes were increased too (P<0.05).The levels of HbA1c,Fbg and Cys C were significantly higher in ACS group than in SAP and non-CAD group (P<0.05).After adjustment for the influencing factors, HbA1 c was still associated with Fbg (P<0 .0 5 ).The levels of HbA1 c and Fbg were closely related to Gensini score (P<0.05).Conclusion In non-diabetes patients,HbA1c and Fbg are significantly related to the severity of coronary artery stenosis,and Cys C may not be an independent risk factor of coronary artery stenosis.

Objective To investigate the clinical significance of soluble CD40 ligand (sCD40L ) and lipoprotein associated phospholipase A2 (Lp-PLA2 ) in the assessment of coronary artery severity and risk classification in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS).Methods Of the 9 6 patients with coronary heart disease diagnosed by coronary angiography,2 8 patients had stable angina pectoris (SAP),38 patients unstable angina pectoris (UAP)and 30 patients acute non-ST-segment elevation myocardial infarction (NSTEMI).Another 30 patients with non-coronary heart disease (NC)served as controls.The sCD40L and Lp-PLA2 levels were determined by enzyme-linked immune sorbent assay (ELISA)method.The Gensini score was used to assess the severity of coronary artery and analyze the correlation with sCD40L and Lp-PLA2.The correlation of sCD40L and Lp-PLA2 with GRACE risk score was analyzed too.Results ① sCD40L was significantly higher in NSTEMI and UAP groups than in SAP and NC groups (P<0 .0 5 ),but there was no significant difference between NSTEMI and UAP groups (P>0 .0 5 )or SAP and NC groups (P>0 .0 5 ).Lp-PLA2 was significantly higher in NSTEMI group than in UAP,SAP and NC groups (P<0.05).Lp-PLA2 was significantly higher in UAP group than in SAP and NC groups (P<0.05).② We found that sCD40L had obvious correlation with Lp-PLA2 (r=0.284, P<0.01),Gensini score (r=0.213,P<0.05),and GRACE (r=0.224,P<0.05).Lp-PLA2 was significantly correlated with Gensini score (r=0.270,P<0.05),and GRACE (r=0.323,P<0.01).③ Multivariate logistic regression analysis showed that Lp-PLA2 was independently associated with NSTE-ACS (P<0.05).Conclusion The sCD40L and Lp-PLA2 which were significantly elevated in NSTE-ACS are correlated with the severity of coronary artery disease.The two indexes indicate the instability of atherosclerotic plaque;thus they can be used as predictors of risk assessment in coronary heart disease.

Objective To study the relationship of the plasma levels of miRNA-491-5p in Han population in Shaanxi Province and the changes of single nucleotide polymorphisms (SNP ) of the target gene matrix metalloproteinases-9 (MMP-9 ) of miRNA-4 9 1-5 p (has-miR-4 9 1-5 p ) with the incidence risk and prognosis of premature coronary artery disease (pCAD)through the case-control design.Methods In this study,we made a consecutive recruitment of 270 pCAD cases in the case group and 300 cases in the control group.Using the polymorphism method of polymerase chain reaction and restriction fragment length (PCR-RFLP),target gene MMP-9 of has-miR-491-5p and rs1056628 genotypes was detected to compare the association between the variant genotypes and pCAD.Results In the changes of rs1056628C-A polymorphisms,compared with that of CC genotypes (the incidence was 42%),the risks of having coronary heart disease in the individuals carrying CA and AA genotypes were 31%,the difference was statistically significant (P=0.045).The risks of developing coronary heart disease in the individuals carrying CA and AA genotypes were reduced more significantly in the population with low total cholesterol (TC),and low low-density lipoprotein cholesterol (LDL-C).Conclusion Target gene MMP-9 of has-miRNA-491-5p rs1056628C-A polymorphism is associated with the reduced incidence risk of pCAD,and carrying C alleles is an independent risk factor for pCAD.

Objective To detect the levels of CD31+/CD42b- and CD144+ endothelial microparticles (EMPs)in plasma,and analyze the relationship with carotid intima-media thickness (CIMT)and the risk factors of atherosclerosis.Methods Totally 122 outpatients and inpatients in our hospital were selected,and carotid artery ultrasound examination was performed.The results were divided into a thickening group (62 cases)and a control group (60 cases).Flow cytometry was used to detect the levels of CD31+/CD42b- and CD144+ EMPs in the blood to analyze the relationship between the level of endothelial cells and CIMT,and to investigate the relationship between the level of plasma EMPs and the risk factors of atherosclerosis.Results Compared with the control group,the levels of EMPs of CD31+/CD42b- and CD144+ were significantly higher.In the correlation analysis, plasma CD31+/CD42b- and CD144+EMPs levels were positively correlated with CIMT;in multi-factor Logistic regression analysis,CD31+/CD42b- EMPs levels were correlated positively with age,TC and Cys C;plasma CD144+ EMPs levels were correlated with UA and BMI.Conclusion The levels of CD31+/CD42b-,CD144+EMPs in plasma were correlated with CIMT,guiding early prevention of cardiovascular diseases.

Objective To investigate the expression of serum angiopoietin-2 (Ang-2 ) and its clinical significance in patients with chronic heart failure (CHF).Methods The levels of serum Ang-2,N-terminal pro-B-type natriuretic peptide (NT-proBNP)and left ventricular ejection fraction (LVEF)were detected in 1 1 3 patients with CHF,who were divided into four groups according to New York Heart Association (NYHA:class Ⅰ,n=3 2;Ⅱ,n=30;Ⅲ,n=26;Ⅳ,n=25).Another 20 healthy volunteers for physical check-up were chosen as the control group.Results With the change of cardiac function (from Ⅰ to Ⅳ),the levels of plasma Ang-2 and NT-proBNP were increased significantly (P<0.05 ).The level of serum Ang-2 was positively correlated with NT-proBNP (r=0.774,P<0.001),but negatively correlated with left ventricular ejection fraction (r=-0.725,P<0.001).Conclusion The level of serum Ang-2 has a significant correlation with the severity of heart failure.Ang-2 is expected to be used to predict and evaluate the severity of CHF.