Biomarkers of inflammation and matrix remodeling in patients with acute coronary syndrome and vulnerable plaque

Aim. To evaluate the relationship between markers of inflammation and matrix remodeling and criteria for a vulnerable plaque according to multislice computed tomography (MSCT) coronary angiography, as well as lipid profile parameters in patients with acute coronary syndrome (ACS).

Material and methods. This prospective single-center study included 125 patients admitted urgently with ACS. All patients underwent percutaneous coronary intervention of the infarct-related artery. In ad­dition, in all patients, there were plaques in one or two non-infarct-related arteries with stenosis <50%. ACS was treated according to clinical guidelines, including statin therapy at the maximum dosage. After 1 month, all patients underwent MSCT coronary angiography to detect vulnerable plaques, as well as assessment of the lipid profile, and following biomarkers of inflammation and matrix remodeling: metalloproteinase-9 with its inhibitor type 1 (MMP-9 and TIMP-1), galectin-3 (Gal-3), neutrophil gelatinase-associated lipocalin (NGAL).

Results. Of the 125 patients, myocardial infarction (MI) was diagnosed in 94 people (75%). Criteria for the plaque vulnerability according to MSCT were identified in 55 (44%) patients, of which positive remodeling was detected in 35 patients, a low-density area (LDA) in 30, and punctate calcifications (PCs) in 11. Gal-3 concentration was significantly higher without LDA — 35,4 (8,6; 65,0) ng/ml, in comparison with the group of patients in whom this criterion was detected and was 16,1 (5,9; 27,4) ng/ml (p=0,006). In the absence of PCs, the Gal-3 concentration was >34,0 (8,6; 61,0) vs 5,9 (2,8; 25,4) ng/ml in the group with PCs (p=0,046). The regression model including the MMP-9, TIMP-1, NGAL, Gal-3 in identifying vulnerable plaques was found to be significant (p<0,001).

Conclusion. Criteria for vulnerable plaque in patients after ACS have a significant relationship with markers of inflammation and matrix remo­deling.

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