Objective To investigate implication of combination detection MCP-1 and RANTES chemotactic factors in patients with ACS compare to the traditional detection of hs-CRP. And to investigate the significance of the combined detection of a variety of chemokines in early identification, risk stratification, prognosis of ACS.
Methods The 300 patients were divided into Coronary Heart Disease (CHD) group (n=240) and control group (n=60) according to the Coronary Angiography (CAG), and CHD group were divided into acute coronary syndrome (ACS) group (n=180) and stable angina pectoris (SAP) group (n=60). The severity and extent of coronary lesions was analysed by CAG and typified by means of Gensini coronary score system. Linked immunosorent assay was used to measure the concentration of MCP-1, RANTES and hs-CRP. At the same time venous blood samples were collected and total cholesterol (TC) triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and red blood cells, white blood cells, platelets count, fibrinogen, and liver and kidney function were detected by automatic biochemical analyser determination.
Results Significantly increasing of MCP-1, RANTES, hs-CRP concentration, blood glucose, LDL-C levels were observed in ACS group compared to the SAP group and the control group (p <0.05). And significantly decreasing of HDL-C concentration in ACS group were observed compared to the SAP group and control group. The accuracy of ACS prediction by combination detection MCP-1 and RANTES according to logistic regression equation is much better than the traditional detection of hs-CRP (90.6% vs 82.8%).
Conclusions Combined with clinical assessment of the actual occurrence of cardiovascular disease using a variety of risk factors, we believe that coronary heart disease and acute coronary syndrome is a complex network systems regulated by multi-element, multi-factor, looking for a single factor as markers for diagnosis of coronary heart disease ACS may be limited. Combined detection of a variety of cytokines which involved in the occurrence of coronary heart disease, and through comprehensive analysis of a number of cytokines to predict cardiac events may more accurately reflect the nature of acute coronary syndrome. MCP-1, RANTES chemokine play a more specific role in monocytes /macrophages, they play a key role in the development and rupture of vulnerable plaque in coronary heart disease, especially in ACS. The effect of combination detection chemotactic factors to predict ACS is better compare to general hs-CRP measurement, multi-chemotactic factors' combination detection maybe come to markers of early identification of ACS.