Relation of coronary vulnerable plaque instability to serum levels of C-reactive protein and B-type natriuretic peptide in ACS.

Objective To explore the relationship between coronary vulnerable plaque instability and serum C-reactive protein(CRP) , B-type natriuretic peptide(BNP) levels in 85 patients with coronary heart disease. Methods Eighty-five patients( aged 63±16,M= 52 ) were divided into two groups.The control group was 28 patients with stable angina pectoris (SAP). The study group was 57 patients with acute coronary syndrome (ACS) .which were further divided into 21 patients with non ST elevated myocardial infarction (NSTEMI) and 36 patients with unstable angina pectoris (UAP). Plasma BNP and CRP were measured as well as coronary angiography made for all 85 patients. Plaques of coronary culprit arteries were classified as I -III three types according to Ambrose classification. Results (1). BNP and CRP levels of NSTEMI and UAP groups were significant higher than in SAP group. (2).The levels of BNP and CRP correlated with Ambrose classification, especially positively with Ambrose II type ,but no relation with coronary narosis. (3). The levels of BNP was much higher in patients of left anterior descending or multiple coronary artery diseases .(4). The Plaques of coronary culprit arteries in high risk of NSTEMI and UAP patients were mostly Ambrose II or III type. Conclusions The prevalence of higher levels of plasma BNP and CRP in patients with ACS ,when compared with those of SAP, was associated with the instability of coronary vulnerable plaques (ie, Ambrose II type). The level of BNP was much higher in patients of left anterior descending or multiple complicated coronary diseases. So, BNP and CRP are not only markers of vulnerable plaques, but also indicators of ACS prognosis.