Clinical impact of NGAL and MMP-9 level according to plaque morphological characteristics assessed by OCT in Acute Coronary Syndrome patients

다국어 초록 (Multilingual Abstract)

Background. Neutrophil gelatinase associated-lipocalin (NGAL) and matrix metalloproteinase-9 (MMP-9) are expressed by macrophage cells in atherosclerotic plaques of the human carotid artery and show elevated levels in patients with acute coronary syndrome (ACS). The aims of the present study were to evaluate morphologic characteristics of the plaques in ACS patients and to correlate morphologic findings with the serum levels of NGAL and MMP-9.
Methods. Current study enrolled 38 patients with ACS, 8 with ST-segment elevation myocardial infarction (STEMI), 11 with non-STEMI (NSTEMI), and 19 with unstable angina (UA). After completion of diagnostic coronary angiography we performed intracoronary optical coherence tomography (OCT). Serum levels of NGAL and MMP-9 were measured in all participants.
Results. Based on OCT findings, the 38 patients enrolled in this study were divided into those with plaque rupture (n=22) and those without plaque rupture (n=16). Serum levels of MMP-9 for patients with plaque rupture were significantly higher than those of patients without plaque rupture (3.75±1.88 ng/mL and 1.72±1.18 ng/mL, p=0.028). Similarly, mean serum level of NGAL among patients with plaque rupture was 2.77±1.39 ng/mL compared to 1.73±0.44 ng/mL for patients without plaque rupture (p=0.045). Receiver operator characteristic analysis showed that the area under the curve was 0.714 for hs-CRP (p=0.305), 0.857 for MMP-9 (p=0.087), and 0.905 for NGAL (p=0.050).
Conclusion. Elevated serum levels of NGAL, MMP-9, and hs-CRP were related to the presence of ruptured coronary plaque. Moreover, NGAL can predict the presence of plaque rupture with excellent accuracy.

목차 (Table of Contents)

• CONTENTS
• CONTENTS
• LIST OF FIGURE AND TABLES
• ?. INTRODUCTION…………………………………………1
• 1. Background of Acute Coronary Syndrome ………1
• 2. Plaque rupture in ACS patients ……………...……4
• 3. Neutrophil gelatinase associated lipocalin ...…… 6
• 4. Matrix Metalloproteinase-9 role in plaque rupture…………………………………………………. 9
• 5. Plaque characterization by OCT imaging …..… 11
• ??. MATERIALS AND METHODS………………………12
• ???. RESULTS………………………………………………20
• IV. DISSCUSSION…………………………………………35
• V. LIMITATIONS……………………………………………38
• VII.REFERENCE ………………………………………..39
• VIII. ABSTRACT ON KOREAN ...………………………. 56
• IX. ACKNOWLEDGEMENTS …………………………… 58