The relationship between serum sTNFR-1,sTNFR-2 and coronary vulnerable plaque instability and acute myocardial infarction
Jiao Wenping
Gao Lin
Li Weicheng
Zhou Liyuan
Liang Sen
Bian Nina
Wang Qiufeng
Abstract：Objective To explore the association between serum soluble tumor necrosis factor receptor-1(sTNFR-1),serum soluble tumor necrosis factor receptor-1(sTNFR-2)and coronary artery vulnerable plaque instability and acute myocardial infarction(AMI).Methods A total of 120 patients with positive vulnerable plaque admitted to Xianyang First People's Hospital from May 2021 to May 2024 were selected as the case group,and they were divided into AMI sub-group(n=44)and non-AMI subgroup(n=76)according to the occurrence of AMI,80 healthy subjects were selected as the healthy control group.The levels of serum sTNFR-1,sTNFR-2,high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α)were detected by enzyme-linked immunosorbent assay,the level of cardiac troponin Ⅰ(cTnⅠ)was detected by fluorescence immunochromatography,the thickness of plaque fibrous cap was examined by coronary angiogra-phy.Pearson product moment correlation analysis was used to analyze the correlation between serum sTNFR-1,sTNFR-2 and hs-CRP,TNF-α,cTnⅠ,plaque fibrous cap thickness;Logistic regression analysis was used to analyze the relationship between serum sTNFR-1,sTNFR-2 and AMI,the receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum sTNFR-1 and sTNFR-2 for AMI.Results The levels of sTNFR-1,sTNFR-2,hs-CRP,TNF-α and cTnⅠ in the case group were higher than those in the control group(t/P=26.083/＜0.001,23.779/＜0.001,31.925/＜0.001,29.491/＜0.001,29.473/＜0.001);Serum sTNFR-1 and sTNFR-2 were positively correlated with hs-CRP,TNF-α and cTnⅠ(sTNFR-1:r/P=0.681/＜0.001,0.634/＜0.001,0.707/＜0.001;sTNFR-2:r/P=0.672/＜0.001,0.619/＜0.001,0.673/＜0.001),and negatively correlated with the thickness of plaque fibrous cap(r/P=-0.723/＜0.001,-0.706/＜0.001);With a history ofhy-pertension,elevated serum hs-CRP,TNF-α,cTnⅠ,sTNFR-1 and sTNFR-2 were independent risk factors for AMI[OR(95％CI)=1.464(1.139-1.881),1.660(1.037-2.658),1.483(1.174-1.872),1.516(1.236-1.859),1.598(1.217-2.099),1.496(1.225-2.827)],increased fibrous cap thickness was a protective factor for AMI[OR(95％CI)=0.583(0.412-0.828)];the AUC of serum sTNFR-1,sTNFR-2 and the combination of the two in predicting AMI were 0.797,0.765 and 0.893,respectively.The com-bined predictive value of the two was greater than that of the single index(Z/P=1.771/0.012,2.261/0.002).Conclusion The up-regulation of serum sTNFR-1 and sTNFR-2 expression mediates the process of coronary vulnerable plaque rupture.Early detection of the two indicators can assist clinical evaluation of coronary vulnerable plaque instability,thus predicting the risk of AMI.
Keywords：Acute myocardial infarctionSoluble tumor necrosis factor receptor-1Soluble tumor necrosis factor re-ceptor-2Coronary artery vulnerable plaqueInstability
Publication Date：2025-03-18
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 274-279 )