scholarly journals The Importance of Age and Statin Therapy in the Interpretation of Lp-PLA2 in ACS Patients, and Relation to CRP

2015 ◽  
pp. 229-245
Author(s):  
J. FRANEKOVÁ ◽  
J. KETTNER ◽  
Z. KUBÍČEK ◽  
A. JABOR
Keyword(s):  
Acute Coronary Syndrome ◽  
Statin Therapy ◽  
Troponin I ◽  
Acute Chest Pain ◽  
Final Diagnosis ◽  
C Reactive Protein ◽  
Plaque Instability ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
History Of

C-reactive protein (CRP) is a marker of arterial inflammation while lipoprotein-associated phospholipase A2 (Lp-PLA2) is related to plaque instability. The aim of this study was to evaluate the correlation between the risk of unstable plaque presenting as acute coronary syndrome (ACS) and Lp-PLA2, and to assess the influence of statins on interpretation of Lp-PLA2. A total of 362 consecutive patients presenting to the emergency department (ED) with acute chest pain suggestive of ACS were evaluated by cardiologists as STEMI, NSTEMI, or unstable angina, and non-ACS. Serum biomarkers measured on admission: troponin I, C-reactive protein (Abbott), and Lp-PLA2 (DiaDexus). Four groups were defined according to the final diagnosis and history of statin medication: ACS/statin−; ACS/statin+; non-ACS/statin−; non-ACS/statin+. Lp-PLA2 was highest in ACS/statin− group; statins decreased Lp-PLA2 both in ACS and non-ACS of about 20 %. Lp-PLA2 was higher in ACS patients in comparison with non-ACS patients group without respect to statin therapy (p<0.001). Lp-PLA2 predicted worse outcome (in terms of acute coronary syndrome) effectively in patients up to 62 years; limited prediction was found in older patients. C-reactive protein (CRP) failed to discriminate four groups of patients. Statin therapy and age should be taken into consideration while interpreting Lp-PLA2 concentrations and lower cut-off values should be used for statin-treated persons.

scholarly journals Correlation of Hemoglobin & C-Reactive Protein Levels with In-hospital Outcome of Patient with Acute Coronary Syndrome

2020 ◽  
Vol 17 (1) ◽  
pp. 3-8
Author(s):  
Md Mahboob Morshed ◽  
Md Joynul Islam ◽  
Fariha Haseen ◽  
Khandokar Shaheed Hussain ◽  
Muhammad Kamrul Amin ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Family History ◽  
C Reactive Protein ◽  
Hospital Outcome ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
History Of ◽  
Study Population

Background: Haemoglobina and CRP level may be related with the in-hospital outcome of acute coronary syndrome patients. Objective: The purpose of the present study was to correlate haemoglobin and CRP level with in-hospital outcome of patient with acute coronary syndrome. Methodology: This cross-sectional study was conducted in the Department of Cardiology at Mymensingh Medical College, Mymensingh, Bangladesh from December 2010 to November 2011 for a period of two (02) years. Patients of ACS who were presented within 12 hours of chest pain were included as study population. Study population were categorized in four groups according to the level of hemoglobin and C-reactive protein. Blood sample was collected for baseline laboratory investigations. Result: The mean age of the population was 52.18±8.88 years. Arrhythmia was more common in Group 1 which was 5(71.4%) cases and 6(46.2%) cases in VT and AF respectively. Arrhythmia was significantly correlated with age, sex, diabetes mellitus & CRP. Death was significantly correlated with age, diabetes mellitus, hypertension & CRP. Heart failure was significantly correlated with family history of IHD, CRP & Hemoglobin. Bleeding was only significantly correlated with CRP. No significant association was revealed between the types of arrhythmia and age, sex, smoking, diabetes, dyslipidaemia, family history of IHD and hypertension (P = 0.087). Only heart failure was strongly and significantly correlated with hemoglobin level (p=0.000). Bleeding (p=0.003), heart failure (p=0.022) and death (p=0.016) were significantly correlated with CRP level. Conclusion: In conclusion there is a correlation of haemoglobin and CRP level with in-hospital outcome of patient with acute coronary syndrome. Journal of Science Foundation 2019;17(1):3-8

scholarly journals Combination of Fibrinogen and High-sensitivity C-reactive Protein Measurements is Potential in Identification of Acute Coronary Syndrome

2015 ◽  
Vol 7 (1) ◽  
pp. 31
Author(s):  
Djanggan Sargowo ◽  
Ferry Sandra
Keyword(s):  
Acute Coronary Syndrome ◽  
Blood Glucose ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Troponin I ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
Hs Crp

BACKGROUND: Acute myocardial infarction (AMI) is one of cardiovascular diseases with high morbidity and mortality rates. Novel biomarkers that can detect accurately acute coronary syndrome (ACS) at early stage, are necessary to improve current strategies and/or to identify subjects who are at risk. Fibrinogen and high-sensitivity C-reactive protein (hs-CRP) roles in inflammation process could be potential for ACS early detection. This study was conducted to evaluate measurements of fibrinogen and hs-CRP on ACS.METHODS: An analytic observational study with cross sectional approach was conducted on patients with Troponin I positive. After signing informed consent, anamnesis and complete blood count were conducted. Besides that, liver function, renal function, and blood glucose tests were conducted as well. Samples of selected subjects were quantified with enzyme-linked immunosorbent assay (ELISA) for Troponin I, fibrinogen and hs-CRP. Then statistical analyses were performed.RESULTS: There were 76 subjects in each ACS and non-ACS groups. ACS group showed significant higher levels of both fibrinogen and hs-CRP compared to Non-ACS group (p=0.000). Among evaluated risk factors, diabetes mellitus (DM) (p=0.003) and hypertension (p=0.000) were significantly higher in ACS group than in non-ACS group. Among evaluated clinical factors, blood glucose (p=0.001) and age (p=0.000) were significantly higher in ACS group than in non-ACS group. Combination of fibrinogen and hs-CRP measurements showed the highest sensitivity (75.00%), specificity (80.26%), accuracy (77.63%), positive predictive value (79.19%) and negative predictive value (76.25%).CONCLUSION: Since fibrinogen and hs-CRP were increased in ACS group and combination of fibrinogen and hs-CRP measurements showed the highest sensitivity, specificity, accuracy, positive predictive value and negative predictive value, we suggest that combination of fibrinogen and hs-CRP measurements could give added value to identify ACS.KEYWORDS: fibrinogen, hs-CRP, biomarker, ACS, acute coronary syndrome, atherosclerosis, inflammation

scholarly journals ACUTE CORONARY SYNDROME;

2017 ◽  
Vol 24 (08) ◽  
pp. 1185-1189
Author(s):  
Abubakar Maqbool ◽  
Naeem Asghar ◽  
Shakeel Ahmad
Keyword(s):  
Acute Coronary Syndrome ◽  
Unstable Angina ◽  
Clinical Presentation ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
Agglutination Method ◽  
History Of ◽  
Male Patients ◽  
The Mean

Introduction: Atherosclerosis is intrinsically an inflammatory disease. Numerousstudies has shown that elevated levels of C-reactive protein (CRP) are associated with increasedcardiovascular risk. The objectives of this study was to determine the correlation of clinicaloutcome in terms of 30 day mortality with various level of C-reactive proteins among patientspresenting with acute coronary syndrome Study Design: Descriptive. Setting: Department ofCardiology, Punjab Institute of Cardiology Lahore. Period: 06 months. Material and Methods:Total 250 patients presented in emergency department and diagnosed as cases of acutecoronary syndrome base on history of chest pain, ECG and cardiac biochemical markers wereincluded in the study. Management of ACS was continued while CRP levels of each patientwere measured by latest Agglutination method. Results: Our study included 250 patients withacute coronary syndrome with a mean age of 52.90±10.34 years. Male patients were 220(88%). Regarding the clinical presentation of patients, 20 (8%) had unstable angina, 95(38%)had NSTEMI and 135 (54%) had STEMI.CRP level were measured, 184(73.6%) patients hadCRP levels < 22mg/L with mortality of 12 (6.5%) at 30 days and 66 (26.4%) patients hadCRP levels >22mg/L with mortality of which 13(19.6%) at 30 days. The mean CRP level was17.9±12.47, 18.08±15.73 and 22.38 + 17.92 for patients with unstable angina, NSTEMI andSTEMI respectively. The stratification of data for effect modifiers showed that 60(24%) patientshad diabetes, 138 (55.2%) patients had hypertension and 65(26%) patients were smokers.Conclusion: Patients having higher CRP levels had higher risk of 30 day mortality.

High and low dose atorvastatin effects on high sensivity C-reactive protein in patient with acute coronary syndrome

2017 ◽  
Vol 21 (4) ◽  
pp. 218-224 ◽  
Author(s):  
Ahmadnoor Abdi ◽  
◽  
Shafei Rahimi ◽  
Hossein Farshidi ◽  
Vahid VahdatKhah ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Low Dose ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Coronary Syndrome

Brain-derived neurotrophic factor is associated with coronary macrophage infiltrates in patients with acute coronary syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R.A Montone ◽  
M Camilli ◽  
M Russo ◽  
M Del Buono ◽  
F Gurguglione ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Neurotrophic Factor ◽  
Serum Levels ◽  
Brain Derived Neurotrophic Factor ◽  
C Reactive Protein ◽  
St Segment Elevation ◽  
Protein Levels ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
St Segment

Abstract Background Brain-derived neurotrophic factor (BDNF) is a neurotrophine that plays a key role in the regulation of both central and peripheral nervous system. Moreover, BDNF is secreted in multiple tissues and exerts systemic, autocrine, and paracrine effects in the cardiovascular system. Of importance, BDNF expression was enhanced in macrophages and smooth muscle cells in atherosclerotic coronary arteries and may be involved in thrombus formation. Thus, BDNF has been suggested as an important link between inflammation and thrombosis, potentially involved in the pathogenesis of acute coronary syndrome (ACS). Purpose In our study we aimed at assessing serum levels of BDNF in patients with ACS, evaluating differences according to clinical presentation [ST-segment elevation myocardial infarction (STEMI) vs. Non-ST-segment elevation ACS (NSTE-ACS)]. Moreover, we assessed the presence of optical coherence (OCT)-defined macrophage infiltrates (MØI) in the culprit vessel of ACS patients and evaluated their relationship with BDNF levels. Methods ACS patients were prospectively selected. Blood samples were collected at admission and serum levels of BDNF were subsequently assessed. Presence of OCT-defined MØI along the culprit vessel was assessed. Results 166 ACS patients were enrolled [mean age 65.3±11.9 years, 125 (75.3%) male, 109 STEMI, 57 NSTE-ACS]. Serum levels of BDNF were higher among STEMI patients compared with NSTE-ACS [median (IQR) 2.48 pg/mL (1.54–3.34) vs. 2.12 pg/mL (1.34–2.47), p=0.007], while C-reactive protein levels did not differ between the two groups. OCT assessment was performed in 53 patients and MØI were detected in 27 patients. Of importance, patients with MØI in the culprit vessel had higher levels of BDNF compared with patients without MØI [median (IQR) 2.23 pg/mL (1.38–2.53) vs. 1.41 pg/mL (0.93–2.07), p=0.023], while C-reactive protein levels did not differ between the two groups. Of note, at multivariate regression analysis BDNF levels were independent predictor of MØI [OR: 2.20; 95% CI (1.02–4.74), p=0.043]. Conclusions Serum levels of BDNF may reliable identify the presence of local macrophage inflammatory infiltrates in patients with ACS. Moreover, BDNF levels are higher in patients with STEMI compared with NSTE-ACS. Taken together, these data suggest that BDNF may represent an interesting link between local inflammatory activation and enhanced thrombosis in ACS. BDNF serum levels Funding Acknowledgement Type of funding source: None

Assessing the Performance of a Novel Point-of-Care Qualitative Assay for Early Diagnosis of Acute Coronary Syndrome

Cardiology ◽  
2020 ◽  
pp. 1-8
Author(s):  
Ronny Alcalai ◽  
Boris Varshisky ◽  
Ahmad Marhig ◽  
David Leibowitz ◽  
Larissa Kogan-Boguslavsky ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Diagnostic Accuracy ◽  
Diagnostic Performance ◽  
Troponin I ◽  
Point Of Care ◽  
Final Diagnosis ◽  
Cardiac Biomarkers ◽  
Fatty Acid Binding ◽  
Coronary Syndrome

<b><i>Background:</i></b> Early and accurate diagnosis of acute coronary syndrome (ACS) is essential for initiating lifesaving interventions. In this article, the diagnostic performance of a novel point-of-care rapid assay (SensAheart<sup>©</sup>) is analyzed. This assay qualitatively determines the presence of 2 cardiac biomarkers troponin I and heart-type fatty acid-binding protein that are present soon after onset of myocardial injury. <b><i>Methods:</i></b> We conducted a prospective observational study of consecutive patients who presented to the emergency department with typical chest pain. Simultaneous high-sensitive cardiac troponin T (hs-cTnT) and SensAheart testing was performed upon hospital admission. Diagnostic accuracy was computed using SensAheart or hs-cTnT levels versus the final diagnosis defined as positive/negative. <b><i>Results:</i></b> Of 225 patients analyzed, a final diagnosis of ACS was established in 138 patients, 87 individuals diagnosed with nonischemic chest pain. In the overall population, as compared to hs-cTnT, the sensitivity of the initial SensAheart assay was significantly higher (80.4 vs. 63.8%, <i>p</i> = 0.002) whereas specificity was lower (78.6 vs. 95.4%, <i>p</i> = 0.036). The overall diagnostic accuracy of SensAheart assay was similar to the hs-cTnT (82.7% compared to 76.0%, <i>p</i> = 0.08). <b><i>Conclusions:</i></b> Upon first medical contact, the novel point-of-care rapid SensAheart assay shows a diagnostic performance similar to hs-cTnT. The combination of 2 cardiac biomarkers in the same kit allows for very early detection of myocardial damage. The SensAheart assay is a reliable and practical tool for ruling-in the diagnosis of ACS.

scholarly journals Serial Analyses of C-Reactive Protein and Myeloperoxidase in Acute Coronary Syndrome

2009 ◽  
Vol 32 (11) ◽  
pp. E58-E62 ◽  
Author(s):  
Flávia K. Borges ◽  
Fernando K. Borges ◽  
Steffan F. Stella ◽  
Juliana F. Souza ◽  
Andréa E. Wendland ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Coronary Syndrome
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