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The utility of inflammation and platelet biomarkers in patients with acute coronary syndromes
Authors:Joanna Kamińska  Olga M Koper  Edyta Siedlecka-Czykier  Joanna Matowicka-Karna  Jerzy Bychowski  Halina Kemona
Institution:1. Department of Clinical Laboratory Diagnostics, Medical University of Bialystok, Poland;2. Department of Cardiology Intensive Care with the Hemodynamic Unit of the J?drzej ?niadecki Provincial Hospital in Bialystok, Poland
Abstract:

Introduction

Thrombotic and inflammatory mechanisms are involved in the pathophysiology of acute coronary syndrome (ACS). The aim of the study was the evaluation of inflammation (white blood cells count/WBC, C-reactive protein/CRP, interleukin-6/IL-6) and platelet (platelet count/PLT, mean platelet volume/MPV, large platelet/LPLT, beta-thromboglobulin/β-TG) biomarkers in the groups of ACS patients depending on the severity of signs and symptoms and compared to controls without coronary artery disease.

Materials and methods

The study group included 93 patients categorized into 3 subgroups depending on the severity of signs and symptoms of ACS. PLT, MPV, LPLT, and WBC were determined on hematological analyzer, IL-6 and β-TG were measured using the ELISA method.

Results

In the whole group of ACS patients WBC, CRP, IL-6, MPV, and β-TG were significantly higher as compared to controls. Analyzing the inflammation and platelet biomarkers depending on the severity of signs and symptoms in comparison to controls, statistically significant differences for above-mentioned parameters were also found. There were no significant differences between the advancement of coronary artery changes and inflammation as well as platelet parameters, except for CRP concentrations. The AUCs for all inflammation parameters tested were similar, however the highest AUCs showed WBC and CRP. Among platelet parameters the highest AUC revealed β-TG.

Conclusion

Markers of inflammation and platelet activation may be associated to myocardial ischemia and myocardial injury. WBC, CRP and IL-6 as inflammation parameters and MPV and β-TG as platelet biomarkers may be useful indicators of the presence of coronary artery disease.
Keywords:ACS  acute coronary syndrome  ACC  diagnostic accuracy  ALT  alanine transaminase  AST  aspartate transaminase  AUC  area under the ROC curve  BP  blood pressure  CRP  C-reactive protein  cTnI  cardiac troponin I  ECG  echocardiogram  eGFR  estimate glomerular filtration rate  F  female  HCT  hematocrit  HDL  high-density lipoprotein cholesterol  HGB  hemoglobin  interferon gamma  IL-6  interleukin-6  LBBB  Left Bundle Branch Block  LDL  low-density lipoprotein cholesterol  L-PLT  large platelet  M  male  MI  myocardial infarction  MPV  mean platelet volume  NPV  negative predictive value  NS  not statistically significant  NSTEMI  non-ST-segment elevation myocardial infarction  PAF  platelet activating factor  PLT  platelet count  PPV  positive predictive value  RBC  red blood cell count  ROC  Receiver operator characteristic  SE  Standard Error  sP-selectin  soluble form of P-selectin  STEMI  ST-segment elevation myocardial infarction  TCH  total cholesterol  TG  triglycerides  TNF-α  tissue necrosis factor alfa  UA  unstable angina  WBC  white blood cells count  β-TG  β-thromboglobulin  Acute coronary syndrome  Beta-thromboglobulin  Inflammation biomarkers  Activated platelet
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