Yıl: 2017 Cilt: 16 Sayı: 1 Sayfa Aralığı: 12 - 18 Metin Dili: İngilizce İndeks Tarihi: 29-07-2022

Diagnostic and Prognostic Significance of Neutrophil Gelatinase- Associated Lipocalin and Pentraxin-3 in Acute Coronary Syndrome

Öz:
Aim: The aim was to evaluate the levels of serum pentraxin-3 (PTX-3) and neutrophil gelatinase-associated lipocalin (NGAL) and the efficiency of making a diagnosis and to estimate the prognosis in patients with chest pain.Materials and Methods: The study was conducted in the Necmettin Erbakan University Meram Medicine School Emergency Department. Patients who had chest pain and met the inclusion criteria were accepted. They were divided into the following groups: acute coronary syndrome (ACS), a diagnosis other than ACS (non-ACS), and control. The patients in theACS and non-ACS groups were divided into five sub-group -groups: ST Elevated Myocardial Infarction (STEMI) Non- ST Elevated Myocardial Infarction (NSTEMI), Unstable Angina Pectoris (USAP), stable angina, and pulmonary embolus. For all patients, serum PTX-3, serum NGAL, troponin I, and creatine kinase-MB fraction (CK-MB) levels were measured.Results: There were 199 patients in the ACS and non-ACS groups and 30 patientsin the control group. There was no significant difference among the study groups in terms of age and PTX-3 and NGAL levels. When comparing survival and non-survival in terms of in-hospital death, CK-MB and troponin I levels were significantly higher in the ACS and non-ACS groups than in the control groups, whereas there was no significant difference in terms of PTX-3 and NGAL levels.Conclusion: The results of our study demonstrated that PTX-3 and NGAL are not effective biomarkers in the differential diagnosis and the determination of in-hospital mortality in ACS. However, the limitations of the study should be considered. The results confirmed that CK-MB and Troponin I can be safely used in the differential diagnosis and the prediction of mortality.
Anahtar Kelime:

Konular: Acil Tıp
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • Solinas L, Raucci R, Terrazzino S, Moscariello F, Pertoldi F, Vajto S, et al. Prevalence, clinical characteristics, resource utilization and outcome of patients with acute chest pain in the emergency department. A multi- center, prospective, observational study in north-eastern Italy. Ital Heart J 2003; 4: 318-24.
  • Task Force for Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes of European Society of Cardiology, Bassand JP, Hamm CW, Ardissino D, Boersma E, Budaj A, Fernández-Avilés F, et al. Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes. Eur Heart J 2007; 28: 1598-660. [CrossRef]
  • Pope JH, Aufderheide TP, Ruthazer R, Woolard RH, Feldman JA, Beshan- sky JR, et al. Missed diagnoses of acute cardiac ischemia in the emergen- cy department. N Engl J Med 2000; 342: 1163-70. [CrossRef]
  • Khan NA, Hemmelgarn BR, Tonelli M, Thompson CR, Levin A. Prognostic value of troponin T and I among asymptomatic patients with end stage renal disease: a meta-analysis. Circulation 2005; 112: 3088-96. [CrossRef]
  • Vasile VC, Babuin L, Rio Perez JA, Alegria JR, Song LM, Chai HS, et al. Long term prognostic significance of elevated cardiac troponin levels in criti- cally ill patients with acute gastrointestinal bleeding. Crit Care Med 2009; 37: 140-7. [CrossRef]
  • Vasile VC, Chai HS, Khambatta S, Afessa B, Jaffe AS. Significance of elevat- ed cardiac troponin T levels in critically ill patients with acute respiratory disease. Am J Med 2010; 123: 1049-58. [CrossRef]
  • Batal O, Jentzer J, Balaney B, Kolia N, Hickey G, Dardari Z, et al. The prog- nostic significance of troponin I elevation in acute ischemic stroke. J Crit Care 2016; 31: 41-7. [CrossRef]
  • Zhang L, Wang Z, Qi S. Cardiac troponin elevation and outcome after subarachnoid hemorrhage: a systematic review and meta-analysis. J Stroke Cerebrovasc Dis 2015; 24: 2375-84. [CrossRef]
  • Freitas C, Larrivée B, Eichmann A. Netrins and UNC5 receptors in angio- genesis. Angiogenesis 2008; 11: 23-9. [CrossRef]
  • Walz A, Baggiolini M. Generation of the neutrophil-activating peptide NAP-2 from platelet basic protein or connective tissue-activating peptide III through monocyte proteases. J Exp Med 1990; 171: 449 54. [CrossRef]
  • Peri G, Introna M, Corradi D, Iacuitti G, Signorini S, Avanzini F, et al. PTX3, a prototypic long pentraxin, is an early indicator of acute myocardial in- farction in humans. Circulation 2000; 102: 636-41. [CrossRef]
  • Eagan TM, Damås JK, Ueland T, Voll-Aanerud M, Mollnes TE, Hardie JA, et al. Neutrophil gelatinase-associated lipocalin: a biomarker in COPD. Chest 2010; 138: 888-95. [CrossRef]
  • Nielsen BS, Borregaard N, Bundgaard JR, Timshel S, Sehested M, Kjeld- sen L. Induction of NGAL synthesis in epithelial cells of human colorec- tal neoplasia and inflammatory bowel diseases. Gut 1996; 38: 414-20. [CrossRef]
  • Flo TH, Smith KD, Sato S, Rodriguez DJ, Holmes MA, Strong RK, et al. Li- pocalin 2 mediates an innate immune response to bacterial infection by sequestrating iron. Nature 2004; 432: 917-21. [CrossRef]
  • Xu S, Venge P. Lipocalins as biochemical markers of disease. Biochim Bio- phys Acta 2000; 1482: 298-307. [CrossRef]
  • Bolignano D, Coppolino G, Lacquaniti A, Buemi M. From kidney to car- diovascular diseases: NGAL as a biomarker beyond the confines of ne- phrology. Eur J Clin Invest 2010; 40: 273-6. [CrossRef]
  • Hamm C, Heeschen C, Falk E, Fox KAA. Acute coronary syndromes: pathophysiology, diagnosis and risk stratification. In: Camm AJ, Luescher TF, Serruys PW, ed. The ESC Textbook of Cardiovascular Medicine. Oxford: UK, Blackwell Publishing; 2006. p333-66.
  • Ariza-Solé A, Formiga F, Lorente V, Sánchez-Salado JC, Sánchez-Elvira G, Roura G, et al. Efficacy of bleeding risk scores in elderly patients with acute coronary syndromes. Rev Esp Cardiol (Engl Ed). 2014; 67: 463-70. [CrossRef]
  • Leurent G, Garlantézec R, Auffret V, Hacot JP, Coudert I, Filippi E, et al. Gender differences in presentation, management and in hospital out come in patients with ST-segment elevation myocardial infarction: Data from 5000 patients included in the ORBI prospective French regional registry. Arch Cardiovasc Dis 2014; 107: 291-8. [CrossRef]
  • Salama M, Çakmak H A, Coşansu K, İkitimur B, Karadağ B, Enar RAkut koroner sendromlarda standart risk skorlamalarıyla birlikte gelişte- ki NT-proBNP düzeyinin 6 aylık mortalite ve morbiditeye etkileri. Turk Kardiyol Dern Ars 2010; Suppl 2: 136.
  • Gay PC, Nishimura RA, Roth CS, Evans WE, Zinsmeister AR, Kottke BA. Lipoprotein analysis in the evaluation of chest pain in the emergency department. Mayo Clin Proc 1991; 66: 885-91. [CrossRef]
  • Bugiardini R. Risk stratification in acute coronary syndrome: focus on unstable angina non-ST segment elevation myocardial infarction. Heart 2004; 90: 729-31. [CrossRef]
  • El-Menyar A, Zubaid M, Shehab A, Bulbanat B, Albustani N, Alenezi F, et al. Prevalence and impact of cardiovascular risk factors among patients presenting with acute coronary syndrome in the Middle East. Clin Cardi- ol 2011; 34: 51-8. [CrossRef]
  • Stähli BE, Yonekawa K, Altwegg LA, Wyss C, Hof D, Fischbacher P, et al. Clinical criteria replenish high-sensitive troponin and inflammatory markers in the stratification of patients with suspected acute coronary syndrome. PLos One 2014; 3: 9: e98626.
  • Hasdai D, Topol EJ, Kilaru R, Battler A, Harrington RA, Vahanian A, et al. Frequency, patient characteristics, and outcomes of mild-to-moderate heart failure complicating ST-segment elevation acute myocardial in- farction: lessons from 4 international fibrinolytic therapy trials. Am Heart J 2003; 145: 73-9. [CrossRef]
  • Aragam KG, Tamhane UU, Kline-Rogers E, Li J, Fox KA, Goodman SG, et al. Does simplicity compromise accuracy in acs risk prediction? A retrospec- tive analysis of the TIMI and GRACE risk scores. PLoS One 2009; 4: e7947. [CrossRef]
  • Wiviott SD, Morrow DA, Giugliano RP, Frederick CH, McCabe CP, Cannon EM, et al. Performance of the thrombolysis in myocardial infarction risk index for early acute coronary syndrome in the National Registry of Myo- cardial Infarction: a simple risk index predicts mortality in both ST and non-ST elevation myocardial infarction. J Am Coll Cardiol 2003; 41: 365-6. [CrossRef]
  • Lusis AJ. Atherosclerosis. Nature 2000; 407: 233-41. [CrossRef]
  • Matsui S, Ishii J, Kitagawa F, Kuno A, Hattori K, Ishikawa M, et al. Pentraxin 3 in unstable angina and non-ST-segment elevation myocardial infarc- tion. Atherosclerosis 2010; 210: 220-5. [CrossRef]
  • Ustundag M, Orak M, Güloğlu C, Sayhan M B, Alyan O, Kale E. Compar- ative diagnostic accuracy of serum levels of neutrophil activating pep- tide-2 and pentraxin-3 versus troponin-I in acute coronary syndrome. Anadolu Kardiyol Derg 2011; 11: 588-94. [CrossRef]
  • Büyükkaya E, Karakaş MF, Kurt M, Motor S, Akçay AB, Büyükkaya S, et al. The serum pentraxin-3 is elevated in patients with cardiac syndrome X. Turk Kardiyol Dern Ars 2013; 41: 290-5. [CrossRef]
  • Latini R, Maggioni AP, Peri G, Gonzini L, Lucci D, Mocarelli P, et al. Prog- nostic significance of the long pentraxin PTX3 in acute myocardial infarc- tion. Circulation 2004: 110: 2349-54. [CrossRef]
  • Suzuki S, Takeishi Y, Niizeki T, Koyama Y, Kitahara T, Sasaki T, et al. Pentrax- in 3, a new marker for vascular inflammation, predicts adverse clinical outcomes in patients with heart failure. Am Heart J 2008; 155: 75-81. [CrossRef]
  • Elneihoum AM, Falke P, Hedblad B, Lindgärde F, Ohlsson K. Leukocyte activation in atherosclerosis: correlation with risk factors. Atherosclerosis 1997; 131: 79-84. [CrossRef]
  • Zografos T, Haliassos A, Korovesis S, Giazitzoglou E, Voridis E, Katritsis D. Association of neutrophil gelatinase-associated lipocalin with the sever- ity of coronary artery disease. Am J Cardiol 2009; 104: 917-20. [CrossRef]
  • Soylu K, Aksan G, Nar G, Özdemir M, Gülel O, İnci S, et al. Serum neu- trophil gelatinase-associated lipocalin levels are correlated with the complexity and severity of atherosclerosis in acute coronary syndrome. Anatol J Cardiol 2015; 15: 450-5. [CrossRef]
  • Choi KM, Lee JS, Kim EJ, Baik SH, Seo HS, Choi DS, et al. Implication of lipocalin-2 and visfatin levels in patients with coronary heart disease. Eur J Endocrinol 2008; 158: 203-7. [CrossRef]
  • Sahinarslan A, Kocaman SA, Bas D, Akyel A, Ercin U, Zengin O, et al. Plas- ma neutrophil gelatinase-associated lipocalin levels in acute myocardial infarction and stable coronary artery disease. Coron Artery Dis 2011; 22: 333-8. [CrossRef]
  • Braunwald E, Antman EM, Beasley JW, Califf RM, Cheitlin MD, Hochman JS, et al. ACC/AHA 2002 guideline update for the management of pa- tients withunstable angina and non-ST segment elevation myocardial infarction-summary article: a report of the American College of Cardiol- ogy/American Heart Association task force on practice guidelines (Com- mittee on the Management of Patients With Unstable Angina). J Am Coll Cardiol 2002; 40: 1366-74. [CrossRef]
  • Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD, et al. Third universal definition of myocardial infarction. Eur Heart J. 2012; 33: 2551-67. [CrossRef]
APA ÖZER M, ergin m, Ibrahim K, DÜNDAR Z, ÖZER N, ÖNAL M, GİRİŞGİN A, Kocak S, GÜL M, Cander B (2017). Diagnostic and Prognostic Significance of Neutrophil Gelatinase- Associated Lipocalin and Pentraxin-3 in Acute Coronary Syndrome. , 12 - 18.
Chicago ÖZER MUHAMMET RAŞİT,ergin mehmet,Ibrahim Kılınc,DÜNDAR ZERRİN DEFNE,ÖZER Nejla,ÖNAL Mehmet Akif,GİRİŞGİN ABDULLAH SADIK,Kocak Sedat,GÜL MEHMET,Cander Başar Diagnostic and Prognostic Significance of Neutrophil Gelatinase- Associated Lipocalin and Pentraxin-3 in Acute Coronary Syndrome. (2017): 12 - 18.
MLA ÖZER MUHAMMET RAŞİT,ergin mehmet,Ibrahim Kılınc,DÜNDAR ZERRİN DEFNE,ÖZER Nejla,ÖNAL Mehmet Akif,GİRİŞGİN ABDULLAH SADIK,Kocak Sedat,GÜL MEHMET,Cander Başar Diagnostic and Prognostic Significance of Neutrophil Gelatinase- Associated Lipocalin and Pentraxin-3 in Acute Coronary Syndrome. , 2017, ss.12 - 18.
AMA ÖZER M,ergin m,Ibrahim K,DÜNDAR Z,ÖZER N,ÖNAL M,GİRİŞGİN A,Kocak S,GÜL M,Cander B Diagnostic and Prognostic Significance of Neutrophil Gelatinase- Associated Lipocalin and Pentraxin-3 in Acute Coronary Syndrome. . 2017; 12 - 18.
Vancouver ÖZER M,ergin m,Ibrahim K,DÜNDAR Z,ÖZER N,ÖNAL M,GİRİŞGİN A,Kocak S,GÜL M,Cander B Diagnostic and Prognostic Significance of Neutrophil Gelatinase- Associated Lipocalin and Pentraxin-3 in Acute Coronary Syndrome. . 2017; 12 - 18.
IEEE ÖZER M,ergin m,Ibrahim K,DÜNDAR Z,ÖZER N,ÖNAL M,GİRİŞGİN A,Kocak S,GÜL M,Cander B "Diagnostic and Prognostic Significance of Neutrophil Gelatinase- Associated Lipocalin and Pentraxin-3 in Acute Coronary Syndrome." , ss.12 - 18, 2017.
ISNAD ÖZER, MUHAMMET RAŞİT vd. "Diagnostic and Prognostic Significance of Neutrophil Gelatinase- Associated Lipocalin and Pentraxin-3 in Acute Coronary Syndrome". (2017), 12-18.
APA ÖZER M, ergin m, Ibrahim K, DÜNDAR Z, ÖZER N, ÖNAL M, GİRİŞGİN A, Kocak S, GÜL M, Cander B (2017). Diagnostic and Prognostic Significance of Neutrophil Gelatinase- Associated Lipocalin and Pentraxin-3 in Acute Coronary Syndrome. Eurasian Journal of Emergency Medicine, 16(1), 12 - 18.
Chicago ÖZER MUHAMMET RAŞİT,ergin mehmet,Ibrahim Kılınc,DÜNDAR ZERRİN DEFNE,ÖZER Nejla,ÖNAL Mehmet Akif,GİRİŞGİN ABDULLAH SADIK,Kocak Sedat,GÜL MEHMET,Cander Başar Diagnostic and Prognostic Significance of Neutrophil Gelatinase- Associated Lipocalin and Pentraxin-3 in Acute Coronary Syndrome. Eurasian Journal of Emergency Medicine 16, no.1 (2017): 12 - 18.
MLA ÖZER MUHAMMET RAŞİT,ergin mehmet,Ibrahim Kılınc,DÜNDAR ZERRİN DEFNE,ÖZER Nejla,ÖNAL Mehmet Akif,GİRİŞGİN ABDULLAH SADIK,Kocak Sedat,GÜL MEHMET,Cander Başar Diagnostic and Prognostic Significance of Neutrophil Gelatinase- Associated Lipocalin and Pentraxin-3 in Acute Coronary Syndrome. Eurasian Journal of Emergency Medicine, vol.16, no.1, 2017, ss.12 - 18.
AMA ÖZER M,ergin m,Ibrahim K,DÜNDAR Z,ÖZER N,ÖNAL M,GİRİŞGİN A,Kocak S,GÜL M,Cander B Diagnostic and Prognostic Significance of Neutrophil Gelatinase- Associated Lipocalin and Pentraxin-3 in Acute Coronary Syndrome. Eurasian Journal of Emergency Medicine. 2017; 16(1): 12 - 18.
Vancouver ÖZER M,ergin m,Ibrahim K,DÜNDAR Z,ÖZER N,ÖNAL M,GİRİŞGİN A,Kocak S,GÜL M,Cander B Diagnostic and Prognostic Significance of Neutrophil Gelatinase- Associated Lipocalin and Pentraxin-3 in Acute Coronary Syndrome. Eurasian Journal of Emergency Medicine. 2017; 16(1): 12 - 18.
IEEE ÖZER M,ergin m,Ibrahim K,DÜNDAR Z,ÖZER N,ÖNAL M,GİRİŞGİN A,Kocak S,GÜL M,Cander B "Diagnostic and Prognostic Significance of Neutrophil Gelatinase- Associated Lipocalin and Pentraxin-3 in Acute Coronary Syndrome." Eurasian Journal of Emergency Medicine, 16, ss.12 - 18, 2017.
ISNAD ÖZER, MUHAMMET RAŞİT vd. "Diagnostic and Prognostic Significance of Neutrophil Gelatinase- Associated Lipocalin and Pentraxin-3 in Acute Coronary Syndrome". Eurasian Journal of Emergency Medicine 16/1 (2017), 12-18.