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非ST段抬高型急性冠状动脉综合征患者生化标志物与冠状动脉造影的相关性

[Correlation between biochemical markers and coronary angiography in patients with non-ST elevation acute coronary syndromes].

作者信息

Magalhães Cynthia Karla, Siqueira Filho Aristarco Gonçalves de, Amino José Geraldo de Castro, Nolasco Mônica

机构信息

Cardiobarra Clínicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ.

出版信息

Arq Bras Cardiol. 2006 Mar;86(3):223-31. doi: 10.1590/s0066-782x2006000300011. Epub 2006 Mar 30.

Abstract

OBJECTIVE

Investigate the correlation between biochemical markers (TNI, CRP and fibrinogen) and anatomical coronary angiographic findings in patients with non-ST elevation acute coronary syndromes (NSTE-ACS).

METHODS

One blood sample was obtained to test for markers, and coronary angiography was performed within the first 72 hours after hospitalization. Univariate analysis was used to search for correlations between the 3 markers and the angiographic findings in the group of patients with an identified ischemia-related artery (IRA), and multivariate analysis was performed to investigate the correlation between these markers and the presence of unstable atherosclerotic lesions solely in the group with a coronary obstruction > 50%.

RESULTS

Prospective study conducted with 84 patients, 65.5% of whom were men. In the IRA-identified group, blood levels of the three markers were higher than in the groups with no IRA-identified or with normal coronary arteries. The analysis used to evaluate the IRA-identified group showed significant correlations between TIMI flow and TN-I (p = 0.006), unstable atherosclerotic lesions and TN-I and fibrinogen (p = 0.02 and p = 0.01, respectively), and multivessel disease and CRP (p = 0.0005). The multivariate analysis showed that CRP, fibrinogen and TN-I were independent predictors of unstable atherosclerotic lesions (p = 0.002; p = 0.003 and p = 0.007, respectively).

CONCLUSION

In NSTE-ACS patients, TN-I, CRP and fibrinogen blood levels within the first 10 hours after hospitalization correlated with coronary angiographic findings.

摘要

目的

研究非ST段抬高型急性冠状动脉综合征(NSTE-ACS)患者生化标志物(肌钙蛋白I、C反应蛋白和纤维蛋白原)与冠状动脉造影解剖学结果之间的相关性。

方法

采集一份血样检测标志物,并在住院后72小时内进行冠状动脉造影。单因素分析用于寻找已识别出缺血相关动脉(IRA)的患者组中3种标志物与造影结果之间的相关性,多因素分析仅在冠状动脉阻塞>50%的患者组中进行,以研究这些标志物与不稳定动脉粥样硬化病变存在之间的相关性。

结果

对84例患者进行前瞻性研究,其中65.5%为男性。在已识别出IRA的组中,三种标志物的血水平高于未识别出IRA或冠状动脉正常的组。用于评估已识别出IRA的组的分析显示,TIMI血流与肌钙蛋白I之间存在显著相关性(p = 0.006),不稳定动脉粥样硬化病变与肌钙蛋白I和纤维蛋白原之间存在显著相关性(分别为p = 0.02和p = 0.01),以及多支血管病变与C反应蛋白之间存在显著相关性(p = 0.0005)。多因素分析表明,C反应蛋白、纤维蛋白原和肌钙蛋白I是不稳定动脉粥样硬化病变的独立预测因子(分别为p = 0.002;p = 0.003和p = 0.007)。

结论

在NSTE-ACS患者中,住院后10小时内的肌钙蛋白I、C反应蛋白和纤维蛋白原血水平与冠状动脉造影结果相关。

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