Medizinische Klinik III, Kardiologie und Kreislauferkrankungen, Eberhard-Karls-Universität Tübingen, Germany.
Medizinische Klinik III, Kardiologie und Kreislauferkrankungen, Eberhard-Karls-Universität Tübingen, Germany.
Int J Cardiol. 2011 Jun 2;149(2):164-168. doi: 10.1016/j.ijcard.2009.12.026. Epub 2010 Jan 13.
The purpose of the study was to test whether an elevated surface expression of platelet collagen receptor glycoprotein VI (GPVI) is an appropriate marker for the diagnosis of the acute coronary syndrome (ACS), especially when the electrocardiogram (ECG) is ambiguous.
Between 2007 to 2008, we consecutively evaluated 378 patients with ACS and ambiguous ECG on hospital admission. In all patients, GPVI surface expression was determined by flow cytometry. In addition, the myocardial necrosis markers troponin-I (Tn-I) and creatine kinase-MB (CKMB) were measured.
We found that in patients with ACS and unclear ECG in whom GPVI levels (mean fluorescence intensity (MFI) ≥ 18.6) were elevated, the relative risk for ACS was 2.6-fold enhanced. Binary logistic regression analysis revealed that an elevated platelet GPVI level is indicating an ACS independent of biomarkers of myocardial necrosis including Tn-I, creatine kinase (CK), CKMB (GPVI: p=0.011; Tn-I: p=0.180; CKMB: p=0.250; CK: p=0.127). Patients with evident T-wave inversion and/or ST-depression showed a strong association between ACS and GPVI expression.
Platelet GPVI surface expression is enhanced in patients with ACS with unclear ECG findings and is strongly associated with myocardial ischemia. Additional to the classical markers of myocardial necrosis Tn-I and CK, GPVI is an early biomarker for the diagnosis of ACS, especially when the ECG is ambiguous.
本研究旨在检验血小板胶原受体糖蛋白 VI（GPVI）表面表达升高是否是急性冠状动脉综合征（ACS）的合适标志物，尤其是当心电图（ECG）不明确时。
在 2007 年至 2008 年间，我们连续评估了 378 例入院时心电图不明确的 ACS 患者。所有患者均通过流式细胞术测定 GPVI 表面表达。此外，还测定了心肌坏死标志物肌钙蛋白 I（Tn-I）和肌酸激酶-MB（CKMB）。
我们发现，在心电图不明确且 GPVI 水平升高（平均荧光强度（MFI）≥18.6）的 ACS 患者中，ACS 的相对风险增加了 2.6 倍。二元逻辑回归分析表明，血小板 GPVI 水平升高可独立于包括 Tn-I、肌酸激酶（CK）、CKMB 在内的心肌坏死标志物提示 ACS（GPVI：p=0.011；Tn-I：p=0.180；CKMB：p=0.250；CK：p=0.127）。存在明显 T 波倒置和/或 ST 段压低的患者，ACS 与 GPVI 表达之间存在强烈关联。
心电图不明确的 ACS 患者的血小板 GPVI 表面表达增强，与心肌缺血密切相关。除了 Tn-I 和 CK 等经典心肌坏死标志物外，GPVI 也是 ACS 的早期诊断标志物，尤其是当心电图不明确时。
