Liu Bei, Fu Qiang, Yan Quan-neng, Jin Wen, Tao Dan-ping, Hua Jing-hai, Li Zhi-liang
Department of Cardiology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2010 May;30(5):1015-9.
To assess the value of biochemical marker detection in risk stratification in hospitalized patients with acute coronary syndrome (ACS).
A total of 264 consecutive patients (180 male and 84 female patients) admitted for complaint of chest tightness or/and pain were evaluated for a decision of coronary angiography (CAG) within 24 h after admission. The patients were divided into two groups to receive emergency or elective CAG. The venous blood samples were taken from the patient immediately after admission for detection of amino-terminal pro-brain natriuretic peptide (NT-pro-BNP), high-sensitivity C-reactive protein (hs-CRP), myeloperoxidase (MPO), monocyte chemoattractant protein 1 (MCP-1), intercellular adhesion molecule (sICAM-1), soluble CD40 ligand (sCD40L), matrix metalloproteinase 9 (MMP-9), interleukin-6 (IL-6), interleukin 27 (IL-27) and creatine kinase isoenzyme (CK-MB) were detected.
No significant differences in NT-proBNP, hs-CRP, MPO, sCD40L, and MMP-9 were found between emergency CAG group and elective CAG group (P<0.05). Logistic regression identified significant differences in NT-proBNP, hs-CRP, MPO, IL-27 and CK-MB between the two groups, and a predictive model for risk stratification of ACS was established using these biomarkers. The ROC curves of this predictive model showed an area under the curve of 98.1, suggesting a high predictive value of this model in assessment of the changes or progression of ACS.
Combined detection of the biochemical markers can be helpful for risk stratification of the hospitalized patients with ACS early after admission.
评估生化标志物检测在急性冠状动脉综合征（ACS）住院患者危险分层中的价值。
共纳入264例因胸闷或/和胸痛入院的连续患者（男性180例，女性84例），入院后24小时内评估是否行冠状动脉造影（CAG）。患者分为两组，分别接受急诊或择期CAG。入院后立即采集患者静脉血样本，检测氨基末端脑钠肽前体（NT-pro-BNP）、高敏C反应蛋白（hs-CRP）、髓过氧化物酶（MPO）、单核细胞趋化蛋白1（MCP-1）、细胞间黏附分子（sICAM-1）、可溶性CD40配体（sCD40L）、基质金属蛋白酶9（MMP-9）、白细胞介素-6（IL-6）、白细胞介素-27（IL-27）及肌酸激酶同工酶（CK-MB）。
急诊CAG组与择期CAG组在NT-proBNP、hs-CRP、MPO、sCD40L及MMP-9方面差异无统计学意义（P<0.05）。Logistic回归分析显示两组在NT-proBNP、hs-CRP、MPO、IL-27及CK-MB方面存在显著差异，并利用这些生物标志物建立了ACS危险分层预测模型。该预测模型的ROC曲线下面积为98.1，提示该模型在评估ACS变化或进展方面具有较高预测价值。
联合检测生化标志物有助于ACS住院患者入院早期进行危险分层。
