Sonmez Ertan, Turkdogan Kenan Ahmet, Karabacak Mustafa, Civelek Cemil, Yilmaz Cahit, Ozer Omer Faruk, Çavuş Umut Yücel
Bezmialem Vakıf University, Department of Emergency Medicine, İstanbul, Turkey.
Isparta State Hospital, Department of Emergency Medicine, Isparta, Turkey.
Am J Emerg Med. 2015 Jan;33(1):21-4. doi: 10.1016/j.ajem.2014.09.047. Epub 2014 Oct 5.
Chest pain and/or electrocardiogram changes in non-ST elevation or suspicious chest pain and cardiac marker elevations are defined as non-ST-elevation acute coronary syndrome (NSTE-ACS). Serial electrocardiogram and marker follow-up are needed to make a diagnosis of NSTE-ACS and to eliminate noncoronary chest pain (NCCP). Signal peptide-C1r/C1s, Uegf, and Bmp1-epidermal growth factor domain-containing protein 1 (SCUBE1) is stored within the α granules of inactive platelets and secreted at a high rate during thrombosis. We believe that SCUBE1 may be a sensitive early diagnostic indicator in distinguishing coronary-induced chest pain from noncoronary-induced chest pain.
The study included 190 patients with an initial diagnosis of acute coronary syndrome in the emergency department. Based on a definitive diagnosis, these patients were classified into 3 groups: ST-elevation myocardial infarction (STEMI), NSTE-ACS, and NCCP.
Plasma SCUBE1 levels were significantly higher in the STEMI group when compared with those of the other groups (P < .05). They were also significantly higher in the NSTE-ACS group when compared with those of the NCCP group (P < .01). Troponin I, creatinine kinase, and creatinine kinase MB levels were significantly different in the NSTE-ACS group when compared with those of the NCCP group (P < .05).
High rates of SCUBE1 were found both in the STEMI and NSTE-ACS patients. Furthermore, in the study group, SCUBE1 was an adequate marker for distinguishing NSTE-ACS from NCCP.
非ST段抬高型胸痛和/或心电图改变、可疑胸痛以及心脏标志物升高被定义为非ST段抬高型急性冠状动脉综合征(NSTE-ACS)。需要进行系列心电图和标志物随访以诊断NSTE-ACS并排除非冠状动脉性胸痛(NCCP)。信号肽C1r/C1s、Uegf和含Bmp1表皮生长因子结构域蛋白1(SCUBE1)储存在静息血小板的α颗粒中,并在血栓形成时大量分泌。我们认为,SCUBE1可能是区分冠状动脉性胸痛与非冠状动脉性胸痛的敏感早期诊断指标。
该研究纳入了190例在急诊科初步诊断为急性冠状动脉综合征的患者。根据明确诊断,这些患者被分为3组:ST段抬高型心肌梗死(STEMI)、NSTE-ACS和NCCP。
与其他组相比,STEMI组的血浆SCUBE1水平显著更高(P <.05)。与NCCP组相比,NSTE-ACS组的血浆SCUBE1水平也显著更高(P <.01)。与NCCP组相比,NSTE-ACS组的肌钙蛋白I、肌酸激酶和肌酸激酶同工酶水平有显著差异(P <.05)。
STEMI和NSTE-ACS患者的SCUBE1水平均较高。此外,在研究组中,SCUBE1是区分NSTE-ACS与NCCP的合适标志物。