Department of Clinical Biochemistry - Student Research Committee - School of Medicine - Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Clinical Biochemistry - Faculty of Medicine - Tabriz University of Medical Sciences, Tabriz, Iran.
Arq Bras Cardiol. 2019 Aug 29;113(4):667-674. doi: 10.5935/abc.20190159. eCollection 2019.
Coronary Artery Disease (CAD) has long been recognized as a global health issue. Inflammation, Fibrinolysis and Oxidative Stress play an important role in the disruption of plaques leading to CAD. Markers that reflect this pathophysiologic mechanism may have prognostic value.
To estimate the serum concentrations of high-sensitivity C-reactive protein (hs-CRP), sialic acid (SA), vitronectin (VN), plasminogen activator inhibitor-1 (PAI-1), oxidized low density lipoprotein (OX-LDL) and malondialdehyde (MDA) with significant prognostic value in patients with CAD.
The markers included, hs-CRP, SA, VN, PAI-1, OX-LDL and MDA, were compared between 160 angiographically diagnosed CAD patients and 20 age- and sex-matched healthy individuals. The subjects were divided into 4 groups according to angiography results, and association between all risk factors of CAD was studied. Serum levels of SA, VN, PAI-1, and OX-LDL were measured by enzyme-linked immunosorbent assay (ELISA); MDA was measured based on reaction with thiobarbituric acid (TBA); and hs-CRP level was estimated by immunoturbidimetry using a commercial kit. The diagnostic value of these variables was further assessed by ROC curve analysis. Multiple logistic regression was used to evaluate the diagnostic power of the combination. Furthermore, p < 0.05 was considered as significant.
Serum levels of hs-CRP, SA, VN, PAI-1, and OX-LDL were significantly higher in patient groups compared to control group (p < 0.001). Using both normal and CAD patients as subjects, ROC analysis was performed. The cutoff for OX-LDL, MDA, PAI-1, VN, hs-CRP and SA was 2.67 (ug/mL), 5.49 (mmol/mL), 67 (ng/mL), 254 (ng/mL), 3.4 (mg/dL), 7/89 (mg/dL), respectively. Eventually, the complete diagnostic efficacy was classified as: SA, hs-CRP, PAI-1, OX-LDL, MDA and VN.
Serum levels SA, hs-CRP, VN, PAI-1, OX-LDL and MDA may be predictive of adverse cardiovascular outcomes. Interestingly, these analyses can help as diagnostic and monitoring markers in CAD patients.
冠心病（CAD）一直是一个全球性的健康问题。炎症、纤维蛋白溶解和氧化应激在斑块破裂导致 CAD 中起着重要作用。反映这种病理生理机制的标志物可能具有预后价值。
评估血清高敏 C 反应蛋白（hs-CRP）、唾液酸（SA）、纤连蛋白（VN）、纤溶酶原激活物抑制剂-1（PAI-1）、氧化型低密度脂蛋白（OX-LDL）和丙二醛（MDA）在 CAD 患者中的血清浓度具有显著的预后价值。
将 160 例经血管造影诊断的 CAD 患者和 20 例年龄和性别匹配的健康个体进行比较，比较 hs-CRP、SA、VN、PAI-1、OX-LDL 和 MDA 等标志物。根据血管造影结果将患者分为 4 组，并研究 CAD 所有危险因素之间的关系。采用酶联免疫吸附试验（ELISA）法测定 SA、VN、PAI-1、OX-LDL 水平；采用硫代巴比妥酸（TBA）法测定 MDA 水平；采用免疫比浊法测定 hs-CRP 水平，试剂盒购自商业公司。通过 ROC 曲线分析进一步评估这些变量的诊断价值。采用多因素逻辑回归评估联合诊断的效能。此外，p<0.05 被认为具有统计学意义。
与对照组相比，患者组的 hs-CRP、SA、VN、PAI-1 和 OX-LDL 血清水平明显升高（p<0.001）。使用正常人和 CAD 患者作为研究对象，进行 ROC 分析。OX-LDL、MDA、PAI-1、VN、hs-CRP 和 SA 的截断值分别为 2.67（μg/ml）、5.49（mmol/ml）、67（ng/ml）、254（ng/ml）、3.4（mg/dl）和 7/89（mg/dl）。最终，完整的诊断效能被分类为：SA、hs-CRP、PAI-1、OX-LDL、MDA 和 VN。
血清 SA、hs-CRP、VN、PAI-1、OX-LDL 和 MDA 水平可能预测不良心血管结局。有趣的是，这些分析可以帮助作为 CAD 患者的诊断和监测标志物。
