Yıldırım Arafat, Kücükosmanoglu Mehmet, Koyunsever Nermin Yildiz, Cekici Yusuf, Dogdus Mustafa, Saracoglu Erhan, Kilic Salih
Department of Cardiology, University of Health Sciences - Adana Health Practice and Research Center, Adana, Turkey.
Department of Cardiology, Uşak University Research and Training Hospital, Uşak, Turkey.
Acta Cardiol. 2021 Sep;76(7):777-784. doi: 10.1080/00015385.2020.1852753. Epub 2020 Dec 7.
The signal peptide-CUB-EGF domain-containing protein-1 (SCUBE1) is a recently available biomarker which is expressed by activated and adhered platelets. In present study, we aimed to investigate the association between SCUBE1 levels and thrombus burden in patients with ST elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PPCI).
A total of 88 patients who were diagnosed with STEMI and underwent PPCI were prospectively included between July 2019 and August 2019. Blood samples were collected for routine biochemistry and serum SCUBE1 levels before PPCI and antiplatelet therapy. Angiographic coronary thrombus burden was classified based on thrombolysis in myocardial infarction (TIMI) thrombus grades. We formed two groups based on the thrombus grade: 37 (42%) patients had high thrombus burden whereas 51 (58%) patients had low thrombus burden.
The mean age of study population was 58.2 ± 11.8 years (34% female). The mean peak troponin I level, SCUBE1 level, SYNTAX score, and pain-to-balloon time were significantly higher in the high thrombus burden group compared to the low thrombus burden group ( < .05, for all). In ROC analysis, SCUBE1 level >65.63 ng/dL had a sensitivity of 91.9% and a specificity of 76.6% to predict high thrombus burden (AUC: 0.9256; < .001). In multivariate analysis, SCUBE1 level (HR: 1.133, = .004) and troponin (HR: 1.002; 95% CI 1.001-1.004, = .003) were independent predictors of high thrombus burden.
In the present study, we showed that SCUBE1, a novel platelet-endothelial adhesion molecule and a marker of platelet activation, is an independent predictor of high thrombus burden in patients with STEMI.
含信号肽-CUB-表皮生长因子结构域蛋白1(SCUBE1)是一种新近可用的生物标志物,由活化和黏附的血小板表达。在本研究中,我们旨在探讨接受直接经皮冠状动脉介入治疗(PPCI)的ST段抬高型心肌梗死(STEMI)患者中SCUBE1水平与血栓负荷之间的关联。
2019年7月至2019年8月前瞻性纳入了88例诊断为STEMI并接受PPCI的患者。在PPCI和抗血小板治疗前采集血样进行常规生化检查及检测血清SCUBE1水平。根据心肌梗死溶栓(TIMI)血栓分级对冠状动脉造影血栓负荷进行分类。我们根据血栓分级形成两组:37例(42%)患者血栓负荷高,而51例(58%)患者血栓负荷低。
研究人群的平均年龄为58.2±11.8岁(34%为女性)。与低血栓负荷组相比,高血栓负荷组的平均肌钙蛋白I峰值水平、SCUBE1水平、SYNTAX评分和疼痛至球囊扩张时间均显著更高(均P<0.05)。在ROC分析中,SCUBE1水平>65.63 ng/dL预测高血栓负荷的灵敏度为91.9%,特异度为76.6%(AUC:0.9256;P<0.001)。在多变量分析中,SCUBE1水平(HR:1.133,P=0.004)和肌钙蛋白(HR:1.002;95%CI 1.001-1.004,P=0.003)是高血栓负荷的独立预测因素。
在本研究中,我们表明SCUBE1,一种新型的血小板-内皮黏附分子及血小板活化标志物,是STEMI患者高血栓负荷的独立预测因素。