Yilmaz Ahmet Seyda, Uslu Abdulkadir, Kara Faruk, Kahraman Fatih, Cirakoglu Omer Faruk
Department of Cardiology, Recep Tayyip Erdogan University Faculty of Medicine, Rize, Turkiye.
Department of Cardiology, Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, Istanbul, Turkiye.
North Clin Istanb. 2023 Feb 13;10(1):17-23. doi: 10.14744/nci.2021.12499. eCollection 2023.
Acute coronary syndrome (ACS) is one of the leading causes of mortality, globally. Atherosclerosis is an underlying factor in ACS process and coagulative cascade is activated secondary to atherosclerotic plaque rupture. Fibrinopeptide A (FPA) takes an active role in thrombus formation and is an indicator of coagulative process. We aimed to evaluate serum FPA level in patients with ACS.
Patients diagnosed with ACS and chronic coronary syndrome (CCS), with non-obstructive coronary artery disease as a control group, were included in the study. Blood samples and demographic data of all patients were obtained at admission. Obtained data were compared between ACS and control groups.
The study consisted of 107 patients with ACS and 69 patients with CCS. ACS group was older (p<0.001) with male preponderance (p<0.001), more likely to had hypertension (p<0.001), and had a higher smoking rate (p<0.001). Serum FPA level was highest in the ST elevated myocardial infarction group (p<0.001). FPA>3.38 ng/mL predicted ACS with 89.7% sensitivity and 78% specificity (AUC: 0.825, 95% CI 0.745-0.905; p<0.001).
Serum FPA may be used for the differential diagnosis of ACS. In addition, patients with increased FPA may be considered to be given more aggressive antithrombotic medication.
急性冠状动脉综合征（ACS）是全球主要的死亡原因之一。动脉粥样硬化是ACS发病过程中的一个潜在因素，凝血级联反应继发于动脉粥样硬化斑块破裂而被激活。纤维蛋白肽A（FPA）在血栓形成中起积极作用，是凝血过程的一个指标。我们旨在评估ACS患者的血清FPA水平。
本研究纳入了诊断为ACS和慢性冠状动脉综合征（CCS）的患者，并将非阻塞性冠状动脉疾病患者作为对照组。所有患者在入院时采集血样和人口统计学数据。对ACS组和对照组获得的数据进行比较。
该研究包括107例ACS患者和69例CCS患者。ACS组年龄更大（p<0.001），男性占优势（p<0.001），更易患高血压（p<0.001），吸烟率更高（p<0.001）。ST段抬高型心肌梗死组的血清FPA水平最高（p<0.001）。FPA>3.38 ng/mL预测ACS的敏感性为89.7%，特异性为78%（AUC：0.825，95%CI 0.745 - 0.905；p<0.001）。
血清FPA可用于ACS的鉴别诊断。此外，FPA升高的患者可能需要考虑给予更积极的抗栓药物治疗。
