Gurbuz Ahmet Seyfeddin, Sahin Ahmet Taha, Sarı Hasan, Kesriklioglu Serhat
Department of Cardiology, Necmettin Erbakan University Meram Medicine Faculty.
Department of Cardiology, Beyhekim Training and Research Hospital, Konya.
Acta Cardiol Sin. 2025 Jul;41(4):530-538. doi: 10.6515/ACS.202507_41(4).20250224F.
This research sought to assess the role of calprotectin as a biomarker in patients with pulmonary embolism (PE) and to explore its correlation with established biomarkers such as D-dimer, troponin, and pro brain natriuretic peptide (BNP). In addition, we examined the correlation between calprotectin level and right ventricular (RV) function in patients with PE.
This prospective study was conducted between January 2022 and December 2023 and included 58 patients diagnosed with acute PE and 31 age- and sex-matched controls. Calprotectin level, renal function, hematological parameters, demographic characteristics, and echocardiographic parameters were recorded. For the PE patients, additional data on troponin, D-dimer, high-sensitivity troponin T (hs-troponin T), blood gas analysis, and Pulmonary Embolism Severity Index scores were also collected.
The patients with PE had significantly higher calprotectin, urea, creatinine and leukocyte levels compared to the controls, as well as lower platelet count (p < 0.001). A calprotectin cut-off level of 1.555 mcg/ml could predict PE with 73% sensitivity and 62% specificity in receiver operating characteristic curve analysis. Elevated calprotectin levels were associated with worse RV function, as evidenced by lower tricuspid annular plane systolic excursion and right ventricular systolic myocardial velocity measurements. Correlation analysis revealed that calprotectin levels were inversely related to tricuspid annular plane systolic excursion (r = -0.315, p = 0.016) and RV systolic myocardial velocity (r = -0.290, p = 0.027). While calprotectin was not correlated with D-dimer or hs-troponin T, it had a weak correlation with proBNP (r = 0.271, p = 0.04).
This study emphasizes the potential of calprotectin as a valuable biomarker in PE, providing additional insights into RV dysfunction. Although further research is needed to fully establish its clinical utility, calprotectin, which was weakly correlated with proBNP in this study, could complement existing biomarkers such as proBNP and hs-troponin T in the evaluation and management of PE.
本研究旨在评估钙卫蛋白作为肺栓塞（PE）患者生物标志物的作用，并探讨其与D-二聚体、肌钙蛋白和脑钠肽前体（BNP）等既定生物标志物的相关性。此外，我们还研究了PE患者钙卫蛋白水平与右心室（RV）功能之间的相关性。
本前瞻性研究于2022年1月至2023年12月进行，纳入了58例诊断为急性PE的患者和31例年龄及性别匹配的对照。记录了钙卫蛋白水平、肾功能、血液学参数、人口统计学特征和超声心动图参数。对于PE患者，还收集了有关肌钙蛋白、D-二聚体、高敏肌钙蛋白T（hs-肌钙蛋白T）、血气分析和肺栓塞严重程度指数评分的额外数据。
与对照组相比，PE患者的钙卫蛋白、尿素、肌酐和白细胞水平显著更高，血小板计数更低（p < 0.001）。在受试者工作特征曲线分析中，钙卫蛋白临界值为1.555 mcg/ml时预测PE的灵敏度为73%，特异度为62%。钙卫蛋白水平升高与RV功能较差相关，这通过较低的三尖瓣环平面收缩期位移和右心室收缩期心肌速度测量得以证明。相关性分析显示，钙卫蛋白水平与三尖瓣环平面收缩期位移呈负相关（r = -0.315，p = 0.016），与RV收缩期心肌速度呈负相关（r = -0.290，p = 0.027）。虽然钙卫蛋白与D-二聚体或hs-肌钙蛋白T无相关性，但它与BNP有弱相关性（r = 0.271，p = 0.04）。
本研究强调了钙卫蛋白作为PE中有价值生物标志物的潜力，为RV功能障碍提供了更多见解。尽管需要进一步研究以充分确立其临床应用价值，但本研究中与BNP有弱相关性的钙卫蛋白，在PE的评估和管理中可以补充诸如BNP和hs-肌钙蛋白T等现有生物标志物。
