Author + information
- Abdullah Orhan Demirtas,
- Turgut Karabağ,
- Muhammet Rasit Sayin,
- Ibrahim Akpinar,
- Nesimi Yavuz and
- Mustafa Aydin
The extension of coronary artery disease in both stable angına pectoris and acute coronary syndromes is important and also closely associated with prognosis. Estimation of severity of coronary artery disease is important before invasive procedures for selection of therapeutic approach. Ischemia modified albumin (IMA) is relatively new molecule and has been conducted researches on it and it is known to be increased during myocardial ischemia. In our study, we investigated whether IMA and brain natriuretic peptide (BNP) levels would predict the extension of coronary artery disease in patients with low-intermediate risk unstable angina pectoris (USAP).
Sixty-five patients (40 M, 25 F; mean age 59.8±12.1 years) admitted to emergency department who presented with low-intermediate risk USAP (hemodinamically stable, slightly elevated troponin levels) were included to the study. All patients underwent coronary angiography within 60 minutes after admission. The extension of coronary artery disease were calculated with Gensini score index. >50% stenosis was accepted as severe coronary artery stenosis. IMA, troponin, BNP, lipid panel and cell blood count were measured from venous blood collected from antecubital vein taken at the admission. The relation between IMA and laboratory parameters were analysed by Spearman correlation analysis.
Coronary angiography revealed at least one critical stenosis in coronary arteries of fifty-one of 65 patients. Coronary angiography revealed no severe coronary artery stenosis in 14 patients. There was no difference between groups in terms of demographic characteristics (Table 1). Diastolic blood pressure was significantly higher in patients with severe coronary stenosis compared to patients with no severe stenosis (Table 1). Gensini scores were 44±29 in patients with severe coronary artery disease and 2.7±3.4 in patients with no severe coronary artery disease. IMA levels were significantly higher in patients with severe coronary disease compared with no severe coronary artery disease (320±306 vs. 143±127; p=0.02). CRP and BNP levels were significantly higher in patients with severe coronary artery disease compared with no severe disease (14.9±21.6 vs 6.7±7.1; p=0.04; 149±161 vs. 46±36; p=0.001 respectively). Troponin levels were similar between the groups. Correlation analysis revealed weak positive correlation between Gensini score and both IMA and age (r=0.25; p=0.05, r=0.24; p=0.054 respectively). The best correlation was between Gensini score and BNP (r=0.44; p=0.02).
It is important to predict the extension of coronary artery disease in low-intermediate risk USAP both for diagnosis and treatment before coronary angiography. According to the results in our study IMA and BNP may predict the extension of coronary artery disease before performing coronary angiography in the early stage of acute coronary syndromes.
|Patients with severe coronary artery disease||Patients without severe coronary artery disease||p|
|Smoking history (n)||21||4||0.29|
|SBP (mm Hg)||134±19||125±12||0.69|
|DBP (mm Hg)||80±12||68±20||0.04|
Demographic characteristics and laboratory findings of the groups