Acute phase reactants and lipid profile in acute chest pain presentations: a multimarker approach

Authors

  • Anees Syyeda Department of Biochemistry, Deccan College of Medical Sciences, Hyderabad, Telangana
  • Jabeen Fatima Department of Biochemistry, Deccan College of Medical Sciences, Hyderabad, Telangana
  • Abbas M. Hyder Department of Biochemistry, Deccan College of Medical Sciences, Hyderabad, Telangana

DOI:

https://doi.org/10.18203/2320-6012.ijrms20162290

Keywords:

Acute phase reactants, hsCRP, Serum ferritin, Lipid profile, AMI

Abstract

Background: Cardiovascular diseases cause more deaths and disability and incur greater economic cost than any other illness in the world. Our objective is to study the biological activity and evaluate the diagnostic and prognostic values of acute phase reactants, high sensitivity C-reactive protein (hsCRP) and ferritin in association with traditional lipid profile, in screening subjects who developed chest pain due to cardiac event as indicated by a positive cardiac troponin I (cTnI) test.

Methods: In this hospital-based prospective study, a total of 150 cases (n=150), presented consecutively to the emergency department with symptoms of cardiac ischemia and tested positive for troponin I (enzyme-linked flourescent assay), were compared with an equal number of age and gender matched healthy controls (n=150) for hsCRP (immunoturbidimetric assay), ferritin (immunoturbidimetric assay) and lipid profile (enzymatic colorimetric assay).

Results: Median serum hsCRP levels were 2.12 mg/L)±1.79 mg/L) than controls (2.82±significantly elevated in cases (3.57 (p0.05) different between the two groups.

Conclusions: hsCRP and ferritin are independent novel predictors for cardiovascular risks and events. Lipid profile demonstrates low specificity in such cases.

 

References

Nomenclature and criteria for diagnosis of ischemic heart disease. Report of the Joint International Society and Federation of Cardiology/ World Health Organization task force on standardization of clinical nomenclature. Circulation. 1979;59:607-9.

Cummins B, Auckland ML, Cummins P. Cardiac-specific troponin-I radioimmunoassay in the diagnosis of acute myocardial infarction. American Heart Journal 1987;113:1333-44.

Katus HA, Remppis A, Looser S, et al. Enzyme linked immunoassay of cardiac troponin T for the detection of acute myocardial infarction in patients. J Mol Cell Cardiol. 1989;21:149-53.

Panteghini M, Apple FS, Christenson RH. Proposals from IFCC Committee on Standardization of Markers of Cardiac Damage (C-SMDC): recommendations on use of biochemical markers of cardiac damage in acute coronary syndromes. Scand J Clin Lab Inv Suppl. 1999;230:103-12.

Thygesen K, Alpert JS, White HD, Jaffe AS, Apple FS, Galvani M. Universal definition of myocardial infarction. Circulation. 2007;116:2634-53.

Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD. Third universal definition of myocardial infarction. Eur Heart J. 2012;33:2551-67.

Eberly LE, Stamler J, Neaton JD. Relation of triglyceride levels, fasting and non-fasting to fatal and non-fatal coronary heart disease. Archives of Internal Medicine. 2003;163:1077-83.

Kannel WB, Vasan RS. Triglycerides as vascular risk factors: New epidemiologic insights. Current Opinion in Cardiology. 2009;24:345-50.

Tonkin AM, Colquhoun D, Emberson J. Effects of pravastatin in 3260 patients with unstable angina: Results from the LIPID study. Lancet. 2000;356:1871-5.

LaRosa JC, Grundy SM, Waters DD, Shear C, Barter P, Fruchart JC. Intensive lipid-lowering with atorvastatin in patients with stable coronary artery disease. The New England Journal of Medicine. 2005;352:1425-35.

Paoletti R, Gotto AM, Hajjar DP. Inflammation in atherosclerosis and implications for therapy. Circulation. 2004;109(suppl III):20-6.

Devaraj S, Davis B, Simon SI, Jialal I. CRP promotes monocyte-endothelial cell adhesion via Fc gamma receptors in human aortic endothelial cells under static and shear flow conditions. Am J Physiol Heart Circ Physiol. 2006;291(3):H1170-6.

Hage F, Szalai A. C-reactive protein gene polymorphisms, C-reactive protein blood levels, and cardiovascular disease risk. Journal of the J Am Coll Cardiol. 2007;50(12):1115-22.

Oliver MF. Antioxidant nutrients, atherosclerosis and coronary heart disease. Brit Heart J. 1995;73:299-301.

Ming YX, Li W. The iron hypothesis of atherosclerosis and its clinical impact. Annals of Medicine. 2003;35:578-91.

Delphine W, Silvia CR, Biswas S, et al. Ferritin: a potent threat for acute myocardial infarction. J Assoc Physicians (India). 2003;51:947-50.

Knuiman MW, Divitni ML, Olynyk JK. Serum ferritin and cardiovascular disease. A 17 year follow-up study in Busselton, Wertern Australia. Am J Epidemiol. 2003;158:144-9.

Price CP, Trull AK, Berry D, Gorman EG. Development and validation of a particle-enhanced turbidimetric immunoassay for C-reactive protein. J Immunol Methods. 1987;99:205-211.

Eda S, Kaufmann J, Roos W, Pohl S. Development of a new micro particle-enhanced turbidimetric assay for C-reactive protein with superior features in analytical sensitivity and dynamic range. J Clin Lab Anal. 1998;12:137-44.

Dubois S, McGovern M, Ehrhardt V. Eisenstoffwechsel - diagnostik mit Boehringer Manheim/ Hitachi analysensystemen: Ferritin, Transferrin und Eisen. GIT Labor-Medizin. 1988;9:468-71.

Abell LL, Levy BB, Kendall FE. Cholesterol in serum. In:Seligon D (ed). Standard methods of clinical chemistry. Academic Press, New York. 1958;2:26-33.

Recommendations for improving cholesterol measurement: A report from the Laboratory Standardization Panel of the National Cholesterol Education Program. NIH Publication No. 1990;90-2964.

Siedel J, Schmuck R, Staepels J. Long term stable, liquid ready-to-use monoreagent for the enzymatic assay of serum or plasma triglycerides (GPO-PAP method). AACC Meeting Abstract 34. Clin Chem. 1993;39:1127.

Sugiuchi H, Uji Y, Okabe H, Irie T, Uekema K, Kayahara N, Miyauchi K. Direct measurement of high-density lipoprotein cholesterol in serum with Polyethylene Glycol-modified enzymes and -cyclodextrin. Clin Chem. 1995;41:717-23.

Matsuzaki Y, Kawaguchi E, Morita Y. Evaluation of two kinds of reagents for direct determination of HDL-cholesterol. Journal of Analytical Bioscience. 1996;9:419-27.

Bachoric P. Measurement of Low-density-lipoprotein. 245-263. In: Handbook of lipoprotein testing. Rifai, Warnick and Dominiczak, eds. 2nd edition, AACC press 2000.

Nahrendorf M, Pittet MJ, Swirski FK. Monocytes: protagonists of infarct inflammation and repair after myocardial infarction. Circulation. 2010;121:2437-45.

Auer J, Berent R, Lassnig E, Eber B. C-reactive protein and activity of coronary artery disease. Jpn Heart J. 2002;43:607-19.

Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation. 2000;105:1135-43.

Pearson TA, Mensah GA, Myers GL, Rifai N, Tracy RP. AHA/CDC scientific statement on markers of inflammation and cardiovascular disease. Circulation. 2003;107:499-511.

Pasceri V, Willerson JT, Yeh ET. Direct proinflammatory effect of C-reactive protein on endothelial cells. Ciculation. 2000;102:2165-8.

Nissen SE, Tuzcu EM, Schoenhagen P, Crowe T, Sasiela WJ, Tsai J. Statin therapy, LDL cholesterol, C-reactive protein and coronary artery disease. N Engl J Med. 2005;352(1):29-38.

Sullivan JL. Iron and the sex difference on heart disease risk. Lancet. 1981;1:1293-94.

Balci B. The modification of serum lipids after acute coronary syndrome and importance in clinical practice. Current Cardiology Reviews. 2011;7:272-6.

MP Holay, AA Choudhary, SD Suryawanshi. Serum ferritin: a novel risk factor in acute myocardial infarction. Indian Heart J. 2012;6402:173-7.

Biorck G, Blomquist G, Sievers J. Cholesterol values in patients with myocardial infarction and in a normal control group. Acta Medica Scandinavica. 1957;156:493-7.

Correia LC, Twikler MT, Sposito AC. Mechanistic insights and clinical relevance of the interaction between acute coronary syndromes and lipid metabolism. Semin Vasc Med. 2004;4:197-202.

Khan HA, Alhomida AS, Sobki SH. Lipid profile of patients with acute myocardial infarction and its correlation with systemic inflammation. Biomark Insights. 2003;8:1-7.

Al-Mallah M, Hatahet H, Cavalcante J, Khanal S, Khawaja OA. Low admission LDL cholesterol is associated with increased 3-year all-cause mortality in patients with non-ST segment elevation myocardial infarction. Cardiol Journal. 2009;16:227-33.

Nigam PK, Narain VS, Hasan M. Serum lipid profile in patients with acute myocardial infarction. Indian J Clin Biochem. 2004;19:67-70.

Downloads

Published

2017-01-04

How to Cite

Syyeda, A., Fatima, J., & Hyder, A. M. (2017). Acute phase reactants and lipid profile in acute chest pain presentations: a multimarker approach. International Journal of Research in Medical Sciences, 4(8), 3336–3342. https://doi.org/10.18203/2320-6012.ijrms20162290

Issue

Section

Original Research Articles