[Inflammation markers and risk stratification in patients with acute coronary syndromes: design of the SIESTA Study (Systemic Inflammation Evaluation in Patients with non-ST segment elevation Acute coronary syndromes)].
OBJECTIVE
Evidence is growing regarding the prognostic value of markers of inflammation in unstable angina/non-ST segment elevation myocardial infarction (UA/NSTEMI). However, the independent value of these variables has not been systematically investigated in prospective studies. The main objective of the SIESTA study is to assess the relative prognostic roles of C-reactive protein, fibrinogen, neopterin, interleukins 6, 8, 10 and 18, tumor necrosis factor, e-selectin, endothelin 1, tissue factor, VCAM-1, ICAM-1, pregnancy-associated plasma protein-A, B-type natriuretic peptide, leukocytes, troponin I or T and serum creatine kinase-MB (CKMB) in UA/NSTEMI patients.


METHODS
SIESTA is a prospective, multicenter trial involving patients with chest pain suggestive of acute coronary syndrome (ACS) within 48 hours of enrolment and at least one of the following: abnormal troponin levels, electrocardiographic signs of ischaemia or previously documented vascular disease. Clinical outcome data and serial biochemical determinations will be assessed during hospital admission and at 30, 180 and 365 days of follow-up. The TIMI (Thrombolysis In Myocardial Infarction) and PEPA (Proyecto de Estudio del Pronóstico de la Angina) risk scores will be also validated. Study variables will include death due to any cause, cardiac death, non-fatal myocardial infarction, unstable angina requiring re-admission, emergency revascularization and a composite of death, myocardial infarction and need for emergency hospitalization or myocardial revascularization. Each of these conditions will be treated as secondary end-points when assessed individually. This study will provide valuable prospective information about the prognostic value of inflammatory markers in real life ACS patients of Mediterranean origin.
Kaski
Juan Carlos
JC
Departamento de Cardiological Sciences, St. George's Hospital Medical Scholl, London, UK. jkaski@sghms.ac.uk
Cruz-Fernández
José María
JM
Fernández-Bergés
Daniel
D
García-Moll
Xavier
X
Martín Jadraque
Luis
L
Mostaza
José
J
López García-Aranda
Víctor
V
González Juanatey
José Ramón
JR
Castro Beiras
Alfonso
A
Martín Luengo
Cándido
C
Alonso García
Angeles
A
López-Bescós
Lorenzo
L
Marcos Gómez
Gonzalo
G
D015415:Biomarkers / Q000097:blood; D004562:Electrocardiography; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000503:physiopathology; D017202:Myocardial Ischemia / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D011446:Prospective Studies; D012107:Research Design; D018570:Risk Assessment / Q000379:methods
D015415:Biomarkers
Marcadores de inflamación y estratificación de riesgo en pacientes con síndorome coronario agudo: diseño del estudio SIESTA (Systemic Inflammation Evaluation in patients with non-ST segment elevaton Acute coronary syndromes).