title: [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)].
abstract: 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.
authors.affiliation: Departamento de Cardiological Sciences, St. George's Hospital Medical Scholl, London, UK. jkaski@sghms.ac.uk
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Kaski
authors.forename: José María
authors.initials: JM
authors.lastname: Cruz-Fernández
authors.forename: Daniel
authors.initials: D
authors.lastname: Fernández-Bergés
authors.forename: Xavier
authors.initials: X
authors.lastname: García-Moll
authors.forename: Luis
authors.initials: L
authors.lastname: Martín Jadraque
authors.forename: José
authors.initials: J
authors.lastname: Mostaza
authors.forename: Víctor
authors.initials: V
authors.lastname: López García-Aranda
authors.forename: José Ramón
authors.initials: JR
authors.lastname: González Juanatey
authors.forename: Alfonso
authors.initials: A
authors.lastname: Castro Beiras
authors.forename: Cándido
authors.initials: C
authors.lastname: Martín Luengo
authors.forename: Angeles
authors.initials: A
authors.lastname: Alonso García
authors.forename: Lorenzo
authors.initials: L
authors.lastname: López-Bescós
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Marcos Gómez
mesh_terms: 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
chemical_list: D015415:Biomarkers
vernacular_title: 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).