Relationship between myocardial injury and soluble P-selectin in non-ST elevation acute coronary syndromes.
BACKGROUND
The relationships among troponin concentration, early phase coagulation activation and soluble P-selectin concentration was evaluated in this study.


RESULTS
Troponin-l, soluble P-selectin, von Willebrand factor (vWF), fibrinogen, plasminogen, plasminogen activator inhibitor 1 (PAI-1) and tissue plasminogen activator (t-PA) concentrations of 202 consecutive patients with non-ST elevation acute coronary syndrome (NSTE-ACS) were measured at the time of admission. Patients were classified into 2 groups as troponin-negative (<0.2 ng/ml, n=129) or positive (>or=0.2 ng/ml, n=73). Soluble P-selectin concentrations were found to be higher (p<0.001) and correlated with troponin concentrations (r=0.313, p<0.005) in troponin-positive patients with NSTE-ACS. In these patients fibrinogen (p<0.001), plasminogen (p<0.001) and PAI-1 (p<0.026) concentrations were higher and t-PA concentrations were lower (p<0.013) and all these parameters correlated with P-selectin concentrations (p<0.001). There was no difference between the groups according to vWF concentrations (p=0.379). Soluble P-selectin concentrations were found to be an independent predictor of troponin positivity (beta=0.295, odds ratio =1.05, p<0.001). Analysis of regression revealed a significant effect of troponin on soluble P-selectin concentrations (r=0.52, r2=0.27, p<0.001).


CONCLUSIONS
The results suggest that higher soluble P-selectin concentrations might be involved in increased coagulation activation and myocardial injury development in patients with NSTE-ACS.
Yazici
Mustafa
M
Ondokuz Mayis University Medical School, Department of Cardiology, Samsun, Turkey. drmeyaz@hotmail.com
Demircan
Sabri
S
Durna
Kenan
K
Yasar
Erdogan
E
Sahin
Mahmut
M
D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001779:Blood Coagulation Factors / Q000032:analysis*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000097:blood* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood*; D019210:Troponin I / Q000097:blood*
D015415:Biomarkers; D001779:Blood Coagulation Factors; D019007:P-Selectin; D019210:Troponin I