[Coronary biomarkers and long-term clinical outcome in acute coronary syndrome without ST segment elevation].
BACKGROUND
The use of new biomarkers improved risk stratification for patients with acute coronary syndromes (ACS).


OBJECTIVE
To evaluate the relationship between multiple biomarkers and long-term clinical outcome in ACS without ST segment elevation.


METHODS
Consecutive patients presenting with suspected ACS were studied. On admission to the emergency room, serum was obtained to determine highly sensitive C reactive protein (hsCRP), erythrocyte sedimentation rate (ESR), lipoprotein (a) (LPa) and soluble P selectin (sPS). Clinical endpoints were mortality and a composite endpoint of major adverse cardiovascular events (MACE) including death, re-infarction, and angina.


RESULTS
Seventy patients, aged 63+/-13 years, 54 males, were studied. Final diagnosis was unstable angina in 71% and non-ST-segment elevation myocardial infarction in 29%. MACE and mortality rate were 17% and 5.8%, respectively. We found higher plasma levels of hsCRP, ESR and Lp(a) in patients with MACE (p=0.032, p=0.015 and p=0.010, respectively). Plasma levels of hsCRP and ESR were also higher in patients who died during the follow up (p=0.002 y p=0.045, respectively).


CONCLUSIONS
Plasma levels of inflammatory markers and atherosclerosis biomarkers are associated with a worse long-term clinical outcome in ACS without ST segment elevation. The inclusion of these biomarkers in the routine blood test on admission, could improve risk stratification of patients with ACS in the future.
Baeza V
Ricardo
R
Departamento de Enfermedades Cardiovasculares, Pontificia Universidad Católica de Chile. rbaeza@puc.cl
Corbalán H
Ramón
R
Castro G
Pablo
P
Acevedo B
Mónica
M
Quiroga G
Teresa
T
Viviani G
Paola
P
D000208:Acute Disease; D000789:Angina, Unstable / Q000097:blood* / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis*; D003324:Coronary Artery Disease / Q000097:blood / Q000401:mortality; D052279:Creatine Kinase, MB Form / Q000097:blood*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood*
D015415:Biomarkers; D017270:Lipoprotein(a); D019007:P-Selectin; D002097:C-Reactive Protein; D052279:Creatine Kinase, MB Form