Platelet glycoprotein VI (GPVI) for early identification of acute coronary syndrome in patients with chest pain.
BACKGROUND
Platelet glycoprotein VI (GPVI) is elevated in patients with acute coronary syndrome (ACS), stroke and associated with acute coronary events. GPVI may be helpful to distinguish an imminent ACS from non-coronary (NC) causes in patients with chest pain who were transferred to chest pain unit, before the myocardial necrosis is evident with classical biomarkers.


METHODS
Based on the findings of our previous studies, we consecutively examined 1004 patients with chest pain in a prospective study design. ACS was found in 416 (41.4%), stable angina pectoris (SAP) in 233 (23.2%), and NC causes of chest pain (hypertension, musculoskeletal disease, pulmonary embolism, myocarditis, cardiophobia) in 355 patients (35.4%). Platelet surface expression of GPVI was measured by flow cytometry.


RESULTS
Patients with ACS showed significantly enhanced GPVI expression levels compared to patients with SAP or NC causes of chest pain (ACSvs.SAP(mean fluorescence intensity (MFI)+/-SD):18.9+/-7.4vs.17.9+/-9.5;P=0.028;ACSvs.NC:15.4+/-6.9;P=0.002). Elevated GPVI expression was associated with ACS independent of markers of myocardial necrosis like troponin and creatine kinase-MB. Patients with an elevated GPVI expression (MFI>or=18.6) had a poorer clinical outcome than patients with baseline GPVI expression in regard to composite cumulative survival that included myocardial infarction, stroke, and cardiovascular death at three months (Log rank;P=0.025).


CONCLUSIONS
Platelet GPVI surface expression is enhanced in patients at risk for an ACS and is an early marker for imminent acute coronary events in patients with chest pain.
Bigalke
Boris
B
Medizinische Klinik III, Kardiologie und Kreislauferkrankungen, Eberhard-Karls-Universität Tübingen, Germany. boris.bigalke@med.uni-tuebingen.de
Haap
Michael
M
Stellos
Konstantinos
K
Geisler
Tobias
T
Seizer
Peter
P
Kremmer
Elisabeth
E
Overkamp
Dietrich
D
Gawaz
Meinrad
M
D054058:Acute Coronary Syndrome / Q000097:blood* / Q000175:diagnosis*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002637:Chest Pain / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010980:Platelet Membrane Glycoproteins / Q000032:analysis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D015415:Biomarkers; D010980:Platelet Membrane Glycoproteins; C098341:platelet membrane glycoprotein VI