title: Prognostic information of glycogen phosphorylase isoenzyme BB in patients with suspected acute coronary syndrome.
abstract: Early and adequate risk stratification is essential in patients with suspected acute coronary syndrome (ACS). The aim of the present study was to investigate whether glycogen phosphorylase BB (GPBB) could add prognostic information in the context of contemporary sensitive troponin I determination and B-type natriuretic peptide (BNP). Patients with suspected ACS were consecutively enrolled at 3 German study centers from January 2007 through December 2008. Troponin I, GPBB, and BNP were determined at admission. Follow-up information on the combined end point of death, myocardial infarction, revascularization, and hospitalization owing to a cardiovascular cause was obtained 6 months after enrollment. In total 1,818 patients (66% men) were enrolled of whom 413 (23%) were diagnosed as having acute myocardial infarction and 240 (13%) as having unstable angina pectoris, whereas in 1,165 patients (64%) an ACS could be excluded. Follow-up information was available in 98% of patients; 203 events were registered. GPBB measured on admission predicted an unfavorable outcome with a hazard ratio of 1.24 (p <0.05) in an unadjusted Cox regression model and showed a tendency with a hazard ratio of 1.13 (p = 0.07) in a fully adjusted model. Kaplan-Meier analysis revealed a poorer outcome in patients with increased GPBB levels amendatory to the information provided by troponin I or BNP. In conclusion, GPBB measurement provides predictive information on midterm prognosis in patients with chest pain in addition to BNP and troponin I.
authors: Department of Internal Medicine II, University Medical Center, Johannes Gutenberg University, Mainz, Germany.
authors: Lars
authors: L
authors: Lillpopp
authors: Stergios
authors: S
authors: Tzikas
authors: Francisco
authors: F
authors: Ojeda
authors: Tanja
authors: T
authors: Zeller
authors: Stephan
authors: S
authors: Baldus
authors: Christoph
authors: C
authors: Bickel
authors: Christoph R
authors: CR
authors: Sinning
authors: Philipp S
authors: PS
authors: Wild
authors: Sabine
authors: S
authors: Genth-Zotz
authors: Ascan
authors: A
authors: Warnholtz
authors: Karl J
authors: KJ
authors: Lackner
authors: Thomas
authors: T
authors: Münzel
authors: Stefan
authors: S
authors: Blankenberg
authors: Till
authors: T
authors: Keller
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D000368:Aged; D000789:Angina, Unstable / Q000097:blood / Q000175:diagnosis / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002637:Chest Pain / Q000097:blood / Q000175:diagnosis / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D025002:Glycogen Phosphorylase, Brain Form / Q000097:blood* / Q000378:metabolism; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis / Q000401:mortality; D020097:Natriuretic Peptide, Brain / Q000097:blood* / Q000378:metabolism; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016019:Survival Analysis; D020107:Troponin T / Q000097:blood* / Q000378:metabolism
chemical_list: D015415:Biomarkers; D020107:Troponin T; D020097:Natriuretic Peptide, Brain; D025002:Glycogen Phosphorylase, Brain Form