title: Soluble endothelial protein C receptor levels and protein C activity in patients with acute ST-segment elevation myocardial infarction.
abstract: OBJECTIVE
  In contrast to its membrane-bound form, soluble endothelial protein C receptor (sEPCR) expresses procoagulant activity through binding to protein C. We aimed to investigate the relationship between sEPCR levels and protein C activity in patients with ST-segment elevation myocardial infarction (STEMI).
  
  
  METHODS
  The study population included 60 STEMI patients who had undergone a primary percutaneous coronary intervention and 29 patients with stable angina pectoris (SAP) with significant coronary stenosis on angiography. Preprocedural sEPCR levels and protein C activity were determined in all study patients.
  
  
  RESULTS
  In the STEMI group, the baseline sEPCR level was significantly higher (172.0±89.3 vs. 107.1±39.2 ng/ml, P<0.001) and protein C activity was significantly lower (91.9±26.4 vs. 124.5±16.2%, P<0.001) compared with patients with SAP. There was a significant negative correlation between protein C activity and sEPCR in the STEMI group (r=-0.38, P=0.002); however, no significant correlation was observed in the SAP group (r=0.02, P=0.91). Angiographic thrombus load and the incidence of no-reflow phenomenon were significantly higher in STEMI patients with protein C activity under the median level.
  
  
  CONCLUSIONS
  The ratio of sEPCR levels to protein C activity is high, with a significant negative correlation in patients with STEMI. Lower protein C activity is associated with the development of no-reflow in STEMI patients. However, the sEPCR level has no relation to the development of no-reflow. The clinical significance of elevated sEPCR level in STEMI should be evaluated in larger studies.
authors: Department of Cardiology, Medicana International Hospital, Ankara, Turkey.
authors: Ali C
authors: AC
authors: Tanalp
authors: Vecih
authors: V
authors: Oduncu
authors: Ayhan
authors: A
authors: Erkol
authors: Gökhan
authors: G
authors: Gözübüyük
authors: Olcay
authors: O
authors: Ozveren
authors: Cihan
authors: C
authors: Dündar
authors: Alper
authors: A
authors: Canbay
authors: Cevat
authors: C
authors: Kirma
mesh_terms: D000328:Adult; D000368:Aged; D060050:Angina, Stable / Q000097:blood; D015703:Antigens, CD / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D000074283:Endothelial Protein C Receptor; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000000981:diagnostic imaging / Q000628:therapy; D054318:No-Reflow Phenomenon / Q000209:etiology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D011237:Predictive Value of Tests; D011486:Protein C / Q000032:analysis*; D011956:Receptors, Cell Surface / Q000097:blood*; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D015703:Antigens, CD; D015415:Biomarkers; D000074283:Endothelial Protein C Receptor; C478370:PROCR protein, human; D011486:Protein C; D011956:Receptors, Cell Surface