title: Estimation of serum neopterin in patients with acute coronary syndrome.
abstract: BACKGROUND
  The aim of our study was to determine neopterin levels in patients with acute coronary syndrome, in which the release of various cytokines activates the cellular immune system. There is an increase in the number and activity of T-cells in unstable atherosclerotic plaques, and of type 1 helper T-cells that produce interferon γ, which in turn produces neopterin, a byproduct of the guanosine triphosphate-biopterin pathway and a marker for activated macrophages.
  
  
  METHODS
  We studied 600 subjects consisting of healthy volunteers and patients with noncardiac chest pain, ST-segment elevation myocardial infarction, non-ST-segment elevation myocardial infarction, or unstable angina. Neopterin levels were determined by high-performance liquid chromatography.
  
  
  RESULTS
  Mean serum neopterin levels in ST-segment elevation myocardial infarction (11.5 ± 3.2 nmol·L(-1)), non-ST-segment elevation myocardial infarction (9.8 ± 2.9 nmol·L(-1)), and unstable angina patients (9.4 ± 2.3 nmol·L(-1)) were significantly higher than those in noncardiac chest pain patients (7.4 ± 1.9 nmol·L(-1)) and healthy volunteers (7.2 ± 0.6 nmol·L(-1); p < 0.001).
  
  
  CONCLUSIONS
  These findings suggest that serum neopterin levels may be a useful marker of systemic inflammation, and measurement of serum neopterin may be helpful in assessing the risk of developing coronary heart disease.
authors.affiliation: Department of Biochemistry, Frontier Lifeline Hospital and Dr KM Cherian Heart Foundation, Chennai, Tamilnadu, India.
authors.forename: Prema
authors.initials: P
authors.lastname: Gurumurthy
authors.forename: Sai Krishna
authors.initials: SK
authors.lastname: Borra
authors.forename: Rama Krishna Reddy
authors.initials: RK
authors.lastname: Yeruva
authors.forename: Sai
authors.initials: S
authors.lastname: Babu
authors.forename: Joy
authors.initials: J
authors.lastname: Thomas
authors.forename: Kotturathu Mammen
authors.initials: KM
authors.lastname: Cherian
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000175:diagnosis / Q000276:immunology; D000789:Angina, Unstable / Q000097:blood* / Q000175:diagnosis / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002851:Chromatography, High Pressure Liquid; D052279:Creatine Kinase, MB Form / Q000097:blood; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000276:immunology; D019798:Neopterin / Q000097:blood*; D011237:Predictive Value of Tests; D019210:Troponin I / Q000097:blood; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D019210:Troponin I; D019798:Neopterin; D052279:Creatine Kinase, MB Form
keywords: Acute coronary syndrome; high pressure liquid chromatography; inflammation; myocardial infarction; unstable angina