title: Evaluation of the endothelial glycocalyx damage in patients with acute coronary syndrome.
abstract: BACKGROUND
  Endothelial glycocalyx (EG) is sugar-based cell-bound surface molecules linked to transmembrane proteins observed on the endothelial surface of the vessels. Damage to this structure causes an increase in platelet and leucocyte adhesion and shear stress in the vessel. We hypothesized a possible link between EG damage and acute coronary syndrome (ACS).
  
  
  METHODS
  We measured the syndecan-1 levels (a biomarker of EG damage) in 141 patients (99 men) with ACS and compared to those of 45 patients (24 men) with non-coronary chest pain (NCCP) and of 24 (14 men) healthy individuals (CONTROL).
  
  
  RESULTS
  The baseline characteristics of the ACS and NCCP groups were similar. Syndecan-1 levels were significantly higher in the ACS group than in the NCCP (p = 0.01) and CONTROL (p = 0.001) groups but did not differ between the NCCP and CONTROL groups (p = 0.83). In analysis according to gender category, the difference among the groups remained significant only for men (p = 0.0009). A syndecan-1 level higher than 148 ng/ml was associated with ACS diagnosis with an odds ratio of 14 (95% confidence interval (CI): 1.8 to 102), p = 0.011. After adjusting for gender, age and current or past tobacco use, this syndecan-1 level remained positively associated with ACS diagnosis with an odds ratio of 12 (95% CI: 1.6 to 93), p = 0.016.
  
  
  CONCLUSIONS
  Higher syndecan-1 levels were observed during ACS, mostly in men, suggesting that EG damage could participate in the atherosclerotic plaque vulnerability process in these patients.
authors.affiliation: Division of Emergency Medicine, Department of Internal Medicine, Ribeirão Preto School of Medicine, São Paulo University, Ribeirão Preto, São Paulo, Brazil. Electronic address: chmiranda@fmrp.usp.br.
authors.forename: Carlos Henrique
authors.initials: CH
authors.lastname: Miranda
authors.affiliation: Division of Emergency Medicine, Department of Internal Medicine, Ribeirão Preto School of Medicine, São Paulo University, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Marcos
authors.initials: M
authors.lastname: de Carvalho Borges
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Ribeirão Preto School of Medicine, São Paulo University, Ribeirão Preto, São Paulo, Brazil.
authors.forename: André
authors.initials: A
authors.lastname: Schmidt
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Ribeirão Preto School of Medicine, São Paulo University, Ribeirão Preto, São Paulo, Brazil.
authors.forename: José Antônio
authors.initials: JA
authors.lastname: Marin-Neto
authors.affiliation: Division of Emergency Medicine, Department of Internal Medicine, Ribeirão Preto School of Medicine, São Paulo University, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Antônio
authors.initials: A
authors.lastname: Pazin-Filho
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000175:diagnosis / Q000473:pathology; D000328:Adult; D000789:Angina, Unstable / Q000097:blood* / Q000175:diagnosis / Q000473:pathology; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D042783:Endothelial Cells / Q000378:metabolism* / Q000473:pathology; D005260:Female; D019276:Glycocalyx / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000473:pathology; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012307:Risk Factors; D012737:Sex Factors; D053668:Syndecan-1 / Q000097:blood*; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; C508241:SDC1 protein, human; D053668:Syndecan-1
keywords: Acute coronary syndrome; Endothelial glycocalyx; Myocardial infarction; Syndecan-1