title: Plasma Levels of Soluble CD146 Reflect the Severity of Pulmonary Congestion Better Than Brain Natriuretic Peptide in Acute Coronary Syndrome.
abstract: BACKGROUND
  Acute heart failure negatively affects short-term outcomes of patients with acute coronary syndrome (ACS). Therefore, reliable and non-invasive assessment of pulmonary congestion is needed to select patients requiring more intensive monitoring and therapy. Since plasma levels of natriuretic peptides are influenced by myocardial ischemia, they might not reliably reflect congestion in the context of ACS. The novel endothelial biomarker, soluble CD146 (sCD146), presents discriminative power for detecting the cardiac origin of acute dyspnea similar to that of natriuretic peptides and is associated with systemic congestion. We evaluated the performance of sCD146 for the assessment of pulmonary congestion in the early phase of ACS.
  
  
  METHODS
  One thousand twenty-one consecutive patients with ACS were prospectively enrolled. Plasma levels of sCD146, brain natriuretic peptide (BNP), and high-sensitive troponin T were measured within 24 hr after the onset of chest pain. Pulmonary congestion on chest radiography was determined and classified in three groups according to the degree of congestion.
  
  
  RESULTS
  Nine hundred twenty-seven patients with ACS were analyzed. Ninety-two (10%) patients showed signs of pulmonary edema on chest radiography. Plasma levels of sCD146 reflected the radiological severity of pulmonary congestion. Higher plasma levels of sCD146 were associated with the worse degree of pulmonary congestion. In contrast to BNP, sCD146 levels were not affected by the level of troponin T.
  
  
  CONCLUSIONS
  The novel endothelial biomarker, sCD146, correlates with radiological severity of pulmonary congestion in the early phase of ACS and, in contrast to BNP, is not affected by the amount of myocardial cell necrosis.
authors.affiliation: Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic.|Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Kubena
authors.affiliation: INSERM UMR-S 942, Paris, France.|Department of Anesthesiology and Critical Care Medicine, AP-HP, Saint Louis Lariboisière University Hospitals, Paris, France.|Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Mattia
authors.initials: M
authors.lastname: Arrigo
authors.affiliation: Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic.|Faculty of Medicine, Masaryk University, Brno, Czech Republic.|International Clinical Research Center-Department of Cardiovascular Disease, University Hospital St Anne's, Brno, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Parenica
authors.affiliation: INSERM UMR-S 942, Paris, France.|Department of Anesthesiology and Critical Care Medicine, AP-HP, Saint Louis Lariboisière University Hospitals, Paris, France.|Université Paris Diderot, PRES Sorbonne Paris Cité, France.
authors.forename: Etienne
authors.initials: E
authors.lastname: Gayat
authors.affiliation: INSERM UMR-S 942, Paris, France.
authors.forename: Malha
authors.initials: M
authors.lastname: Sadoune
authors.affiliation: Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic.|Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Eva
authors.initials: E
authors.lastname: Ganovska
authors.affiliation: Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic.|Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Marie
authors.initials: M
authors.lastname: Pavlusova
authors.affiliation: Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Simona
authors.initials: S
authors.lastname: Littnerova
authors.affiliation: Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic.|Faculty of Medicine, Masaryk University, Brno, Czech Republic.|International Clinical Research Center-Department of Cardiovascular Disease, University Hospital St Anne's, Brno, Czech Republic.
authors.forename: Jindrich
authors.initials: J
authors.lastname: Spinar
authors.affiliation: INSERM UMR-S 942, Paris, France.|Department of Anesthesiology and Critical Care Medicine, AP-HP, Saint Louis Lariboisière University Hospitals, Paris, France.|Université Paris Diderot, PRES Sorbonne Paris Cité, France. alexandre.mebazaa@aphp.fr.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Mebazaa
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000000981:diagnostic imaging; D000368:Aged; D015415:Biomarkers / Q000097:blood; D051929:CD146 Antigen / Q000097:blood; D002637:Chest Pain / Q000000981:diagnostic imaging / Q000473:pathology*; D004562:Electrocardiography; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D012720:Severity of Illness Index; D020107:Troponin T / Q000097:blood
chemical_list: D015415:Biomarkers; D051929:CD146 Antigen; C497902:MCAM protein, human; D020107:Troponin T; D020097:Natriuretic Peptide, Brain
keywords: Acute coronary syndrome; Myocardial infarction; Pulmonary congestion; Pulmonary edema; sCD146