title: Procalcitonin is an independent predictor for coronary atherosclerotic burden in patients with stable coronary artery disease.
abstract: OBJECTIVE
  Higher coronary atherosclerotic burden has been associated with increased cardiovascular events including mortality. The SYNTAX score (SXs) reflects coronary atherosclerotic burden. Given the body of evidence implicating inflammation in atherosclerotic process, we hypothesized that procalcitonin (PCT) as an inflammatory marker may be related to coronary atherosclerotic burden. Thus, we aimed to investigate the relationship between serum PCT levels and SXs in patients with stable CAD.
  
  
  METHODS
  A total of 400 patients (mean age 62.8±10.6years) with evidence of significant CAD were included in this study. Serum PCT and high-sensitivity c-reactive protein (hs-CRP) levels were measured. To calculate the burden of CAD, the SX scoring algorithm system was applied. Patients with a SXs<23 (n=320) were classified as the low SXs group and those with a SXs≥23 (n=80) were classified as the high SXs group.
  
  
  RESULTS
  Serum PCT levels were higher in the high SXs group compared to the low SXs group (p<0.001). Receiver operating characteristic curve analysis showed that the cut-off value of PCT was 0.0335ng/mL for the prediction of high SXs (area under the curve: 0.753, sensitivity: 72.5%, specificity: 61.3%) After multivariate analysis, PCT, together with current smoking (OR 2.237, p=0.027), triglyceride (OR 1.005, p=0.001), and hs-CRP (OR 1.119, p=0.018), remained an independent predictor of high SXs (OR 3.021; 95% CI [1.492-6.097]; p=0.002).
  
  
  CONCLUSIONS
  Serum PCT is independently and positively associated with SXs. Thus, elevated PCT levels may be useful to identify patients with high coronary atherosclerotic burden in patients with stable CAD.
authors.affiliation: Ankara Education and Research Hospital, Department of Cardiology, Ankara, Turkey. Electronic address: alpkurtul@yahoo.com.
authors.forename: Alparslan
authors.initials: A
authors.lastname: Kurtul
authors.affiliation: Ankara Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Elcik
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis; D017281:Cost of Illness; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012107:Research Design; D014421:Turkey
chemical_list: D015415:Biomarkers; D002116:Calcitonin; D002097:C-Reactive Protein
keywords: Coronary atherosclerotic burden; Procalcitonin; Stable coronary artery disease