ANALYSIS OF CARDIOSPECIFIC ENZYMES IN PATIENTS WITH CORONARY ARTERY DISEASE
Keywords:
acute coronary syndrome, cardiac enzymes, troponin, coronary angiographyAbstract
The primary aim was to compare the specific and nonspecific cardiac enzymes in patients presented with acute coronary syndrome and those with selective coronary angiography. The second aim was to evaluate the relationship between different outcomes and levels of cardiac enzymes.
Retrospectively were analyzed 270 patients, 94 cases with acute coronary syndrome and 176 patients with selective coronary angiography (SCA). In all patients, myocardial serum enzyme levels (troponin I, creatinine phosphokinase (CK), aspartate aminotransferase (AST), lactate dehydrogenase (LDH)), and inflammatory markers (C-reactive protein and white blood cells) were measured. All patients were submitted to coronary angiography and outcomes were analyzed.
From 94 patients with ACSy, 56 (59.6%) patients received at least one coronary artery stent, 27 (28.7%) were referred to cardiac surgery for aorta-coronary bypass, and 11 (11.7%) died. From 176 patients with SCA, 46 (26.1%) received at least one coronary artery stent, 24 (13.6%) patients were referred for aorta-coronary bypass, 106 (60.2%) patients were without significant coronary plaques and were discharged with drug treatment, and no one died.
Patients with ACSy had significantly higher levels of troponin, AST, CK, and LDH compared to patients in SCA group. Mean values of CK-MB, CRP and peripheral white blood counts were not significantly different in patients with ACSy than in patients with SCA.
Statistically significant positive correlation between the ACSy event and troponin, AST, CK, and CKMB values were found. The correlation coefficient was strong for troponin and weak in other enzymes.
Using the general linear model-univariate procedure, only the age have statistically significant effect on coronary angiographic outcome.
Our findings suggest that serum levels of specific myocardial enzymes are elevated in patients presented with ASCy and can be used to identify patients for urgent coronary angiography. According to our results, the levels of the inflammatory markers can’t be used for prognosis stratifications.
The advanced age have the highest impact on the coronary angiography outcomes in the group of patients which fulfill criteria for coronary angiography. Number of other cardiac markers (myoglobin, hyperuricemia and interleukins) were not analyzed in this study.
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