The utility of inflammation and platelet biomarkers in patients with acute coronary syndromes

Joanna Kamińska; Olga M Koper; Edyta Siedlecka-Czykier; Joanna Matowicka-Karna; Jerzy Bychowski; Halina Kemona

doi:10.1016/j.sjbs.2016.10.015

The utility of inflammation and platelet biomarkers in patients with acute coronary syndromes

Saudi J Biol Sci. 2018 Nov;25(7):1263-1271. doi: 10.1016/j.sjbs.2016.10.015. Epub 2016 Oct 24.

Authors

Joanna Kamińska¹, Olga M Koper¹, Edyta Siedlecka-Czykier², Joanna Matowicka-Karna¹, Jerzy Bychowski², Halina Kemona¹

Affiliations

¹ Department of Clinical Laboratory Diagnostics, Medical University of Bialystok, Poland.
² Department of Cardiology Intensive Care with the Hemodynamic Unit of the Jędrzej Śniadecki Provincial Hospital in Bialystok, Poland.

Abstract

Introduction: Thrombotic and inflammatory mechanisms are involved in the pathophysiology of acute coronary syndrome (ACS). The aim of the study was the evaluation of inflammation (white blood cells count/WBC, C-reactive protein/CRP, interleukin-6/IL-6) and platelet (platelet count/PLT, mean platelet volume/MPV, large platelet/LPLT, beta-thromboglobulin/β-TG) biomarkers in the groups of ACS patients depending on the severity of signs and symptoms and compared to controls without coronary artery disease.

Materials and methods: The study group included 93 patients categorized into 3 subgroups depending on the severity of signs and symptoms of ACS. PLT, MPV, LPLT, and WBC were determined on hematological analyzer, IL-6 and β-TG were measured using the ELISA method.

Results: In the whole group of ACS patients WBC, CRP, IL-6, MPV, and β-TG were significantly higher as compared to controls. Analyzing the inflammation and platelet biomarkers depending on the severity of signs and symptoms in comparison to controls, statistically significant differences for above-mentioned parameters were also found. There were no significant differences between the advancement of coronary artery changes and inflammation as well as platelet parameters, except for CRP concentrations. The AUCs for all inflammation parameters tested were similar, however the highest AUCs showed WBC and CRP. Among platelet parameters the highest AUC revealed β-TG.

Conclusion: Markers of inflammation and platelet activation may be associated to myocardial ischemia and myocardial injury. WBC, CRP and IL-6 as inflammation parameters and MPV and β-TG as platelet biomarkers may be useful indicators of the presence of coronary artery disease.

Keywords: ACC, diagnostic accuracy; ACS, acute coronary syndrome; ALT, alanine transaminase; AST, aspartate transaminase; AUC, area under the ROC curve; Activated platelet; Acute coronary syndrome; BP, blood pressure; Beta-thromboglobulin; CRP, C-reactive protein; ECG, echocardiogram; F, female; HCT, hematocrit; HDL, high-density lipoprotein cholesterol; HGB, hemoglobin; IFN- ɣ , interferon gamma; IL-6, interleukin-6; Inflammation biomarkers; L-PLT, large platelet; LBBB, Left Bundle Branch Block; LDL, low-density lipoprotein cholesterol; M, male; MI, myocardial infarction; MPV, mean platelet volume; NPV, negative predictive value; NS, not statistically significant; NSTEMI, non-ST-segment elevation myocardial infarction; PAF, platelet activating factor; PLT, platelet count; PPV, positive predictive value; RBC, red blood cell count; ROC, Receiver operator characteristic; SE, Standard Error; STEMI, ST-segment elevation myocardial infarction; TCH, total cholesterol; TG, triglycerides; TNF-α, tissue necrosis factor alfa; UA, unstable angina; WBC, white blood cells count; cTnI, cardiac troponin I; eGFR, estimate glomerular filtration rate; sP-selectin, soluble form of P-selectin; β-TG, β-thromboglobulin.