The Correlation between Cardiac Enzymes and Cardiotrophin-1 Levels in Patients with Acute Coronary Syndrome

Polat, Ufuk; Aydinlar, Ali; Caliskan, Serhat; Boyuk, Ferit; Unal, Orcun

doi:10.36660/ijcs.20200102

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International Journal of Cardiovascular Sciences

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Sumário

ORIGINAL ARTICLE • Int J Cardiovasc Sci 34 (5 Supl 1) • 2021 • https://doi.org/10.36660/ijcs.20200102 copy

The Correlation between Cardiac Enzymes and Cardiotrophin-1 Levels in Patients with Acute Coronary Syndrome

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Background

In the current era, there is always search for better cardiovascular biomarkers to early diagnose the disease.

Objectives

We aimed to investigate the association between a novel biomarker, cardiothropin-1 (CT-1), and standard markers of myocardial ischemia in patients with acute coronary syndrome (ACS) in Turkey.

Patients and Methods

In this prospective cohort study, patients who were admitted to our institution between July 2012 and July 2013 with the diagnosis of ACS were included. The standard markers of myocardial necrosis and CT-1 were evaluated at the time of admission and after 6 hours. Changes in laboratory parameters were statistically tested and correlated with routinely used markers of myocardial ischemia. The distribution of the data was analyzed by the Kolmogorov-Smirnov test. Proportional analysis and changes in laboratory parameters were evaluated with Chi-Square test and Fisher Exact test. Statistical significance was defined as p<0.05.

Results

The study enrolled 24 patients (14 male, 10 female) with ST-segment elevation myocardial infarction (STEMI) and 16 patients (9 male, 7 female) with non-ST-segment elevation myocardial infarction (NSTEMI) with elevated cardiac enzymes such as creatine kinase (CK), creatine kinase-MB (CK-MB) and Troponin-T (Tn-T). The average age of the patients was 61.45 ± 11.04 years. Increasing CT-1 levels were correlated with the increasing CK (p=0.035 and p=0.018, respectively), CK-MB (p=0.006 and p=0.096, respectively), and Tn-T (p=0.041 and p=0.000, respectively) at first and at the 6th hour measurements. The CT-1 values were found to be more increased in the STEMI group (p=0.0074).

Conclusion

CT-1 is one of the novel biomarkers for cardiac injury. It is correlated with standard markers of myocardial ischemia and the results suggest that CT-1 can be used as a new biomarker.

Myocardial infarction; Acute coronary syndrome; Cardiotrophin-1; Atiral fibrillation; Troponin-T

Gender (n, %) (male/female)	14/10 (58.3, 41.7)
Age (Year) (Mean ± SD)	62,25 ±8,3
Diabetes mellitus (n, %)	6 (25)
Hypertension (n, %)	15 (62,5)
Dyslipidemia (n, %)	2 (8,3)
Smoking (n, %)	4 (16,6)
Coronary artery disease (n, %)	10 (41,6)
Family History (n, %)	4 (16,6)
ACE inh/ARB (n, %)	17 (70,8)
B-blocker (n, %)	5 (20,8)
Statin (n, %)	4 (16,6)
Acetylsalicylic Acid (n, %)	5 (20,8)
Calcium Channel Blocker (n, %)	5 (20,8)

Gender (n, %) (Male/Female)	9/7 (56.2, 43.8)
Age (Year) (Mean ± SD)	60.25 ± 3,5
Diabetes mellitus (n, %)	5 (31.2)
Hypertension (n, %)	13 (81.2)
Dyslipidemia (n, %)	3 (18.7)
Smoking (n, %)	0 (0)
Coronary artery disease (n, %)	5 (31,2)
Family History (n, %)	7 (43.7)
ACE inh/ARB (n, %)	9 (56.2)
B-blocker (n, %)	2 (12.5)
Statin (n, %)	7 (43.7)
Acetyl Salicylic Acid (n, %)	7 (43.7)
Calcium Channel Blocker (n, %)	5 (31.2)

	0. hour	6. hour	p value
WBC (K/Μl)	10.68 ± 4.01	11.62 ± 3.29	0.024*
HG (g/dl)	12.90 ± 1.77	12.46 ± 1.84*	0.022
AST (IU/L)	48.77 ± 13.34	56.45 ± 18.32	0.0045*
ALT (IU/L)	26.85 ± 11.89	29.13 ± 8.01	0.0071*
CK (IU/L)	Range: 254-493 Median: 372.5	Range: 416-829 Median: 712.3	0.0082**
CK-MB (IU/L)	48.08 ± 24.5	90.18 ± 33.14	0.0065*
Tn-T (ng/mL)	Range: 1354-2462 Median: 1758.4	Range: 2519-6128 Median: 4732.6	0.0092**
CT-1 (pg/mL)	132.04 ± 48.1	322.19 ± 98.12	0.0084*

0.hour CT-1	r value	p value
0.hour CK	0.335	0.035
0.hour CK-MB	0.427	0.006
0.hour Tn-T	0.085	0.041
6.hour CK-MB	0.396	0.011
6.hour CK	0.372	0.018
6.hour Tn-T	0.064	0.096
6.hour CT-1	0.702	0.000

6. hour CT-1	r value	p value
0.hour Tn-T	0.003	0.047
0.hour CT-1	0.702	0.000
6.hour CK	0.656	0.000
6.hour CKM-B	0.683	0.000
6.hour Tn-T	0.011	0.046

6. hour Troponin-T	r value	p value
0.hour Tn-T	0.976	0.000
0.hour CT-1	0.064	0.036
6.hour CT-1	0.011	0.044
6.hour CK	0.042	0.795
6.hour CK-MB	0.683	0.000

	AF Developers N:4	Non-AF Patients N:36	p value*
Age	Range: 48-78 Median:68	Range: 42-75 Median: 65.4	0.23*
Gender Male Female	(n, %) 2 (50) 2 (50)	21 (58.3) 15 (41.6)	0.027 0.019
Diabetes mellitus (n, %)	1 (25)	10 (27.7)	0.012**
Hypertension (n, %)	4 (100)	24 (66.6)	0.032***
Dyslipidemia (n, %)	1 (25)	4 (11.1)	0.11**
Smoker	1 (25)	14 (38.8)	0.014**
Family history	0 (0)	4 (11.1)
Coronary artery disease history	2 (50)	9 (25)	0.0093**
WBC (K/µl)	Range: 9.2-14.5 Median: 11.5	Range: 9.58-15.3 Median: 10.8	0.21*
HG (g/dl)	Range: 8-13.4 Median: 12.8	Range: 8.6-14.4 Median: 13.6	0.25*
AST (IU/L)	Range: 30-52 Median: 40.3	Range: 34-63 Median: 55.6	0.025*
ALT (IU/L)	Range: 20-27 Median: 22.8	Range: 22-35 Median: 32.1	0.034*
CK (IU/L)	Range: 200-320 Median: 251	Range: 375-594 Median: 402	0.031*
CK MB (IU/L)	Range: 35-72 Median: 33.4	Range: 42-87 Median: 62	0.021*
Tn- T (ng/ml)	Range: 10020-10940 Median: 10502	Range: 952-1402 Median: 1024	0.0081*
CT-1 (pg/ml)	Range: 97-114 Median: 108	Range: 110-203 Median: 157.4	0.014*

	0. hour	6. hour	p value
WBC (K/Μl)	10.68 ± 4.01	11.62 ± 3.29	0.024*
HG (g/dl)	12.90 ± 1.77	12.46 ± 1.84	0.022*
AST (IU/L)	48.77 ± 13.34	56.45 ± 18.32	0.0045*
ALT (IU/L)	26.85 ± 11.89	29.13 ± 8.01	0.0071*
CK (IU/L)	Range: 254-493 Median: 372.5	Range: 416-829 Median: 712.3	0.0082**
CK-MB (IU/L)	48.08 ± 24.5	90.18 ± 33.14	0.0065*
Tn-T (ng/mL)	Range: 1354-2462 Median: 1758.4	Range: 2519-6128 Median: 4732.6	0.0092**
CT-1 (pg/mL)	132.04 ± 48.1	322.19 ± 98.12	0.0084*

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[1] Mailing Address: Orcun Unal Yedikule Thoracic Diseases Education and Research Hospital - Cardiovascular Surgery Clinic Kazlicesme Mahallesi, Belgrat Kapi Yolu Caddesi, No:1, 34020 Zeytinburnu, Istanbul – Turkey E-mail: orcunal@gmail.com