Early identification of acute myocardial infarction by activated protein C--protein C inhibitor complex.
INTRODUCTION: Increased coagulation activity due to coronary thrombosis in a ruptured plaque should result in activation of the protein C anticoagulant system with formation of complexes between activated protein C (APC) and the protein C inhibitor ( PCI), which reflects coagulation activity. We hypothesized that elevated APC- PCI concentration might allow earlier detection of ongoing myocardial infarction than traditional biochemical markers. We have evaluated a newly devised immunofluorimetric assay for measuring plasma concentration of APC- PCI complexes among patients with suspected acute coronary syndrome. MATERIALS AND METHODS: Blood samples were taken from 340 patients (median 71 years, range 31-97) with suspected acute coronary syndrome at first presentation in the emergency department. Electrocardiogram was recorded and APC- PCI, Troponin I and Creatine kinase-MB concentrations were repeatedly measured 3 times at 6 h interval. RESULTS: The 74 patients who were eventually diagnosed with myocardial infarction had a higher median level of APC- PCI complex than those without myocardial damage; 0.27 vs. 0.20 microg/L (p = 0.001). In a multivariate regression model, APC- PCI level in the fourth quartile (>0.32 microg/L) independently predicted myocardial infarction with an odds ratio of 3.7 (95% CI 1.4-9.6, p < 0.01). CONCLUSION: Early APC- PCI elevation can be detected among patients with a normal first Troponin I and non-ST-elevation myocardial infarction and provides additional risk assessment in acute coronary syndrome.[1]References
- Early identification of acute myocardial infarction by activated protein C--protein C inhibitor complex. Bhiladvala, P., Strandberg, K., Stenflo, J., Holm, J. Thromb. Res. (2006) [Pubmed]
Annotations and hyperlinks in this abstract are from individual authors of WikiGenes or automatically generated by the WikiGenes Data Mining Engine. The abstract is from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.About WikiGenesOpen Access LicencePrivacy PolicyTerms of Useapsburg