A Novel Index for Prompt Prediction of Severity in Patients with Unstable Angina Pectoris

Abstract

Objectives. Rapid risk stratification by emergency department (ED) physicians to evaluate patients with chest pain for predicting the short-term occurrence of major adverse cardiac event (MACE) is crucial. The aim of this study was to investigate the predictive value of platelet-lymphocyte ratio (PLR) levels and compare with the modified heart score (m-HS) and stress testing to predict the severity of high-risk patients with unstable angina pectoris (UAP) in the ED. Methods. This study is prospective which included 316 patients with UAP and 316 control healthy subjects. The study took place from 01 April 2016, until 01 April 2017, in Medipol University. Result. The mean PLR levels in the UAP group were higher than those in the control group (p<0.001). The mean PLR of the m-HS ≥4 group was higher than that in the m-HS ≤3 group (p<0.001). The mean levels of PLR in the subgroups based on the stress testing positivity were higher than those in the stress testing negative subgroup (p<0.001). PLR levels were positively correlated with the m-HS, stress testing, and treatment decision in this study (r = 0.559; p<0.001; r = 0.582; p<0.001; r = 0.789; p<0.001, respectively). Conclusion. A positive correlation was determined with an increase in m-HS, treatment decision, and positive exercise testing as the PLR levels increased, indicating the severity of high risk of UAP in the ED.

Biomarker Discovery of Acute Coronary Syndrome Using Proteomic Approach

“…Additionally, troponin level has been found to be elevated in not only acute myocardial infarction (AMI), but also in other diseases and complications that cause myocardial damage, such as myocarditis and stress-induced cardiomyopathy [ 10 ]. Studies have shown that troponin may also be useful in the diagnosis of AMI associated with ACS, but not UA [ 12 ]. Therefore, the need for new biomarkers for ACS remains unmet.…”

“…Furthermore, since chest pain, a typical symptom of ACS, is a common symptom in other diseases, it is difficult to diagnose ACS in patients who report the development of chest pain [ 10 ]. Finally, UA cannot be diagnosed using existing biomarkers, which are typically used to diagnose the existence of myocardial necrosis [ 12 ]. Therefore, the identification of novel ACS diagnostic biomarkers with high specificity and sensitivity is warranted.…”

Serum biomarker discovery related to pathogenesis in acute coronary syndrome by proteomic approach

“…Troponin levels may be elevated not only in coronary artery disease (CAD) such as ACS but also in other diseases that cause myocardial damage [11]; thus, its positive Downloaded from http://portlandpress.com/bioscirep/article-pdf/doi/10.1042/BSR20210344/911318/bsr-2021-0344-t.pdf by guest on 24 May 2021 predictive value may be limited. Furthermore, these biomarkers may not be useful to differentiate AMI from UA [12], which amplifies the need for new diagnostic biomarkers with high sensitivity and specificity for diagnosing ACS.…”

Improving Communication with Patients Discharged from the Emergency Department with Noncardiac Chest Pain: A Scoping Review with Narrative Synthesis

“…Despite the advancements and innovations in diagnostic and interventional methods, evaluation of patients who present to the emergency department with chest pain is still challenging [1][2][3]. Patients who present to the emergency department with chest pain are often thought to have acute coronary syndrome which is a frequent serious health concern among emergency patients [4,5]. Of the patients who present to the emergency department with chest pain, about 20% will receive a diagnosis of acute coronary syndrome and require prolonged stay at the hospital.…”