Cystatin-C in patients with acute coronary syndrome: Correlation with ventricular dysfunction, and affected coronary vessels

Abstract

Objective: This study designed to inspect the circulating levels of Cy/C in patients with ACS and to evaluate the association of Cy/C levels with ejection fraction and angiographic number of stenosed coronaries. Methods: 136 participants with ACS were enrolled in this case-control survey and compared with 94 control. Hematological assessments were done for all the participants and included Cy/C, creatinine and uric acid were measured using conventional technique. Creatinine clearance rate was calculated and Estimated glomerular-filtration-rate (eGFR) were measured. Echocardiographic assessment of ejection fraction was done with a cut-off-point <40 LVEF% designated for LV systolic dysfunction. Angiographic evaluation involved in this study depending on the severity of stenosed coronaries by calculating number of arteries display not less than 1 critical stenosis (designed as >70% decrease in caliber). Results: Ejection fraction was significantly lower in in ACS patients than control group (p<0.05). Serum Cy/C was significantly higher in patients' group. The mean plasma uric acids values were significantly higher in patients' group (p-0.001) but with no significant differences in creatinine and creatinine clearance (p>0.05) observed between groups. The eGFR were significantly lower in ACS people compared to healthy persons. Correlation studies of Cy/C showed positive correlation with serum creatinine and serum uric acid; as well as non-significant negative correlation with eGFR (p>0.05). Conclusion: Besides the role of Cy/C in early detection of renal dysfunction, it could have a role in diagnosis of ACS and evaluation of LV systolic dysfunction. Nevertheless, this study showed Cy/C was not related to the number of coronary arteries affected.

Correlation of N-terminal fragments of Atrial Natriuretic Neuropeptides (NT-ProANP) with Left Ventricle Ejection Fraction in Cases with Acute Myocardial Infarction

“…Still, assessing troponin-I in the blood remains the "goldstandard" laboratory test to diagnose acute myocardial infarction [8,9]. This is because troponin-I is exclusively expressed in cardiomyocytes making it highly specific and sensitive to cardiac necrosis [8][9][10] The "atrial natriuretic peptide" (ANP) is a peptide neurohormone secreted from the left atrium, although it can be produced from the ventricular cells under certain conditions too. ANP is produced initially as a preprohormone precursor "pre-proANP" [11], and then modified to prohormone (proANP), which is deposited in specific granules of atriomyocytes and finally cleaved into the "98 amino-acid N-terminal fragments (NT-ProANP) and the 28 amino-acid active ANP neurohormone".…”