The Biochemical Markers Associated with the Occurrence of Coronary Spasm

Li, Liang; Jin, Yongping; Xia, Shujun; Feng, Chao

doi:10.1155/2019/4834202

Cited by 4 publications

(9 citation statements)

References 94 publications

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“…We collected clinical serum samples from 2 groups of subjects categorized as the CAS patients ( n = 25) and the non-CAS patients ( n = 49). Since the gold standard for the definite diagnosis of CAS-intracoronary provocation tests with the aid of coronary angiograph [ 26 ] was not commonly recommended in Western countries and in China for safety concerns [ 47 , 48 ], we modified the inclusion criteria for the CAS group with a comprehensive assessment of clinical symptoms, ECG changes, circadian patterns, and their responses to calcium channel blockers (CCBs). Patients with normal coronary arteries but manifesting recurrent resting chest pains and ECG ST-segment elevation, these patients were considered to be affected by spasms if the clinical scenario was consistent with the characteristics of CAS [ 49 ].…”

Section: Methodsmentioning

confidence: 99%

Serum SELENBP1 and VCL Are Effective Biomarkers for Clinical and Forensic Diagnosis of Coronary Artery Spasm

Lin

Zhao

et al. 2022

IJMS

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Coronary artery spasm (CAS) plays an important role in the pathogenesis of many ischemic heart entities; however, there are no established diagnostic biomarkers for CAS in clinical and forensic settings. This present study aimed to identify such serum biomarkers by establishing a rabbit CAS provocation model and integrating quantitative serum proteomics, parallel reaction monitoring/mass spectrometry-based targeted proteomics, and partial least-squares discriminant analysis (PLS-DA). Our results suggested that SELENBP1 and VCL were potential candidate biomarkers for CAS. In independent clinical samples, SELENBP1 and VCL were validated to be significantly lower in serum but not blood cells from CAS patients, with the reasons for this possibly due to the decreased secretion from cardiomyocytes. The areas under the curve of the receiver operating characteristics (ROC) analysis were 0.9384 for SELENBP1 and 0.9180 for VCL when diagnosing CAS. The CAS risk decreased by 32.3% and 53.6% for every 10 unit increases in the serum SELENBP1 and VCL, respectively. In forensic samples, serum SELENBP1 alone diagnosed CAS-induced deaths at a sensitivity of 100.0% and specificity of 72.73%, and its combination with VCL yielded a diagnostic specificity of 100.0%, which was superior to the traditional biomarkers of cTnI and CK-MB. Therefore, serum SELENBP1 and VCL could be effective biomarkers for both the clinical and forensic diagnosis of CAS.

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Section: Methodsmentioning

confidence: 99%

Serum SELENBP1 and VCL Are Effective Biomarkers for Clinical and Forensic Diagnosis of Coronary Artery Spasm

Lin

Zhao

et al. 2022

IJMS

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“…Recently, non-invasive biochemical markers have been found to associate with the occurrence of CAS [ 141 ], including inflammatory factors, Lipoprotein a, Cystatin C, 5-HT, and ET-1 etc. (Table 2 , Ref.…”

Section: Novel Diagnostic Approachesmentioning

confidence: 99%

Coronary Artery Spasm: Risk Factors, Pathophysiological Mechanisms and Novel Diagnostic Approaches

Lin¹,

Lin²,

Xin³

et al. 2022

Rev. Cardiovasc. Med.

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Coronary artery spasm (CAS) is a transient reversible subtotal or complete occlusion induced by coronary hypercontraction and the critical cause of myocardial ischaemia with non-obstructive coronary arteries. During the past decades, our knowledge of the risk factors and pathophysiological mechanisms of CAS have been increasingly progressed, and various diagnostic approaches, including imaging technologies and novel biomarkers, have been proposed to serve well to diagnose CAS clinically. This review aims to summarize these research progresses on the risk factors of CAS and introduce current knowledge about the mechanisms accounting for CAS, including endothelial dysfunction, vascular smooth muscle cell hyperreactivity, and adventitial and perivascular adipose tissue inflammation. We also gathered the recently evolved diagnostic approaches and analyzed their advantages/disadvantages, in purpose of enhancing the diagnostic yield on the basis of ensuring accuracy.

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“…Recent studies have explored the use of biomarkers via blood test as a possible component in the workup for CAVS. One study explored a number of biomarkers including: (1) Inflammatory markers including C-reactive proteins (CRP), cytokines, lipoprotein (a), and cystatin-C as precipitating factors; (2) Vasoconstrictors including rho-kinase, serotonin (5-hydroxytryptamine), and endothelin-1 (ET-1); and (3) Oxidative stressors including thioredoxin and nitrotyrosine[ 32 ].…”

Section: Diagnosticsmentioning

confidence: 99%

“…Previous studies have stipulated that increased testing and sensitivity of provocative testing can enhance detection of CAVS worldwide (especially Western countries), but this must be weighed against the risks associated with such testing[ 14 , 32 ]. Notably, rapid administration of intracoronary nitrate following provocative testing has resulted in no reported procedure-related deaths[ 13 ].…”

Section: Diagnosticsmentioning

confidence: 99%

See 1 more Smart Citation

Coronary vasospasm: A narrative review

Jewulski¹,

Khanal²,

Dahal³

2021

WJC

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Coronary artery vasospasm (CAVS) plays an important role in acute chest pain syndrome caused by transient and partial or complete occlusion of the coronary arteries. Pathophysiology of the disease remains incompletely understood, with autonomic and endothelial dysfunction thought to play an important role. Due to the dynamic nature of the disease, its exact prevalence is not entirely clear but is found to be more prevalent in East Asian and female population. Cigarette smoking remains a prominent risk factor, although CAVS does not follow traditional coronary artery disease risk factors. Many triggers continue to be identified, with recent findings identifying chemotherapeutics, allergens, and inflammatory mediators as playing some role in the exacerbation of CAVS. Provocative testing with direct visualization is currently the gold-standard for diagnosis, but non-invasive tests, including the use of biomarkers, are being increasingly studied to aid in the diagnosis. Treatment of the CAVS is an area of active research. Apart from risk factor modification, calcium channel blockers are currently the first line treatment, with nitrates playing an important adjunct role. High-risk patients with life-threatening complications should be considered for implantable cardioverter defibrillator (ICD), although timing criteria for escalated therapy require further investigation. The role of pharmaceuticals targeting oxidative stress remains incompletely understood.

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The Biochemical Markers Associated with the Occurrence of Coronary Spasm

Cited by 4 publications

References 94 publications

Serum SELENBP1 and VCL Are Effective Biomarkers for Clinical and Forensic Diagnosis of Coronary Artery Spasm

Serum SELENBP1 and VCL Are Effective Biomarkers for Clinical and Forensic Diagnosis of Coronary Artery Spasm

Coronary Artery Spasm: Risk Factors, Pathophysiological Mechanisms and Novel Diagnostic Approaches

Coronary vasospasm: A narrative review

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