Investigation of the cellular and soluble markers of inflammation for the assessment of cardiovascular risk in patients with acute coronary syndrome in Bangladesh

Choudhury, Talita Zahin; Kamruzzaman, Mohammad; Islam, Laila N.

doi:10.1504/ijeh.2019.108564

Cited by 5 publications

(15 citation statements)

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“…Recent research has found IMA to be an ideal biomarker for ischemia [ 8 ], which has been described as a sensitive biomarker for identifying ACS in patients presenting with acute chest pain [ 30 ] and thus, a possible diagnostic tool. In the present study, a significantly higher IMA was recorded in ACS cases, which was consistent with previous findings [ 20 , 31 ]. The present study found an IMA level greater than 1.74 U/mL has a diagnostic sensitivity and specificity of 83.0 and 71.2%, respectively and may be used as a reference value upon further validation.…”

Section: Discussionsupporting

confidence: 93%

“…The FAR was calculated from the values obtained by direct measurement of fibrinogen and HSA. The IMA in the serum was determined according to the method of Bar-Or et al [ 7 ] and detailed previously [ 20 ]. Protein oxidation was estimated by measuring the protein carbonyl content of the plasma samples by the method described by Levine et al [ 21 ] and detailed previously [ 22 ].…”

Section: Methodsmentioning

confidence: 99%

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Association of albumin, fibrinogen, and modified proteins with acute coronary syndrome

et al. 2022

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Acute coronary syndrome (ACS) comprises a pathophysiological spectrum of cardiovascular diseases related to atherosclerotic coronary plaque erosion. Oxidative stress and inflammation play pivotal roles in the development and progression of atherosclerosis, which affects circulatory proteins, including albumin and fibrinogen, thereby causing an imbalance in albumin to globulin and fibrinogen to albumin ratios. This study aimed to assess the effect of oxidative stress on circulatory proteins, correlate these parameters, and investigate their significance in patients with ACS. In this case-control study, the major blood proteins in patients with ACS and a control group were evaluated using standard methods. Out of 70 ACS cases, 75.7% had ST-elevation myocardial infarction (STEMI), 18.6% had non-STEMI, and 5.7% had unstable angina. The mean cardiac troponin I level in patients was 12.42 ng/mL. The patients demonstrated a significantly reduced level of human serum albumin (HSA), 3.81 ± 0.99 g/dL, compared to controls, 5.33 ± 0.66 g/dL. The albumin to globulin ratio (AGR) was significantly depressed in patients while their mean fibrinogen level and the fibrinogen to albumin ratio (FAR) were significantly higher. Multivariate logistic regression analysis showed that albumin and fibrinogen were significantly associated with the risk of ACS, showing the potential of these parameters to be used for risk assessment of ACS. The ischemia modified albumin (IMA) and protein carbonyls were significantly higher in patients which showed significant positive correlations with FAR. Albumin, IMA and protein carbonyls were found to have high diagnostic sensitivity and specificity for ACS. Overall, these circulatory and modified proteins in ACS patients, particularly lower HSA, AGR, and higher IMA and protein carbonyls may help assess risk.

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Section: Discussionsupporting

confidence: 93%

Section: Methodsmentioning

confidence: 99%

Association of albumin, fibrinogen, and modified proteins with acute coronary syndrome

et al. 2022

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“…The differential WBC counts further revealed significant associations of decreased eosinophil and lymphocyte counts with ACS, which was consistent with the findings of a recent cohort study showing lower counts of these cells in the general population were associated with the increased short-term incidence of heart failure and coronary death (Shah et al, 2016). Another important finding of this study was a significantly higher neutrophil to lymphocyte ratio in ACS patients compared to the controls, which was consistent with previous findings (Choudhury et al, 2019).…”

Section: Discussionsupporting

confidence: 92%

“…It has been shown that chronic anemia has adverse effects on myocardial and large arterial remodeling and anemia has been marked as a risk factor for CVD (Sarnak et al, 2002). This study found associations of higher leukocyte count and ACS, and increased neutrophils was attributed to the higher count of total WBC among ACS patients, as observed previously (Rana et al, 2007;and Choudhury et al, 2019). The differential WBC counts further revealed significant associations of decreased eosinophil and lymphocyte counts with ACS, which was consistent with the findings of a recent cohort study showing lower counts of these cells in the general population were associated with the increased short-term incidence of heart failure and coronary death (Shah et al, 2016).…”

Section: Discussionsupporting

confidence: 82%

Role of complete blood count, antioxidants, and total antioxidant capacity in the pathophysiology of acute coronary syndrome

Haque¹,

Hafiz²,

Habib³

et al. 2022

African Journal of Biological Sciences

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Acute Coronary Syndrome (ACS) resulting from sudden rupture of arterial plaques with exposure of highly thrombogenic fatty deposits in the coronary arteries is one of the most common causes of mortality worldwide, needs further attention. In this case control study, a total of 138 patients with ACS and 134 non-ACS controls were enrolled. The Red Blood Cell (RBC) count, hemoglobin, and hematocrit were significantly lower in patients. The White Blood Cell (WBC) and platelet counts, and neutrophil to lymphocyte ratio were significantly higher in patients (11.76 ± 2.49 × 10 6 cells/mL, 343.80 ± 113.76 × 10 9 cells/L, and 3.88 ± 2.24, respectively), which strongly indicated inflammatory responses. The serum and RBC lysate reduced glutathione (GSH), antioxidant vitamins -C, D and alpha-tocopherol, total bilirubin, and Total Antioxidant Capacity (TAC) were significantly lower in ACS patients (3.78 ± 1.53 and 384.21 ± 184.86 µmol/L, 0.30 ± 0.22 mg/dL, 49.46 ± 47.11 ng/mL, 2.66 ± 3.67 µg/mL, 0.51 ± 0.27 mg/dL and 533.61 ± 232.47 µmol/L, respectively). Their serum GSH showed significant positive correlation with vitamin C and hemoglobin, and significant negative correlations were found between WBC count and serum GSH, and platelet count with TAC. Neutrophils and platelets play pivotal roles in mediating inflammatory responses, and significant reduction of antioxidants cause increased oxidative stress in patients with ACS, indicating that administration of antioxidant vitamins could reduce oxidative stress and inflammatory conditions.

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“…The 18 selected studies included 32 comparator arms in 1654 ACS patients (mean age 60 years, 60% men) and 1023 healthy controls or subjects with atypical chest pain without ACS (mean age 53 years, 58% men) ( Table 1 ) [ 11 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ]. IMA was measured using automated analysers in two studies [ 24 , 35 ], enzyme-linked immunosorbent assay in one [ 31 ], and the spectrophotometric albumin cobalt binding assay in the remaining 15 [ 11 , 21 , 22 , 23 , 25 , 26 , 27 , 28 , 29 , 30 , 32 , 33 , 34 , 36 , 37 ]. Six comparative arms investigated overall ACS [ 21 , 22 , 25 , 28 , 29 , 34 ], two overall AMI [ 24 , 26 ], seven STEMI [ 11 , 27 , 30 , 31 , 33 , 35 , 36 ], nine NSTEMI [ ...…”

Section: Resultsmentioning

confidence: 99%

Serum Concentrations of Ischaemia-Modified Albumin in Acute Coronary Syndrome: A Systematic Review and Meta-Analysis

Mangoni

Zinellu

2022

JCM

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The identification of novel circulating biomarkers of acute coronary syndrome (ACS) may improve diagnosis and management. We conducted a systematic review and meta-analysis of ischaemia-modified albumin (IMA), an emerging biomarker of ischaemia and oxidative stress, in ACS. We searched PubMed, Web of Science, and Scopus from inception to March 2022, and assessed the risk of bias and certainty of evidence with the Joanna Briggs Institute Critical Appraisal Checklist and GRADE, respectively. In 18 studies (1654 ACS patients and 1023 healthy controls), IMA concentrations were significantly higher in ACS (standard mean difference, SMD = 2.38, 95% CI 1.88 to 2.88; p < 0.001; low certainty of evidence). The effect size was not associated with pre-defined study or patient characteristics, barring the country where the study was conducted. There were no significant differences in effect size between acute myocardial infarction (MI) and unstable angina (UA), and between ST-elevation (STEMI) and non-ST-elevation MI (NSTEMI). However, the effect size was progressively larger in UA (SMD = 1.63), NSTEMI (SMD = 1.91), and STEMI (3.26). Our meta-analysis suggests that IMA might be useful to diagnose ACS. Further studies are warranted to compare the diagnostic performance of IMA vs. established markers, e.g., troponin, and to determine its potential utility in discriminating between UA, NSTEMI, and STEMI (PROSPERO registration number: CRD42021324603).

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Investigation of the cellular and soluble markers of inflammation for the assessment of cardiovascular risk in patients with acute coronary syndrome in Bangladesh

Cited by 5 publications

References 0 publications

Association of albumin, fibrinogen, and modified proteins with acute coronary syndrome

Association of albumin, fibrinogen, and modified proteins with acute coronary syndrome

Role of complete blood count, antioxidants, and total antioxidant capacity in the pathophysiology of acute coronary syndrome

Serum Concentrations of Ischaemia-Modified Albumin in Acute Coronary Syndrome: A Systematic Review and Meta-Analysis

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