The utility of inflammation and platelet biomarkers in patients with acute coronary syndromes

Abstract

IntroductionThrombotic and inflammatory mechanisms are involved in the pathophysiology of acute coronary syndrome (ACS). The aim of the study was the evaluation of inflammation (white blood cells count/WBC, C-reactive protein/CRP, interleukin-6/IL-6) and platelet (platelet count/PLT, mean platelet volume/MPV, large platelet/LPLT, beta-thromboglobulin/β-TG) biomarkers in the groups of ACS patients depending on the severity of signs and symptoms and compared to controls without coronary artery disease.Materials and methodsThe study group included 93 patients categorized into 3 subgroups depending on the severity of signs and symptoms of ACS. PLT, MPV, LPLT, and WBC were determined on hematological analyzer, IL-6 and β-TG were measured using the ELISA method.ResultsIn the whole group of ACS patients WBC, CRP, IL-6, MPV, and β-TG were significantly higher as compared to controls. Analyzing the inflammation and platelet biomarkers depending on the severity of signs and symptoms in comparison to controls, statistically significant differences for above-mentioned parameters were also found. There were no significant differences between the advancement of coronary artery changes and inflammation as well as platelet parameters, except for CRP concentrations. The AUCs for all inflammation parameters tested were similar, however the highest AUCs showed WBC and CRP. Among platelet parameters the highest AUC revealed β-TG.ConclusionMarkers of inflammation and platelet activation may be associated to myocardial ischemia and myocardial injury. WBC, CRP and IL-6 as inflammation parameters and MPV and β-TG as platelet biomarkers may be useful indicators of the presence of coronary artery disease.

Useful Platelet Indices for the Diagnosis and Follow-Up of Patent Ductus Arteriosus

“…Adult studies have shown that high MPV increases thrombosis. 34,35 Studies in adults also showed that increased RDW and RPR are correlated with inflammation. [18][19][20][21]36 The increase in RDW is thought to occur as a result of inflammatory cytokines inhibiting erythrocyte maturation and accelerating the passage of younger and larger reticulocytes into the peripheral circulation.…”

The Biomarkers for Acute Myocardial Infarction and Heart Failure

“…IL-6 expression is shown to be elevated in induced myocardial infarction by transcoronary ablation of septal hypertrophy, suggesting its diagnostic role [75]. Additionally, CRP and IL-6 are both significantly upregulated in acute coronary syndrome [76]. e IL-6 concentration, independent of the already established predictors, is also related to adverse cardiac events [77,78], supporting its potential therapeutic target in unstable ischemic heart disease [78].…”

“…Mean platelet volume (MPV) and beta-thromboglobulin (beta-TG) are two important platelet biomarkers that may increase during platelet activation and have a higher expression in patients with coronary artery diseases [76]. High MPV value also correlates with an increased incidence of long-term adverse events, especially all-cause mortality in NSTEMI patients undergoing PCI [107].…”

Relationship between White Blood Count to Mean Platelet Volume Ratio and Clinical Outcomes and Severity of Coronary Artery Disease in Patients Undergoing Primary Percutaneous Coronary Intervention

“…WBCs play a crucial role in the progression of atherosclerosis and destabilization and rupture of a plaque, leading to thrombotic events. Previous studies have reported increased admission WBC count to be a robust predictor of morbidity and mortality in patients with acute coronary syndrome (ACS) [ 1 , 2 ]. Platelets play a key role in atherothrombosis leading to ACS, and patients with increased platelet activation are at higher risk of cardiovascular events in the setting of ACS.…”