Vascular versus myocardial dysfunction in acute coronary syndrome: Are the adhesion molecules as powerful as NT-proBNP for long-term risk stratification?

Abstract

Objectives-To determine if elevations of adhesion molecules in acute coronary syndrome (ACS) are useful for risk stratification.Design and methods-A cell adhesion array (Randox Ltd.) and NT-proBNP were measured in 216 ACS patients.Results-Kaplan-Meier and Cox models indicate early elevations of NT-proBNP but not the adhesion molecules are predictive of future death/myocardial infarction.Discussion-Elevations of adhesion molecules early after pain onset in ACS are not useful for long-term risk stratification.

PAPP-A as a marker of increased long-term risk in patients with chest pain

“…The use of sensitive troponin assays has helped with better diagnosis [8], but additional biomarkers would be especially useful to identify patients at long-term risk after presentation. A few acute-care markers such as cardiac troponin (cTn), natriuretic peptides and C-reactive protein (CRP), have been shown to have longerterm predictive value in patients with ACS [7,[9][10][11][12][13][14][15][16] but there are additional patients at risk who are not identified, perhaps in part because none of these biomarkers provides information about atherosclerotic plaque instability. A sensitive and specific early biomarker of atherosclerotic plaque instability would assist in risk stratification.…”

Biomarkers of Atherosclerosis and Acute Coronary Syndromes - A Clinical Perspective

“…Several investigators have demonstrated significantly raised soluble Pselectin levels in patients with AMI (77-84), unstable angina (85)(86)(87)(88) and cohorts of patients with any ACS (89,90). However conflicting results have also been reported, with two reports that P-selectin does not help to predict adverse events in patients with ACS and two studies that did not detect any elevation of plasma P-selectin levels in patients with ACS compared with controls (91)(92)(93).…”