calca-protein--human and Angina--Unstable

Available evidence on the prognostic role of procalcitonin levels in acute coronary syndromes (ACS) is so far controversial.. To evaluate the association between procalcitonin, major cardiovascular events (MACE) and total mortality in acute coronary syndromes.. Procalcitonin levels were measured in 247 patients admitted to our Intensive Cardiac Care Unit (ICCU) with ACS. Three subgroups were considered according to procalcitonin levels.. At Cox regression analysis, procalcitonin levels were both an unadjusted and an adjusted predictor (corrected for diagnosis and TnI) of intra-ICCU mortality and of 1-year follow-up MACE and total mortality.. In ACS, admission procalcitonin values identify a "higher risk" group of patients for short and long-term mortality.

Topics: Acute Coronary Syndrome; Aged; Aged, 80 and over; Angina, Unstable; Biomarkers; Calcitonin; Calcitonin Gene-Related Peptide; Diagnostic Tests, Routine; Female; Follow-Up Studies; Humans; Intensive Care Units; Italy; Male; Middle Aged; Patient Admission; Pilot Projects; Prognosis; Protein Precursors; Regression Analysis; Retrospective Studies; Risk Factors; Severity of Illness Index; Shock, Cardiogenic; Troponin I

Procalcitonin (PCT) is known to be a biological diagnostic marker for severe sepsis, or septic shock in critically ill patients. There are still contrasting data about a role of procalcitonin in patients with acute myocardial infarction or cardiogenic shock, and in those with acute coronary syndromes, that is, non-ST-elevation myocardial infarction or unstable angina. We evaluated plasma levels of procalcitonin and C-reactive protein (CRP) in 52 patients admitted to our intensive cardiac care unit (ICCU): 14 patients with cardiogenic shock (CS) following ST-elevation myocardial infarction (STEMI), 15 patients with uncomplicated ST-elevation myocardial infarction (STEMI), and 24 with non-ST-elevation myocardial infarction or unstable angina (NSTEMI/UA). In all patients, infective processes were excluded. Procalcitonin values were significantly higher in CS patients with respect to the other two subgroups (P < 0.001, P < 0.001) while CRP levels were higher than NSTEMI/UA patients (P < 0.001) but not with respect to STEMI patients (P = 0.063). No correlations were found in cardiogenic shock patients between CRP and PCT values (R = 0.02; P = 0.762, ns). Procalcitonin levels measured on ICCU admission are significantly higher in patients with cardiogenic shock following the acute myocardial infarction, and they are not correlated with those of CRP. The degree of myocardial ischemia (clinically indicated by the whole spectrum of ACS, from unstable angina to cardiogenic shock ST-elevation following myocardial infarction) and the related inflammatory-induced response are better reflected by CRP (which was positive in most acute cardiac care patients of all our subgroups), than by PCT which seems more reflective of a higher degree of inflammatory activation, being positive only in all CS patients.

Topics: Acute Coronary Syndrome; Aged; Aged, 80 and over; Angina, Unstable; Biomarkers; C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Female; Humans; Inflammation; Intensive Care Units; Italy; Male; Middle Aged; Myocardial Infarction; Protein Precursors; Shock, Cardiogenic

The aim of this study is to determine the relation of high-sensitive serum C-reactive protein (hsCRP) and procalcitonin with presence and severity of coronary artery disease and early prognosis in patients with acute coronary syndrome (ACS).. Procalcitonin and hsCRP levels were measured at admission and after 48 hours in 50 patients (41 men, 9 women) with ACS. The patients were assigned to three groups according to their clinical diagnosis: unstable angina pectoris (UAP) (Braunwald III-B), non-ST-segment elevation myocardial infarction (NSTEMI) and ST-segment elevation myocardial infarction (STEMI). Incidences of adverse cardiac events were recorded in a 3-month follow-up. Coronary angiography was performed to evaluate presence and severity of coronary artery disease. In the groups of STEMI, NSTEMI and UAP, procalcitonin (P = 0.01 3, P = 0.045 and P = 0.000 1, respectively) and hsCRP (P = 0.000 1, P = 0.01 and P = 0.00 1, respectively) levels were significantly increased. No significant correlation was found between these markers and the presence and severity of coronary artery disease. There was no correlation between procalcitonin and hsCRP levels at admission and after 48 hours and primary end points after 3 months except in the group of UAP with revascularization procedure. In the group of UAP, hsCRP levels at 48 hours were found higher in the patients with a revascularization procedure (P = 0.04).. In conclusion, levels of hsCRP and procalcitonin are increased in patients with ACS but failed to correlate with severity of coronary disease and early prognosis.

Topics: Acute Disease; Adult; Aged; Analysis of Variance; Angina, Unstable; Angioplasty, Balloon, Coronary; C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Coronary Angiography; Coronary Artery Bypass; Coronary Artery Disease; Creatine Kinase, MB Form; Female; Follow-Up Studies; Humans; Inflammation Mediators; Male; Middle Aged; Myocardial Infarction; Prognosis; Protein Precursors; Research Design; Severity of Illness Index; Syndrome; Treatment Outcome; Troponin I; Turkey