Predictive value of fibrinogen-to-albumin ratio in acute coronary syndrome.

BACKGROUND: We aimed to investigate the predictive value of the fibrinogen-to-albumin ratio (FAR) regarding the development of major cardiovascular events (MACE) in patients treated with percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). METHODS: This was a prospective, observational cohort study that included 261 consecutive patients who were treated with PCI. The patients were grouped according to the occurrence of MACE during the follow-up period. RESULTS: During follow-up, MACE occurred in 68 (26%) patients. The FAR was independently predictive of MACE (HR: 1.017, 95% CI: 1.010-1.024, p < 0.001). In addition, left ventricular ejection fraction (LVEF) and a diagnosis of ST-segment elevation myocardial infarction (STEMI) were independent predictors of MACE. The area under the curve (AUC) of the multivariable model, including LVEF and diagnosis of STEMI, was 0.707 (95% CI: 0.631-0.782, p < 0.001). When the FAR was added to the multivariable model, the AUC was 0.770 (95% CI: 0.702-0.838, z = 2.820, difference p = 0.0048). CONCLUSION: The FAR could be used for the prediction of MACE in patients with ACS who have undergone PCI.

Comparision of inflammatory biomarkers for detection of coronary stenosis in patients with stable coronary artery disease.

BACKGROUND: The objective of the current study was to evaluate the role of various inflammatory biomarkers in detection of coronary stenosis in patients with stable coronary artery disease (CAD) and healthy people. METHODS: A total of 111 patients with stable coronary artery disease, and 66 healthy subjects were enrolled in the study. Serum levels of lipoprotein-associated-phospholipase A2 (Lp-PLA2), high-sensitivity C-reactive protein (hs-CRP), and myeloperoxidase (MPO) were measured to compare patient and control groups. RESULTS: Baseline characteristics were similar between healthy and patient groups, with the exception of age. ANCOVA and log-transformed data of inflammatory biomarkers revealed that, Lp-PLA2 (p < 0.001) and hs-CRP (p < 0.05) levels in all patient groups were significantly higher than in the control group. Conversely, there was no significant difference in MPO levels among groups. CONCLUSIONS: In stable CAD patients, serum Lp-PLA2 levels are more compatible than hs-CRP and MPO levels in the detection of coronary stenosis.      

Severity of coronary artery disease and prostate-specific antigen relationship in men.

OBJECTIVE: Prostate-specific antigen (PSA) is a well-known prostate cancer marker. Recent studies have shown that serum PSA levels can fluctuate in response to cardiovascular stress. In this study we aimed to determine if serum PSA levels correlate with the presence and stages of coronary artery disease (CAD) and whether PSA can be used as a marker for the diagnosis and severity of CAD. PATIENTS AND METHODS: This was a retrospective chart review of male patients who underwent coronary angiography for suspected CAD. A total of 100 patients with angiographic data and baseline serum PSA measurements were included. Patients with previous history of coronary angiography, stent implantation, benign prostate hypertrophy, known prostate cancer or prostatitis were excluded. RESULTS: The mean age was 57±10 years. Coronary angiography results were normal in 13%, non-obstructive CAD (non-critical plaque formation) in 16%, one-vessel disease in 21%, two-vessel disease in 30% and multi-vessel disease in 20%. Mean values of total and free serum PSA were 1.4±1.3 ng/mL and 0.4±0.4 ng/mL, respectively. Although there was an increasing trend of PSA with more advanced stages of CAD, no significant relationship was established (p > 0.05). Patients with hypertension had significantly elevated total and free serum PSA compared to normotensives. There is no comparison of PSA levels between patients with CAD and without CAD. CONCLUSIONS: Our study suggests that there is no direct relationship between increasing levels of PSA and stage of CAD. Thus, PSA level does not appear to be a suitable marker for diagnosis or severity of CAD.