Significance of neutrophilic CD64 as an early marker for detection of neonatal sepsis and prediction of disease outcome.

BACKGROUND: Neonatal sepsis (NS) is a global health problem owing to its significant contribution to morbidity and mortality. We evaluated the significance of neutrophilic CD64 (nCD64) expression as an early marker for diagnosis of NS compared to CRP and assessed its relation to disease outcome. METHODS: High sensitivity CRP (hs-CRP) and nCD64 were measured in 60 neonates with symptoms and signs of sepsis (40% were culture-proved) and 30 age- and sex-matched controls. RESULTS: Baseline hs-CRP and nCD64% were significantly higher among septic neonates compared with the controls (p < 0.05), while, no significant difference was found between the two septic groups (p > 0.05). nCD64 cutoff value > 34.1% was able to discriminate septic neonates from controls with higher sensitivity and specificity than hs-CRP. The mortality rate was 21.7% among septic neonates. Baseline nCD64% was significantly higher among died patients compared with recovered neonates (p = 0.009) while no significant difference was found between baseline hs-CRP and disease outcome (p = 0.117). CONCLUSION: Flow cytometric assessment of nCD64 was able to discriminate neonates with sepsis from controls with higher accuracy than hs-CRP; however, the combination of both nCD64% and hs-CRP enhances the ability to diagnose NS. Quantitative measurement of nCD64 can predict disease outcome in NS.

Clinical Relevance of matrix metalloproteinase 9 in patients with acute coronary syndrome.

We measured levels of matrix metalloproteinase 9 (MMP-9) as a potential risk factor in 75 patients with acute coronary syndrome (ACS) compared to 25 patients with stable angina (SA) and 20 healthy participants. Patients were studied stressing on smoking, hypertension, diabetes, lipid profile, cardiac enzymes, MMP-9, and electrocardiography. Patients with ACS had higher MMP-9 levels than the SA group. The highest MMP-9 levels were found among ST-elevated myocardial infarction (MI), while the lowest levels were found among the control group. The MMP-9 level was significantly higher among patients with ACS having poor disease outcome (recurrent ischemic attacks, congestive heart failure, or death). The MMP-9 cutoff value of 3100 pg/mL was able to discriminate MI from unstable angina (UA), while the best prognostic utility was established at 4700 pg/mL. We suggest that serum MMP-9 could be an early marker that discriminates MI from UA and predicts poor outcome in terms of disease severity and extent of disease complications.