The Relationship between Cardiac Fatty Acid Binding Protein and Acute Coronary Syndrome Risk Scores

Yıl 2020, Cilt 5, Sayı 1, 165 - 175, 31.03.2020

Uğur KÜÇÜK Burak ALTUN Hakan TÜRKÖN

https://doi.org/10.26453/otjhs.566720

Öz

Objective: Heart type fatty acid binding protein (H-FABP) is a low moleculer weight major cytoplasmic protein and released quickly from cardiomyocytes in response to myocardial injury. We searched functionality of H-FABP in diagnosis of acute coronary syndrome (ACS) and prevalence of coronary artery disease, relationship with its severity and early diagnosis.

Materials and Methods: This was a prospective observational study. We took in 110 patients- aged 18 and above-diagnosed ACS between the dates February 2016 and January 2017. The patient population was divided into two groups as ST segment elevation ACS (STEMI, 52 patients) and Non-ST segment elevation ACS (NSTE-ACS, 58 patients). For H-FABP and cardiac troponin I (cTnI) blood samples of the patients were taken both when they first applied to the hospital and six hours later. Coronary angiography was performed to all the patients. 

Results: On admission, it wasn’t found a statistically significant relationship in both groups, GRACE (Global Registry of Acute Coronary Events), SYNTAX (The synergy between percutaneous coronary intervention with taxus and cardiac surgery) and between Gensini Risk skores (p=0.056, p=0.791, p=0.278). The H-FABP level of blood samples looked over six hours later with GRACE and Gensini risk scores were statistically significant in the H-FABP positive group (p=0.003, p=0.011). However SYNTAX risk score in H-FABP positive group was not statistically significant (p=0.984).

Conclusion: In our study, we demonstrated the relationship between H-FABP and coronary artery disease risk scores and that H-FABP can be used in the diagnosis of ACS.

Anahtar Kelimeler

Heart-type fatty acid binding protein, acute coronary syndrome, cardiac biomarker, inflammation, , atherosclerosis

Kalp Tipi Yağ Asid Bağlayıcı Proteinin Akut Koroner Sendrom Risk Skorları ile İlişkisi

Öz

Amaç: Kalp tipi yağ asid bağlayıcı protein (H-FABP) düşük moleküler ağırlıklı majör sitoplazmik bir proteindir ve miyokard yaralanmasına cevap olarak hızlı bir şekilde kardiyomiyositlerden salınır. H-FABP'ın akut koroner sendrom (ACS) tanısında kullanılabilirliğini ve koroner arter hastalığının (KAH) prevalansı, şiddeti ve erken teşhisi ile olan ilişkisini araştırdık.
Materyal ve Metod: Bu prospektif gözlemsel çalışmamıza, kliniğimize Şubat 2016 ile Ocak 2017 tarihleri arasında başvuran 18 yaş ve üstü AKS tanılı 110 hasta dahil ettik.Hastaları iki gruba ayırdık: ST yükselmeli olmayan AKS (NSTE-AKS) ve ST yükselmeli AKS (STEMI).H-FABP ve kardiyak troponin I (cTnI) için hastalardan ilk hastaneye başvuru anında ve 6 saat sonra tekrar kan örnekleri alındı. Tüm hastalara koroner anjiografi yapıldı.
Bulgular: Başvuru anında, her iki grupta GRACE (Global Registry of Acute Coronary Events), SYNTAX (The synergy between percutaneous coronary intervention with taxus and cardiac surgery) ve Gensini risk skorları arasında istatistiksel olarak anlamlı bir ilişki bulunmadı (p=0,056, p=0,791, p=0,278). Altıncı saatte bakılan H-FABP düzeyi ile GRACE ve Gensini risk skorları H-FABP pozitif grupta istatistiksel olarak anlamlıydı (p=0,003, p=0,011). Ancak, SYNTAX risk skoru H-FABP pozitif grupta istatistiksel olarak anlamlı değildi (p=0,984).
Sonuç: Çalışmamızda H-FABP ile koroner arter hastalığı risk skorları arasındaki ilişkiyi ve H-FABP'ın AKS tanılı hastalarda tanısında kullanılabileceğini gösterdik.

Anahtar Kelimeler

Kalp tipi yağ asidi bağlayıcı protein, akut koroner sendrom, kardiyak biyobelirteç, inflamasyon, ateroskleroz

Kaynakça

• 1. Van Domburg RT, Miltenburg-van Zijl AJ, Veerhoek RJ, et al. Unstable angina: good long-term outcome after a complicated early course. J Am Coll Cardiol. 1998;31:1534–9.
• 2. Thygesen K, Alpert JS, White HD. Universal definition of myocardial infarction. Eur Heart J. 2007;28:2525-38.
• 3. Cohen M, Antman EM, Murphy SA, et al. Mode and timing of treatment fail-ure (recurrent ischemic events) after hospital admission for non- ST segment elevation acute coronary syndromes. Am Heart J. 2002;143:63–9.
• 4. Jaffe AS, Babuin L, Apple FS. Biomarkers in acute cardiac disease. J Am Coll Cardiol. 2006;48:1–11.
• 5. Hamm CW, Katus HA. New biochemical markers for myocardial cell injury. Curr Opin Cardiol. 1995;10:355-60.
• 6. Glatz JF, van Bilsen M, Paulussen RJ, et al. Release of fatty acid-binding protein from isolated rat heart subjected to ischemia and reperfusion or to the calcium paradox. Biochim Biophys Acta. 1988;961:148-52.
• 7. Offner GD, Brecher P, Sawlivich WB, et al. Characterization and amino acid sequence of a fatty acid binding protein from human heart. Biochem J. 1998;252:191-8.
• 8. Lindholm D, James SK, Bertilsson M, et al. Biomarkers and Coronary Lesions Predict Outcomes after Revascularization in Non-ST-Elevation Acute Coronary Syndrome. Clin Chem. 2017;63:573-84.
• 9. Bawamia, B, Mehran, R, Qiu, W. Risk scores in acute coronary syndrome and percutaneous coronary intervention: a review. Am Heart J. 2013;165:441–50.
• 10. Tanboga IH, Ekinci M, Isik T, et al. Reproducibility of syntax score: from core lab to real world. J Interv Cardiol. 2011;24:302-6.
• 11. Fox KA, Dabbous OH, GoldbERG RJ, et al. Prediction of risk of death and myocardial infarction in the six months after presentation with acute coronary syndrome: prospective multinational observational study (GRACE). BMJ. 2006;333:1091.
• 12. Serruys PW, Onuma Y, Garg S, et al. Assessment of the SYNTAX score in the Syntax study. Euro Intervention. 2009;5:50-56.
• 13. Nurkalem Z, Hasdemir H, Ergelen M, et al. The relationship between glucose tolerance and severityof coronary artery disease using the Gensini score. Angiology. 2010;61:751–5.
• 14. Widera C, Pencina MJ, Meisner A, et al. Adjustment of the GRACE score by growth differentia-tion factor 15 enables a more accurate appreciation of risk in non-ST-elevationacute coronary syndrome. Eur Heart J. 2012;33:1095–104.
• 15. Lloyd-Jones D, Adams RJ, Brown TM, et al. Executive summary: heart disease and stroke statistics--2010 update: a report from the American Heart Association. Circulation. 2010;121:480-86.
• 16. Dong C, Crawford LE, Goldschmidt-Clermon PJ. Endothelial progenitor obsolescense and atherosckerotic inflammation. J Am Coll Cardiol. 2005;45:1458-60.
• 17. Hagensen MK, Shim J, Thim T, et al. Circulating endothelial progenitor cells do not contribute to plaque endothelium in murine atherosclerosis. Circulation. 2010;121:898-905.
• 18. Libby P, Shi GP. Mast cells as mediators and modulators of atherogenesis. Circulation. 2007;115:2471-3.
• 19. Granger CB, Goldberg RJ, Dabbous O, et al. Predictors of hospital mortality in the global registry of acute coronary events. Arch Intern Med. 2003;163:2345-53.
• 20. Nurkalem Z, Hasdemir H, Ergelen M, et al. The relationship between glucose tolerance and severity of coronary artery disease using the Gensini score. Angiology. 2010;61:751–5.
• 21. McManus DD, Gore J, Yarzebski J, et al. Recent trends in the incidence, treatment, and outcomes of patients with STEMI and NSTEMI. Am J Med. 2011;124:40-7
• 22. Şevki Hakan EREN, Kerim YILMAZ, İlhan KORKMAZ, ve ark. Acil Serviste Akut Miyokard Enfarktüsü Tanısı Almış Hastalarda Trombolitik Tedavi Uygulanmasını Etkileyen Faktörler Fırat Tıp Dergisi. 2006;11:163-5
• 23. Mehta SR, Grange6r CB, Boden WE, et al. Early versus delayed invasive intervention in acute coro-nary syndromes. N Engl J Med. 2009;360:2165–75.
• 24. Huang G, Zhao JL, Du H, et al. Coronary score adds prognostic information for patients with acute coronary syndrome. Circ J. 2010;74:490-5.
• 25. Cakar MA, Sahinkus S, Aydin E, et al. Relation between the GRACE score and severity of atherosclerosis in acute coronary syndrome Journal of Cardiology. 2014;63:24–8.
• 26. Umut Cavus, Figen Coskun, Bunyamin Yavuz, et al. Heart-type, fatty-acid binding protein can be a diagnostic marker in acute coronary syndromes. J Natl Med Assoc. 2006;98:1067–1070.
• 27. Valle HA, Riesgo LG, Bel MS, et al. Clinical assessment of heart-type fatty acid binding protein in early diagnosis of acute coronary syndrome. Eur J Emerg Med 2008;15:140-4.
• 28. Inoue K, Suwa S, Ohta H, et al. Heart Fatty Acid-Binding Protein Offers Similar Diagnostic Performance to High-Sensitivity Troponin T in Emergency Room Patients Presenting With Chest Pain. Circ J. 2011;75:2813-20.
• 29. Ruzgar O, Bilge AK, Bugra Z, et al. The use of human heart-type fatty acid-binding protein as an early diagnostic biochemical marker of myocardial necrosis in patients with acute coronary syndrome, and its comparison with troponin-T and creatine kinase-myocardial band. Heart Vessels. 2006;21:309-14.
• 30. Gururajan P, Gurumurthy P, Nayar P, et al. Heart fatty acid binding protein (HFABP) as a diagnostic biomarker in patients with acute coronary syndrome. Heart Lung Circ. 2010;19:660-4.