The relationship between neopterin levels and cardiac troponinin patients with non-ST segment elevation acute coronary syndromes [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2007; 35(4): 209-215

The relationship between neopterin levels and cardiac troponinin patients with non-ST segment elevation acute coronary syndromes

Mustafa Yazıcı, Kenan Durna, Sabri Demircan, Okan Gülel, Mahmut Şahin
Ondokuz Mayis University Medical Faculty, Department of Cardiology, Samsun, Turkey


OBJECTIVES
We examined the relationship between neopterin level, a locally and specific marker of inflammation, and cardiac troponin release in patients with non-ST elevation acute coronary syndromes (NSTE-ACS).

STUDY DESIGN
The study included 234 patients with NSTE-ACS and angiographically documented coronary artery disease. Serum levels of neopterin and cardiac troponin-I (cTn-I) were measured on admission. The patients were analyzed in two groups: 137 patients were cTn-I negative (<0.2 ng/ml), 97 patients were cTn-I positive (≥0.2 ng/ml). The presence of thrombus, lesion morphology, and TIMI flow were examined by coronary angiography.

RESULTS
The two groups did not differ significantly with regard to the localization of culprit lesions and lesion morphology. The presence of TIMI ≤2 flow was significantly higher in cTn-I positive patients (p<0.001). The rates of visible thrombi during coronary angiography were 24.7% and 7.3% in cTn-I positive and negative patients, respectively (p=0.012). Serum neopterin levels were higher in cTn-I positive patients (p<0.001) and were correlated with cTn-I levels (r=0.817, p<0.001). In logistic regression analysis, neopterin was found as the only independent factor affecting cTn-I positivity (Odds ratio=1.4; p<0.001). ROC analysis showed 12.55 nmol as the optimal cutoff for neopterin level. The rates of sensitivity, specificity, positive predictive value, and negative predictive value for neopterin in distinguishing cTn-I positive and negative patients were 65.9%, 64.2%, 56.2%, and 72.1%, respectively.

CONCLUSION
Our results demonstrate that higher cTn-I levels may be related with neopterin levels, which reflect local inflammatory activity in patients with NSTE-ACS.

Keywords: Angina, unstable, coronary angiography, coronary disease; coronary thrombosis; neopterin/blood; troponin I/blood

How to cite this article
Mustafa Yazıcı, Kenan Durna, Sabri Demircan, Okan Gülel, Mahmut Şahin. The relationship between neopterin levels and cardiac troponinin patients with non-ST segment elevation acute coronary syndromes. Turk Kardiyol Dern Ars. 2007; 35(4): 209-215

Corresponding Author: Mustafa Yazıcı, Türkiye
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