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Evaluation of C-Reactive Protein, Fibrinogen and Antithrombin-III As

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Evaluation of C-Reactive Protein, Fibrinogen and Antithrombin-III As yriginl ertiles ivlution of gEetive roteinD pirinogen nd entithrominEsss s isk ptors for goronry ertery hisese uksel gvusoglu whD fulent qorenek whD eref elpsoy whD ehmet nlir whD xemi et wh nd filgin imurlp wh heprtment of grdiologyD ysmngzi niversityD iskisehirD urkey uey wordsX gEretive proteinD firinogenD ntithrominEsssD oronry rtery disese ipidemiologil studies hve shown signifint ssoition por iditoril see pge QT etween severl risk ftorsD suh s smokingD hypertensionD dyslipidemiD dietes mellitusD nd the pthogenesis of oronry theroslerosisF gurrentlyD severl new risk ftors ± estrt nmely elevted levels of lipoprotein@AD homoysteinemiD fkgroundX snflmmtion is n importnt feture of elevted levels of plsminogen tivtor inhiitorD exessive therosleroti lesions nd inresed prodution of the uteE iron lod in the odyD n imlne etween oxidnt nd phse retntF he ontriution of ogultion ftor to the ntioxidnt speiesD nd ngiotensinEonverting enzyme polyE development of oronry rtery disese hs not yet een morphism ± re eing desried in theroslerosis I±TF lerly estlishedF purthermoreD experimentl nd linil studies hve provided yjetivesX o test whether gEretive proteinD firinogen evidene for the presene of ongoing inflmmtion in theroE nd ntithrominEsss re ssoited with ngiogrphi gehD slerosis UDVF sn dditionD new dt suggest tht terilD history of myordil infrtion nd extensive therosleroti prsiti or virl infetion my initite the inflmmtory involvementF proess WF wethodsX flood smples were tested for gD firinogen nd eEsss levels from PIW individuls undergoing oronry gEretive protein nd firinogen re esily mesurle nd ngiogrphyF highly sensitive uteEphse retnts tht re synthesized in esultsX g ws higher in ptients with geh response to proEinflmmtory ytokinesD suh s interleukinETD @HFWSCIFQID naIVHD vsF HFQWCHFTI mgGdlD naQWD whih is the mjor determinnt of uteEphse protein produE `HFHHHIA nd in those with history of ws @IFHUCIFTRD tion IHF snresed onentrtions of g pper to e naWTD vsF HFTSCHFUP mgGdlD naVRD `HFHSA thn in ontrol preditive of higher risk for oronry events in ptients with sujetsF he ptients who developed unstle ngin hd stle nd unstle nginD s well s in symptomti ptients higher g levels thn the ptients with stle geh t risk for oronry rtery disese IIDIPF st hs een suggested @PFHUCPFQVD naUD vsF HFVHCIFIQ mgGdlD naIUQD `HFHHIAF tht firinogenD whih plys pivotl role in the ogultion pirinogen ws signifintly higher in ptients with geh thn in sdeD is n independent rdiovsulr risk ftor IQF those without geh @PWVCIHV vsF PSVCTQ mgGdlD `HFHIAF sn woreoverD ntithrominEsssD whih is n inhiitor of thromin ptients with gehD men eEsss vlue ws less thn in ptients nd of ftor D my hve n importnt etiologi role in the without gehD ut this differene ws not sttistilly signifint prognosis of ptients with ngin petoris IRF hereforeD in @aHFHVAF xo differene ws found in gD firinogen nd eE this study we investigted the vlue of serum levels of gD sss vlues mong the ptients with singleD doule or triple firinogen nd eEsss in ptients with stle ngin undergoing vessel diseseF oronry ngiogrphyF gonlusionsX g is elevted in ptients with geh nd history of wsF ilevted levels of g t the time of hospitl wethods dmission is preditive vlue for future ishemi eventsF tient popultion here is n ssoition etween higher levels of firinogen nd he study popultion onsisted of PIW onseutive ptients gehF he ssoition of eEsss levels with geh needs testing who hd suspeted or known geh nd were sheduled for in further studiesF oronry ngiogrphy le IF o support the presene of ishemi hert diseseD ptients must hve met t lest one of swet PHHIYQXIQEIT the following riteriX history of typil myordil ishemiEtype disomfortD eletrordiogrphi hnges @ segment devition or wve inversionD or othA in geh a oronry rtery disese ssoition with ishemi disomfortD previous positive g a gEretive protein exerise testD reversile ishemi t myordil perfusion eEsss a ntithrominEsss imgingD history of previous myordil infrtionD ws a myordil infrtion swe F ol Q F tnury PHHI gD pirinogen nd entithrominEsss in geh IQ t yriginl ertiles le IF glinil nd ngiogrphi hrteritis of study ptients of new resting hest pin ssoited with trnsient igq signs of myordil ishemiF tients @naPIWA xoF 7 ttistil nlysis ege @yrA SV IH wle IRU TU7 he sttistil nlysis ws performed using the ttistil ystemi hypertension IHW RW7 kge for oil ienes softwre @ for indowsAF hietes mellitus QV IU7 gontinuous vriles were ompred using t tests for pired nd ryperholesterolemi PW IQ7 unpired vrilesD s ppropriteF roportions were ompred gigrette smoking WT RQ7 using the hiEsqure testF he vriles re expressed s men pmily history of geh RR PH7 stndrd devitionY vlues `HFHS were onsidered sttistilly revious ws @b Q monthsA WT signifintF enterior SH snferior QI xonE IS esults tients with geh IVH VP7 tient groups ingle vessel disese WR glinil nd ngiogrphi hrteristis re summrized in houle vessel disese RS le IF yf the PIW study sujetsD IVH @VP7A hd evidene of riple vessel disese RI geh rnging from bPH7 to signifint stenoses y oronry tients without geh QW IV7 ngiogrphyF he remining QW ptients whose oronry rteries were judged to e ngiogrphilly smooth were defined previous oronry ngiogrphy showing SH7 stenosis of s eing free of gehF tients with geh nd those without mjor epirdil oronry vesselD previous oronry ngioE geh did not otherwise differ signifintly in rdiovsulr plstyD or oronry rtery ypss grft surgeryF ixlusion risk ftorsF eltogether WT ptients @RQ7A hd hd previous wsF riteri wereX unstle nginD ute ws within Q monthsD here were WR @SP7A ptients with singleEvessel disese mong inflmmtory onditions likely to e ssoited with n uteE the ptients with gehD nd of these ptients TR @TV7A hd left phse response @suh s feverD inresed level of leukoytesD nterior desending diseseD IV @IW7A hd irumflex diseseD hroni infetion nd inflmmtory disesesAD hroni sigE nd IP @IQ7A hd right oronry rtery diseseF nifint heptiD pulmonry or renl disesesD nd neoplsti diseseF et the time of oronry ngiogrphyD ll ptients gD firinogenD eEsss levels in ptients with geh were on orl spirin nd isosoride dinitrteF wen g nd firinogen vlues were signifintly higher in ptients with geh ompred to those without geh flood smpling @`HFHHHI nd `HFHID respetivelyAF ilevted levels of g eripherl lood smples for mesurement of gD firinogen were found to e n importnt risk ftor for gehF sn ptients nd eEsss were tken from n nteuitl vein fter dmission with gehD men eEsss vlue ws less thn in ptients without to hospitlD efore the oronry ngiogrphy nd without ny gehD ut this differene ws not signifint sttistilly intrvenous drug dministrtionF @aHFHVA le PF vortory ssys gD firinogenD eEsss levels in ptients with history gEretive protein nd eEsss were ssyed y n utomted of ws or unstle ngin nephelometri immunossy using fekmn erry instrument sn ptients who hd previous wsD the g vlue ws @fekmn erry QTH systemD gndAF pirinogen ws meE signifintly higher thn in ptients without previous wsD s sured using photoEopti method on the yrgnon ehni shown in pigure I @IFHUCIFTR vsF HFTSCHFUP mgGdlD `HFHSD hurhm goEe instrument @yrgnon ehniD xorth groliE respetivelyAD wheres firinogen nd eEsss vlues were not nD eAF different etween these two sugroups @PWSCIIP vsF PVSCWQ mgGdlD bHFHS nd PUFUICQFSP vsF PUFSRCQFUP mgGdlD bHFHSD goronry ngiogrphy respetivelyAF purthermoreD in the sugroup of ptients with he proedure ws performed using stndrd oronry hest pin ssoited with trnsient igq signs of myordil theters vi the femorl routeF e defined ptient s hving geh if there ws ny ngiogrphi evidene of theroslerosisD le PF vevels of gD firinogenD eEsss in ptients with nd without exluding `PH7 stenoses or ny luminl wll irregulrity of the geh epirdil oronry treeF e ptient ws defined s eing free of tients vlue tients geh if ll oronry rteries were judged to e ngiogrphilly with geh without geh smoothF ell ptients were oserved for RV hours fter the g @mgGdlA HFWSCIFQI HFQWCHFTI `HFHHHI oronry ngiogrphyD efore hospitl dishrgeF sn the period pirinogen @mgGdlA PWVCIHV PSVCTQ `HFHI etween oronry ngiogrphy nd hospitl dishrgeD ptient eEsss @mgGdlA PUFQWCQFTP PVFRUCQFRV a HFHV ws onsidered to hve unstle ngin if there ws reurrene IR F gvusoglu et lF swe F ol Q F tnury PHHI t yriginl ertiles le QF vevels of gD firinogenD eEsss in ptients with single vessel disese onsidering lesion loliztion veh disese g disese ge disese g @mgGdlA IFIICIFVQ HFSPCHFSIB HFSPCHFSIB pirinogen @mgGdlA PVVCIHH QHVCIIW QIVCIQR eEsss @mgGdlA PTFWHCQFUI PVFQRCQFUT PWFRPCQFUR B `HFHS vsF g level of vehF not with history of ws nd future unstle nginF here ws weker positive reltion with deresed levels of eEsss nd geh @aHFHVAD nd no reltion with eEsss levels nd history of wsD nor future unstle nginF snflmmtion is n importnt feture of therosleroti lesions nd inresed prodution of the uteEphse retntsF huring the therosleroti proess the presene of lol pigure IF wen levels of g in ptients without previous ws nd inflmmtory response with monoytesD mrophges nd with previous wsF `HFHSF lymphoytes in the rteril wll hs een inresingly reogE nized nd doumented VDISF elese of key ytokinesD suh s interleukinETD result in stimultion of hepti prodution of ishemi efore dishrge @U ptientsAD g ws found to e uteEphse retnts ITF husD uteEphse retnts hve signifintly higher thn in ptients without ny evidene of een proposed s potentil inditor of underlying theroE ishemi @PFHUCPFQV vsF HFVHCIFIQ mgGdlD `HFHHID respeE sleroti diseseF gEretive protein nd firinogen re highly tivelyAF here ws no differene etween these two sugroups sensitive
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