Abstract
The “Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines” (CRUSADE) score emerged as a predictor of major bleeding in patients presenting with the acute coronary syndrome. On the other hand, previous studies established the association of dephosphorylated-uncarboxylated Matrix Gla protein (dp-ucMGP) and vitamin K, as well as their subsequent impact on coagulation cascade and bleeding tendency. Therefore, in the present study, we explored if dp-ucMGP plasma levels were associated with CRUSADE bleeding score. In this cross-sectional study, physical examination and clinical data, including plasma dp-ucMGP levels, were obtained from 80 consecutive patients with acute myocardial infarction (AMI). A significant positive correlation was found between CRUSADE bleeding score and both dp-ucMGP plasma levels (r = 0.442, p < 0.001) and risk score of in-hospital mortality (r = 0.520, p < 0.001), respectively. In comparing the three risk groups of risk for in-hospital bleeding, the high/very high-risk group had significantly higher dp-ucMGP levels from both very low/low group (1277 vs. 794 pmol/L, p < 0.001) and the moderate group (1277 vs. 941 pmol/L, p = 0.047). Overall, since higher dp-ucMGP levels were associated with elevated CRUSADE score and prolonged hemostasis parameters, this may suggest that there is a biological link between dp-ucMGP plasma levels and the risk of bleeding in patients who present with AMI.
Highlights
Appearing in various clinical presentations and severity, coronary artery disease (CAD) represents one of the major challenges of 21st century medicine, with acute coronary syndrome (ACS) being one of its most dramatic manifestations [1]
When acute myocardial infarction (AMI) patients were stratified into three groups according to the risk for inhospital major bleeding estimated by the Can Rapid risk ternational ratio (CRUSADE) score and were compared concerning the plasma dp-ucMGP levels, no significant differences were observed between very low/low and moderate group (794 vs. 941 pmol/L, p = 0.430)
prothrombin time (PT)-international normalized ratio (INR)), as well as validated scoring system esmating the risk of in-hospital major bleeding (CRUSADE score) were significantly higher timating the risk of in-hospital major bleeding (CRUSADE score) were significantly higher among patients that had the highest dp-uc Matrix γ-carboxyglutamate (Gla) protein (MGP) plasma levels when compared to patients within the lowest side of the dp-uc MGP level spectrum
Summary
Appearing in various clinical presentations and severity, coronary artery disease (CAD) represents one of the major challenges of 21st century medicine, with acute coronary syndrome (ACS) being one of its most dramatic manifestations [1]. Among several bleeding risk scores that developed over the years, the “Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines” (CRUSADE) score emerged as one of the robustly validated tools for estimation of major bleeding probability in ACS [6,7]. Since this score was derived from a large patient registry reflecting real-world clinical practice, its variables are readily applicable in the ACS setting, with some notable limitations [8,9]. Biomarkers that might complement clinical scores such as CRUSADE, and aid in bleeding risk assessment of the ACS population are needed
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
