Diagnostic Value of CRP, H-FABP, PCT, Lp-PLA2 and Cytokines in Stable Angina

Abstract

Coronary artery disease (CAD) is a significant cause of worldwide mortality and morbidity. This study aims to evaluate the levels of serum H-FABP (fatty acid-binding protein), hs-CRP (high sensitivity- CPR), Lp-PLA2 (lipoprotein PLA2), PCT (procalcitonin) and cytokines, in addition to routinely used diagnostic tests, Troponin I (Trop I), Myoglobin (MYO) and Creatine kinase MB (CK-MB) in patients with stable angina to determine their sensitivity in diagnosing stable angina and facilitating faster decision-making in the emergency unit. The current study was performed on 86 patients complaining stable angina, at Nasiriyah Heart Center from October 2021 to October 2022. Eighty-six, healthy subjects (age-matched) were taken as a control group. Blood samples were collected in the emergency department. Serum levels of hs CRP, H-FABP, CK-MB, Trop I, MYO, Lp-PLA2 and PCT were determined using electro-chemiluminescence immunoassay. Blood sugar and serum total cholesterol, triglycerides, LDL, VLDL and HDL were determined using Cobas C311 photometric assays. Serum IL-6 was determined by using electro-chemiluminescence immunoassay, while, IL-9, IL-1β and TNF-α were assayed by ELISA. The study showed that the level of troponin I didn’t significantly change in patients with stable angina. However, compared with healthy controls, patients showed a significant increase in serum levels of CK-MB, myoglobin, hs-CRP, H-FABP, Lp-PLA2 and PCT. Significantly elevated levels of serum IL-6, IL1β, IL-9 and TNF-α were also recorded in patients with stable angina compared to healthy controls. The results also revealed that patients with stable angina had significantly elevated serum levels of serum triglycerides, total cholesterol, LDL and VLDL with a significant decline of serum HDL compared to healthy controls. We can concluded that, in addition to cTnI, CK-MB and MYO, other biomarkers such as hs-CRP, H-FABP, Lp-PLA2 and PCT are sensitive; and can serve as diagnostic indicators of stable angina pectoris for fast treatment. Furthermore, the detection of inflammatory biomarkers was found to be an additional diagnostic parameter in stable angina.