Abstract
BackgroundNetrin-1 is a recently discovered diagnostic biomarker that indicates atherosclerosis, angiogenesis, and ischemia-reperfusion damage. There are no human studies about Netrin-1 in acute coronary syndrome (ACS). The purpose of the present study was to investigate Netrin-1 levels in the early diagnosis and successful reperfusion of ACS.MethodThe study was conducted with 188 patients diagnosed with ACS and 50 healthy subjects at the emergency unit in a prospective design. Blood samples were collected from the patient group at initial admission and after angiography. The control group consisted of healthy adult subjects without any disease. Netrin-1 levels were studied in both groups.ResultsThe Netrin-1 levels of the patient group at the time of admission were found to be higher than of the control group (p<0.001). In the patient group, netrin-1 levels measured at initial admission (1.53±0.19) and after angiography (1.49±0.19) were determined to be statistically significant (p:0.049). In the patient group, where the Thrombolysis in Myocardial Infarction (TIMI) 3 flow was established after angiography, netrin-1 levels were detected to be low (p:0.039). Netrin-1 levels obtained at the time of admission were determined to be significantly different in the Global Registry of Acute Coronary Events (GRACE) moderate and high-risk groups in comparison to the low-risk group (p:0.017).ConclusionNetrin-1 was shown to increase in the early diagnosis of ACS and to decrease in patients for whom reperfusion was established after angiography. Therefore, Netrin-1 can be an important biomarker as an indicator of diagnosis and successful reperfusion in ACS.
Highlights
In the USA and Europe, approximately 15-20 million individuals present to the emergency rooms with acute chest pain and other symptoms of acute coronary syndrome (ACS) annually
Netrin-1 levels obtained at the time of admission were determined to be significantly different in the Global Registry of Acute Coronary Events (GRACE) moderate and high-risk groups in comparison to the low-risk group (p:0.017)
It has been shown that clinical risk scores, such as Global Registry of Acute Coronary Events (GRACE) and Thrombolysis in Myocardial Ischemia (TIMI), which have significant distinguishing power in calculating the hospital mortality risks, hospital discharge, and six-month mortality risks mentioned in ACS guidelines, can be improved with some biomarkers and new parameters [7,8]
Summary
In the USA and Europe, approximately 15-20 million individuals present to the emergency rooms with acute chest pain and other symptoms of acute coronary syndrome (ACS) annually. Two components of ACS, acute myocardial infarction and unstable angina, are the major causes of death and disability worldwide [3,4]. It has been shown that clinical risk scores, such as Global Registry of Acute Coronary Events (GRACE) and Thrombolysis in Myocardial Ischemia (TIMI), which have significant distinguishing power in calculating the hospital mortality risks, hospital discharge, and six-month mortality risks mentioned in ACS guidelines, can be improved with some biomarkers and new parameters [7,8]. There are no human studies about Netrin-1 in acute coronary syndrome (ACS). The purpose of the present study was to investigate Netrin-1 levels in the early diagnosis and successful reperfusion of ACS
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