Neoptrein Serum Level as a Marker in Egyptian Patients with Acute Coronary Syndrome

Acute coronary syndrome (ACS) refers to a spectrum of clinical presentations ranging from those st-segment elevation myocardial infarction, to presentations found in non-st-segment elevation myocardial infarction or unstable angina. In terms of pathology, ACS is almost always associated with rupture of an atherosclerotic plaque and partial or complete thrombosis of the infarct-related artery. They found neopterin to be an independent predictor for both all-cause and cardiovascular mortality in patients with and without coronary artery disease. High-sensitivity c-reactive protein (hsCRP) appears to have the best profile as an independent predictor of increased. Despite being a non specific acute-phase reactant, hsCRP 2 coronary risk has been shown in large epidemiological and clinical studies to be an independent predictor of cardiovascular events. Methods: 70 patients were included in this study (40) with unstable angina, (30) patients with MI diagnosed by typical chest pain ECG and cardiac enzymes all patients were not diabetic some of them were hypertensive (HTN) aged (50-70), patients were subdivided into smoker group (39) and non smokers (31). All patients recruited from ICU Department and Internal Medicine in Patients of Kasr Al Aini Hospital over 1 year from June 2010-June 2011. Also 15 healthy subjects age matched served as control. All patients and control were subjected to full clinical examination through history taking, ECG, troponin I, high sensitive CRP, neoptrein, cholesterol LDL. Results: Serum neopterin level was significantly higher in patients with acute MI (11.64±3.1nmol/l) than control group (4.12±2.0) p-value 0.0001. It was also higher significantly in patients with unstable angina (7.35±1.8) than control group with p-value 0.0001. It was siginficantly higher in MI group than angina group (p-value 0.01). We found also higher level of highly senstive CRP in MI patients than control group (11.6±3.7) and (1.2±0.48) respectivly p-value 0.0001. It was also higher in angina group than control (3.8±2.4) and (1.2±0.48) respectivly p-value 0.0001. CRP was higher in MI group than angina patients p-value 0.0001. Also troponin I was higher in MI group with p-value 0.0001 than both angina group and control group. LDL cholesterol level is significantly higher in MI patients than both control and angina group p-value 0.0001. We studied neopterin in subgroups smokers, we found its serum level higher in smokers than non smokers but this was not statistically significant (p-value 0.20). Conclusion: Serum neopterin may be used as a marker in acute coronary syndrome activity.