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Article Type

Original Study

Abstract

Background: Acute coronarysyndrome (ACS) is a potentially lifethreatening manifestation of coronaryartery disease (CAD). Apoptoticmicroparticlesare responsible for almostall tissue factor activity of theplaquelipid core. The elevated levelsof procoagulant microparticlescouldalso circulate in the peripheralbloodof patients with recent clinicalsignsof plaque disruption and thrombosis. Subjects and Methods: Thepresent study included 60 acute coronarysyndrome (ACS) adult patientsselectedfrom Cardiology Departmentin Mansoura Specialized Hospital,Mansoura University during theperiodbetween February 2013 toNovember2013. Group < br />I: comprised 30 diabetic patients presented withACS. Group II: comprised 30 nondiabeticpatients presented with ACSand25 healthy subjects as a controlgroup.ACS patients were furtherclassifiedaccording to laboratoryandradiological findings (Troponintestand ECG) into: Group < br />A: comprised16 ST segment elevationmyocardialinfarction (STEMI) patients. Group B: comprised 19 nonST segment elevation myocardial infarction(NSTEMI) patients. Group < br />C:comprised25 unstable angina patients.Traditional laboratory investigationsand special laboratory assessmentof CD144 FITC by flowcytometrywere done. Results:thepresentstudy revealed highly elevatedCD144 percentages in diabetic ACS patients compared to healthycontrols (P= <0.0001), highly elevatedCK-MB, fasting sugar, total cholesterol(TC), triglyceride (TG), andLDLcholesterol (P=0.0001,P=0.0001,P=0.0002, P=0.0002 andP=0.0001respectively). In contrast,nondiabetic ACS patients had significantlyelevated CD144, CK-MB, TC,TGand LDL (P=0.0001, P=0.0001,P=0.0001,P=0.0021 and P=0.0021respectively)while fasting blood sugarand HbA1c were non significantlychanged.On the other hand group B(NSTEMI)patients had significantlyelevatedCD144 percent in comparisonto patients with unstable angina(group < br />c) (P=0.05) but patients withgroup < br />A (STEMI) had significantly elevatedCK-MB compared to patientswithunstable angina (group c)(P=0.02).Conclusion:Thehigh levelsof CD144 circulating microparticlesof endothelial origin are increasedin diabetic patients withcoronaryartery disease (CAD) suggestingan important role for endothelialinjury in prediction of ACS.Hyperglycemiain acute coronarysyndromeis associated with enhancedlocal thrombin generationandplatelet activation, as well as unfavorablyaltered clot features in patientswith and without a previous

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Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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