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Association Between SYNTAX Score and Neopterin Levels in Patients with Chronic Coronary Artery Disease
Zeynep Yapan Emren1, Sadik Volkan Emren2, Oktay Senoz1
1Department of Cardiology, Bakircay University, Cigli Research and Training Hospital, Izmir, Turkiye.
Objective:
To explore the relationship between the Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery (SYNTAX) score and neopterin levels in patients with coronary artery disease (CAD).
Study Design:
An observational study. Place and Duration of the Study: Cardiology outpatient clinic, Bakircay University, Cigli Research and Training Hospital, from August 2023 to August 2024.
Methodology:
Thirty-five patients over the age of 40 with CAD and 33 healthy controls were enrolled. Exclusion criteria included active infection, malignancy, recent acute coronary syndrome (within six months), recent trauma or surgery, cerebrovascular events, use of steroids or immunosuppressants, liver or renal failure, significant valvular disease, thyroid disorders, and stenosis <50%. Comparisons between categorical variables were performed using the chi-square (χ2) test. Differences among single-, double-, and triple-vessel disease groups were analysed with the Kruskal-Wallis test. The association between SYNTAX scores and serum neopterin levels was assessed using Spearman's rank-order correlation (ρ). A two-tailed p-value of <0.05 was considered statistically significant.
Results:
Patients with CAD had significantly higher neopterin levels than those in the Control group, median (IQR): 6.5 (4.3-12.9) nmol/L vs. 5.0 (3.5-7.5) nmol/L, (p = 0.028). Elevated neopterin levels were found in individuals with more extensively stenosed coronary arteries [single-vessel disease: 4.9 (4.1-7.79) nmol/L; double-vessel disease: 7.2 (4.3-8.9) nmol/L; triple-vessel disease: 16.5 (13-23.6) nmol/L, p = 0.002]. Patients with triple-vessel disease demonstrated the greatest neopterin elevation in post hoc comparisons [single vs. double vessel: p = 0.426; double vs. triple vessel: p = 0.022; single vs. triple vessel: p = 0.001]. Neopterin levels showed a strong positive correlation with the SYNTAX score (Rho = 0.61, p <0.001).
Conclusion:
Neopterin elevation in CAD patients is associated with both higher SYNTAX scores and increased numbers of critically narrowed coronary arteries.
Key Words:
Coronary artery disease, SYNTAX score, Neopterin, Inflammation, Atherosclerosis.
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