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Serum endocan levels in non-ST segment elevation myocardial infarction patients
Adem Melekoglu1, Alp Giray Aydin1, Uğur Kahveci2
1Sisli Hamidiye Etfal Education and Research Hospital, Emergency Medicine, İstanbul, Türkiye.
Background:
Endothelial dysfunction and inflammation play a key role in the pathophysiology of acute coronary syndrome (ACS). Endocan has emerged as a novel biomarker reflecting endothelial activation.
Objective:
To investigate serum endocan levels in patients with non-ST-segment elevation myocardial infarction (NSTEMI) and their association with coronary stenosis severity.
Methods:
This prospective observational study included 81 NSTEMI patients undergoing coronary angiography. Patients were classified into clinically significant coronary stenosis and non-significant coronary stenosis groups. Serum endocan levels were measured at admission.
Results:
Patients who underwent coronary angiography (n = 81) were divided into two groups as those with clinically significant coronary stenosis (n = 40) and non-significant coronary stenosis (n = 41). Serum endocan levels were significantly higher in the group with clinically significant coronary stenosis (p < 0.001). Mean age and body mass index (BMI) were higher and statistically significant in the group with clinically significant coronary stenosis (p = 0.038, p = 0.042). Inflammation parameters C-reactive protein (CRP), White Blood Cell (WBC) and Neutrophil Lymphocyte ratio (NLR) were higher in the group with clinically significant coronary stenosis (p < 0.001, p = 0.011, p = 0.038). In multivariate logistic regression analysis, endocan (p < 0.001, 95% CI: 1.010-1.035), BMI (p = 0.020, 95% CI: 1.070-2.237), and CRP (p = 0.039, 95% CI: 1.003-1.099) were independently associated with clinically significant coronary stenosis. In Receiver operating curve (ROC) analysis performed to discriminate between patients with and without clinically significant coronary stenosis, the endocan cut-off value was determined as > 393.1 ng/L [p < 0.001, The Area Under the Curve (AUC) = 0.826, 95% CI = 0.732-0.919, Likelihood Ratio + = 7.65, LR - = 0.28].
Conclusion:
Endocan levels are elevated in NSTEMI patients with clinically significant coronary stenosis and may reflect endothelial dysfunction and atherosclerotic burden.
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