Clinical Diagnostic Value of Stromelysin-2 and Highly Sensitive-Cardiac Troponin I in the Severity of Coronary Artery Obstruction

المؤلفون

DOI:

https://doi.org/10.32007/jfacmedbaghdad3122

الكلمات المفتاحية:

Atherosclerosis، Coronary Angiography، Coronary Artery Disease، Coronary Occlusion، Stromelysin-2

الملخص

Background: Coronary artery disease is a leading cause of death worldwide. Troponin is released into blood from patients with reversible myocardial ischemia. Stromelysin-2 is also involved in the development and progression of atherosclerosis by tissue remodeling and degradation of extracellular matrix proteins.
Objectives: To investigate the role of serum high-sensitive cardiac troponin I (hs-cTn I) and Stromelysin-2 (Str-2) in the diagnosis and determination of the severity of coronary artery obstruction.
Methods: This cross-sectional study was conducted on 125 subjects undergoing coronary angiography for suspicion of coronary artery disease in Baghdad Teaching Hospital/ Medical City complex/ Baghdad/ Iraq by the Department of Biochemistry/ College of Medicine/ University of Baghdad between March and December 2024. The participants were divided into three groups: Group I included 48 subjects with no coronary artery lesion or with < 50% stenosis), Group II included 47 subjects with > 50% stenosis in a single or double coronary arteries, and Group III included 30 subjects with > 50% stenosis in ≥ three coronary arteries or ≥ 50% stenosis in the left main stem. Serum levels of hs-cTn I and Str-2 were measured by the ELISA technique.
Results: The median and 1st – 3rd quartile values of hs-cTn I and Str-2 levels of group III and group II were significantly higher than those of groups I (p= 0.001). The median value of hs-cTn I was significantly higher in group III than in group II (p<0.001). Receiver operating characteristic curve and area under curve tests revealed that hs-cTn I and Str-2 have a high diagnostic ability of coronary artery obstruction along with a high discriminative ability of hs-cTn I in assessment of severity of coronary artery obstruction.
Conclusion: Measurements of serum Str-2 level can be used in the diagnosis of coronary artery obstruction, while serum hs-cTn I level can be used in the diagnosis and differentiation of severity of coronary artery obstruction. Combining both markers add no significant benefit

المراجع

1. Nedkoff L, Briffa T, Zemedikun D, Herrington S, Wright FL. Global Trends in Atherosclerotic Cardiovascular Disease. Clin Ther. 2023;45(11):1087-91. https://doi.org/10.1016/j.clinthera.2023.09.020.

2. Majeed SM, Bahjet Al Saffar H, AL- Marayati AN. Complication Following percutaneous coronary intervention via the femoral artery Experience in lraqi center for the Heart Disease and lbn Al-Bitar Hospital for cardiac surgery. J Fac Med Baghdad. 2016;58(4):325-9. https://doi.org/10.32007/jfacmedbagdad.584277.

3. Rosenthal RL. The 50% coronary stenosis. Am J Cardiol. 2015; 115(8):1162-5. https://doi.org/10.1016/j.amjcard.2015.01.553.

4. Virani SS, Newby LK, Arnold SV, Bittner V, Brewer LPC, Demeter SH, et al. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Vol. 148, Circulation. 2023. 9-119 p. https://doi.org/10.1161/CIR.0000000000001183.

5. Byrne RA, Rossello X, Coughlan JJ, Barbato E, Berry C, Chieffo A, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023;44(38):3720-826.

6. Yassen ST. Evaluation of Preptin and Other Biomarkers in Coronary Artery Disease Patients with and without Diabetes Mellitus. 2024;65(4):431-6. https://doi.org/10.32007/jfacmedbaghdad.6642350.

7. Polonskaya YV, Kashtanova EV, Murashov IS, Striukova EV, Kurguzov AV, Stakhneva EM, et al. Association of matrix metalloproteinases with coronary artery calcification in patients with CHD. J Pers Med. 2021;11(6). https://doi.org/10.3390/jpm11060506.

8. Purroy A, Roncal C, Orbe J, Meilhac O, Belzunce M, Zalba G, et al. Matrix metalloproteinase-10 deficiency delays atherosclerosis progression and plaque calcification. Atherosclerosis. 2018;278:124-34. https://doi.org/10.1016/j.atherosclerosis.2018.09.022.

9. Orbe J, Montero I, Rodríguez JA, Beloqui O, Roncal C, Páramo JA. Independent association of matrix metalloproteinase-10, cardiovascular risk factors and subclinical atherosclerosis. J Thromb Haemost. 2007;5(1):91-7. https://doi.org/10.1111/j.1538-7836.2006.02276.x.

10. Bräuninger H, Krüger S, Bacmeister L, Nyström A, Eyerich K, Westermann D, et al. Matrix metalloproteinases in coronary artery disease and myocardial infarction. Basic Res Cardiol. 2023;118(1):1-17. https://doi.org/10.1007/s00395-023-00987-2.

11. Gokhan I, Dong W, Grubman D, Mezue K, Yang D, Wang Y, et al. Clinical Biochemistry of Serum Troponin. Diagnostics. 2024;14(4):1-21. https://doi.org/10.3390/diagnostics14040378.

12. Wu AHB. Release of cardiac troponin from healthy and damaged myocardium. Front Lab Med. 2017;1(3):144-50. https://doi.org/10.1016/j.flm.2017.09.003.

13. Kesieme EB, Iruolagbe CO, Omoregbee BI, Inuwa IM. Basic Overview of Conventional Coronary Angiography for Planning Cardiac Surgery. Cureus. 2024;16(1). https://doi.org/10.7759/cureus.52942.

14. Ahmed SK. How to choose a sampling technique and determine sample size for research: A simplified guide for researchers. Oral Oncol Reports. 2024 Dec;12:https://doi.org/10.1016/j.oor.2024.100662.

15. Edition T, Thompson SK, Wiley J, Wiley J. Estimating Proportions, Ratios, and Subpopulation Means. 2012;57-66.

https://doi.org/10.1002/9781118162934.ch5.

16. Yang F, Xu L, Dias ACP, Zhang X. A sensitive sandwich ELISA using a modified biotin-streptavidin amplified system for histamine detection in fish, prawn and crab. Food Chem. 2021;350, https://doi.org/10.1016/j.foodchem.2021.129196.

17. Almahmeed W, Arnaout SM, Chettaoui R, Ibrahim M, Kurdi IM, Taher AM, et al. Coronary artery disease in Africa and the Middle East. Ther Clin Risk Manag. 2012; 8:65-72. https://doi.org/10.2147/TCRM.S26414.

18. Arif AM, Rasheed KM, Ismaeel AA. Study some biochemical parameters in patients with Coronary artery disease with and without Type 2 diabetes. J Fac Med Baghdad. 2024;66(1):51-7. https://doi.org/10.32007/jfacmedbagdad.6612173.

19. Omidi N, Sadeghian S, Salarifar M, Jalali A, Abbasi SH, Yavari N, et al. Relationship between the severity of coronary artery disease and cardiovascular risk factors in acute coronary syndrome: Based on tehran heart center's data registry. J Tehran Univ Hear Cent. 2020;15(4):171-6. https://doi.org/10.18502/jthc.v15i4.5942.

20. Charach L, Blatt A, Jonas M, Teodorovitz N, Haberman D, Gendelman G, et al. Using the Gensini score to estimate severity of STEMI, NSTEMI, unstable angina, and anginal syndrome. Med (United States). 2021;100(41):E27331. https://doi.org/10.1097/MD.0000000000027331.

21. Aksu F, Ahmed S. Gensini Score's Severity and Its Relationship with Risk Factors for Coronary Artery Disease Among Patients Who Underwent Angiography in Somalia's Largest PCI Centre. Int J Gen Med. 2024;Volume 17(January):187-92. https://doi.org/10.2147/IJGM.S384626.

22. Dos Santos LCC, Matharoo AS, Pinzón Cueva E, Amin U, Perez Ramos AA, Mann NK, et al. The Influence of Sex, Age, and Race on Coronary Artery Disease: A Narrative Review. Cureus. 2023;15(10). https://doi.org/10.7759/cureus.47799.

23. Salehi N, Janjani P, Tadbiri H, Rozbahani M, Jalilian M. Effect of cigarette smoking on coronary arteries and pattern and severity of coronary artery disease: a review. J Int Med Res. 2021;49(12). https://doi.org/10.1177/03000605211059893.

24. De Chillou C, Riff P, Sadoul N, Éthevenot G, Feldmann L, Isaaz K, et al. Influence of cigarette smoking on rate of reopening of the infarct-related coronary artery after myocardial infarction: A multivariate analysis. J Am Coll Cardiol. 1996;27(7):1662-8. https://doi.org/10.1016/0735-1097(96)00091-5.

25. Ng VG, Lansky AJ, Meller S, Witzenbichler B, Guagliumi G, Peruga JZ, et al. The prognostic importance of left ventricular function in patients with ST-segment elevation myocardial infarction: The HORIZONS-AMI trial. Eur Hear J Acute Cardiovasc Care. 2014;3(1):67-77. https://doi.org/10.1177/2048872613507149.

26. Sabatine MS, Braunwald E. Thrombolysis In Myocardial Infarction (TIMI) Study Group: JACC Focus Seminar 2/8. J Am Coll Cardiol. 2021;77(22):2822-45. https://doi.org/10.1016/j.jacc.2021.01.060.

27. Rgeeb AN, Alsalkh HA, Radhi AK, Amber K. Effect of Intravenous Abciximab on Coronary Flow Improvement After Re-vascularization in Primary Coronary Intervention and Short-Term Impact. Med Arch (Sarajevo, Bosnia Herzegovina). 2020;74(4):265-9.

https://doi.org/10.5455/medarh.2020.74.265-269.

28. Kodaira M, Miyata H, Numasawa Y, Ueda I, Maekawa Y, Sueyoshi K, et al. Effect of smoking status on clinical outcome and efficacy of clopidogrel in acute coronary syndrome. Circ J. 2016;80(7):1590-9. https://doi.org/10.1253/circj.CJ-16-0032.

29. Lazar DR, Lazar FL, Homorodean C, Cainap C, Focsan M, Cainap S, et al. High-Sensitivity Troponin: A Review on Characteristics, Assessment, and Clinical Implications. Vol. 2022, Disease Markers. Hindawi Limited; 2022. https://doi.org/10.1155/2022/9713326.

30. Lee KK, Bularga A, O'Brien R, Ferry A V, Doudesis D, Fujisawa T, et al. Troponin-Guided Coronary Computed Tomographic Angiography After Exclusion of Myocardial Infarction. J Am Coll Cardiol. 2021;78(14):1407-17. https://doi.org/10.1016/j.jacc.2021.07.055.

31. Jakubiak GK. Cardiac Troponin Serum Concentration Measurement Is Useful Not Only in the Diagnosis of Acute Cardiovascular Events. Vol. 14, Journal of Personalized Medicine. Multidisciplinary Digital Publishing Institute (MDPI); 2024. https://doi.org/10.3390/jpm14030230.

32. Souaid T, Hijazi Z, Barakett V, Sarkis A, Kadri Z, Batra G, et al. Association of GDF-15, hs-cTnT and NT-proBNP with coronary artery disease in patients undergoing elective angiography. Future Cardiol. 2022;18(8):635-46. https://doi.org/10.2217/fca-2021-0137.

33. Chaulin AM. Cardiac troponins metabolism: From biochemical mechanisms to clinical practice (literature review). Int J Mol Sci. 2021;22(20). https://doi.org/10.3390/ijms222010928.

34. Sandoval Y, Jaffe AS. The Evolving Role of Cardiac Troponin: From Acute to Chronic Coronary Syndromes. Vol. 82, Journal of the American College of Cardiology. Elsevier Inc.; 2023. p. 486-8. https://doi.org/10.1016/j.jacc.2023.05.047.

35. Wereski R, Adamson P, Shek Daud NS, McDermott M, Taggart C, Bularga A, et al. High-Sensitivity Cardiac Troponin for Risk Assessment in Patients With Chronic Coronary Artery Disease. J Am Coll Cardiol. 2023;82(6):473-85. https://doi.org/10.1016/j.jacc.2023.05.046.

36. Verovenko V, Tennstedt S, Kleinecke M, Kessler T, Schunkert H, Erdmann J, et al. Identification of a functional missense variant in the matrix metallopeptidase 10 (MMP10) gene in two families with premature myocardial infarction. Sci Rep. 2024;14(1). https://doi.org/10.1038/s41598-024-62878-3

Atherosclerosis, Coronary Angiography, Coronary Artery Disease, Coronary Occlusion, Stromelysin-2

التنزيلات

إصدار

القسم

Articles

الفئات

كيفية الاقتباس

1.
Hammoodi AA, Saleh BO, Al-Alwany AA. Clinical Diagnostic Value of Stromelysin-2 and Highly Sensitive-Cardiac Troponin I in the Severity of Coronary Artery Obstruction. J Fac Med Baghdad [انترنت]. [وثق 24 يونيو، 2025];. موجود في: https://www.iqjmc.uobaghdad.edu.iq/index.php/19JFacMedBaghdad36/article/view/3122