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Coronary Artery Disease:
doi: 10.1097/MCA.0b013e32835e5c45
Diagnostic Methods

Soluble endothelial protein C receptor levels and protein C activity in patients with acute ST-segment elevation myocardial infarction

Tanalp, Ali C.a; Oduncu, Vecihb; Erkol, Ayhane; Gözübüyük, Gökhanf; Ozveren, Olcayc; Dündar, Cihang; Canbay, Alpera; Kirma, Cevatd

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Abstract

Objectives

In contrast to its membrane-bound form, soluble endothelial protein C receptor (sEPCR) expresses procoagulant activity through binding to protein C. We aimed to investigate the relationship between sEPCR levels and protein C activity in patients with ST-segment elevation myocardial infarction (STEMI).

Methods

The study population included 60 STEMI patients who had undergone a primary percutaneous coronary intervention and 29 patients with stable angina pectoris (SAP) with significant coronary stenosis on angiography. Preprocedural sEPCR levels and protein C activity were determined in all study patients.

Results

In the STEMI group, the baseline sEPCR level was significantly higher (172.0±89.3 vs. 107.1±39.2 ng/ml, P<0.001) and protein C activity was significantly lower (91.9±26.4 vs. 124.5±16.2%, P<0.001) compared with patients with SAP. There was a significant negative correlation between protein C activity and sEPCR in the STEMI group (r=−0.38, P=0.002); however, no significant correlation was observed in the SAP group (r=0.02, P=0.91). Angiographic thrombus load and the incidence of no-reflow phenomenon were significantly higher in STEMI patients with protein C activity under the median level.

Conclusion

The ratio of sEPCR levels to protein C activity is high, with a significant negative correlation in patients with STEMI. Lower protein C activity is associated with the development of no-reflow in STEMI patients. However, the sEPCR level has no relation to the development of no-reflow. The clinical significance of elevated sEPCR level in STEMI should be evaluated in larger studies.

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

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