The The Correlation between Serum Amyloid A, Mean Platelet Volume, and Creatine Kinase Myocardial B in Acute Coronary Syndrome

Syaiful Anwar; Purwanto Adhipireno; Ria Triwardhani; Edward Kurnia Setiawan Limijadi

doi:10.3889/oamjms.2021.5922

Authors

Syaiful Anwar Department of Clinical Pathology, Medical Science Faculty, Diponegoro University, Semarang, Indonesia
Purwanto Adhipireno Department of Clinical Pathology, Medical Science Faculty, Diponegoro University, Semarang, Indonesia
Ria Triwardhani Department of Clinical Pathology, Medical Science Faculty, Diponegoro University, Semarang, Indonesia
Edward Kurnia Setiawan Limijadi Department of Clinical Pathology, Medical Science Faculty, Diponegoro University, Semarang, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2021.5922

Keywords:

Serum, Amyloid A, Platelet, CKMB, Acute, Coroner

Abstract

BACKGROUND: Atherosclerosis causes acute myocardial necrosis and inflammation characterized by increased mean platelet volume (MPV) and serum amyloid A (SAA). Creatine Kinase Myocardial Band (CKMB) is known as myocardial necrosis marker commonly used in daily practice to help diagnosing acute coronary syndrome.

AIM: The purpose of this study was to determine the correlation between MPV, SAA, and CKMB in patients with acute coronary syndrome.

METHODS: An analytic observational study with a cross-sectional approach was conducted from May to July 2019. This study involved 32 patients with ACS at the Emergency Department of Dr Kariadi Public Hospital. The inclusion criteria of this study were patients with chest pain, aged 30–75 years, and normal body temperature while the exclusion criteria were malignancy, undergoing chemotherapy/radiation, renal failure, hypertension, and liver disease. Examination of CKMB was done using the spectrophotometry method, MPV value was measured using a hematology analyzer, and SAA level was measured using the ELISA method. Statistical test was done using Spearman correlation.

RESULTS: The median (min-max) of MPV and SAA values was 9.85 (2.78-11.7) fL and 40.454 (5.879–66.059) μg/ml, while the mean ± SD (min-max) value of CKMB was 115.47 ± 155.97 (10–608) U/L. The correlation coefficient between CKMB level with MPV and SAA levels were r = −0.244 (p = 0.179) and r = 0.442 (p = 0.011), respectively.

CONCLUSION: There was a significant positive moderate correlation between CKMB and SAA levels which could be used as a marker of acute inflammation in ACS, whereas inflammatory marker of MPV did not have a significant correlation.

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References

Badan Penelitian dan Pengembangan Kesehatan, Kementerian Kesehatan Republik Indonesia. Riset Kesehatan Dasar. Jakarta: Kementerian Kesehatan Republik Indonesia; 2013. p. 1-384. https://doi.org/10.31002/rep.v5i1.2050 DOI: https://doi.org/10.31002/rep.v5i1.2050

Knuuti J, Wijns W, Saraste A, Capodanno D, Barbato E, Funck-Brentano C, et al. ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2020;41(3):404-77. https://doi.org/10.1093/ehjci/jez219 PMid:31504439 DOI: https://doi.org/10.1093/ehjci/jez219

Amsterdam EA, Wenger NK, Brindis RG, Casey DE, Ganiats TG, Holmes DR, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: A report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines. Circulation. 2014;130:e344-426. https://doi.org/10.1161/cir.0000000000000134 PMid:25249585 DOI: https://doi.org/10.1161/CIR.0000000000000134

Kim J, Hashim IA. The clinical utility of CK-MB measurement in patients suspected of acute coronary syndrome. Clin Chim Acta. 2016;456:89-92. https://doi.org/10.1016/j.cca.2016.02.030 PMid:26945601 DOI: https://doi.org/10.1016/j.cca.2016.02.030

Pal R, Bagarhatta R, Gulati S, Rathore M, Sharma N. Mean platelet volume in patients with acute coronary syndromes: A supportive diagnostic predictor. J Clin Diagn Res. 2014;8(8):MC01-4. https://doi.org/10.7860/jcdr/2014/8394.4650 PMid:25302226 DOI: https://doi.org/10.7860/JCDR/2014/8394.4650

Huang H, Chen C, Kung C, Li Y, Sung P, You H, et al. Clinical utility of mean platelet volume and immature platelet fraction in acute coronary syndrome. Biomed J. 2019;42(2):107-15. https://doi.org/10.1016/j.bj.2018.12.005 PMid:31130246 DOI: https://doi.org/10.1016/j.bj.2018.12.005

Taskesen T, Sekhon H, Wroblewski I, Goldfarb M, Ahmad MB, Nguyen QT, et al. Usefulness of mean platelet volume to predict significant coronary artery disease in patients with non-ST-elevation acute coronary syndromes. Am J Cardiol. 2017;119(2):192-6. https://doi.org/10.1016/j.amjcard.2016.09.042 PMid:27814786 DOI: https://doi.org/10.1016/j.amjcard.2016.09.042

Zhou J, Lu Y, Wang S, Chen K. Association between serum amyloid A levels and coronary heart disease: A systematic review and meta-analysis of 26 studies. Inflamm Res. 2020;69(4):331- 45. https://doi.org/10.1007/s00011-020-01325-1 PMid:32088731 DOI: https://doi.org/10.1007/s00011-020-01325-1

Targońska-Stępniak B, Majdan M. Serum amyloid A as a marker of persistent inflammation and an indicator of cardiovascular and renal involvement in patients with rheumatoid arthritis. Mediators Inflamm. 2014;2014:793628. https://doi.org/10.1155/2014/793628 PMid:25525305 DOI: https://doi.org/10.1155/2014/793628

Siegmund SV, Schlosser M, Schildberg FA, Seki E, De Minicis S, Uchinami H, et al. Serum Amyloid A induces inflammation, proliferation and cell death in activated hepatic stellate cells. PLoS One. 2016;11(3):e0150893. https://doi.org/10.1371/journal.pone.0150893 PMid:26937641 DOI: https://doi.org/10.1371/journal.pone.0150893

Mercan R, Demir C, Dilek I, Asker M, Atmaca M. Mean platelet volume in acute coronary syndrome. Van Tıp Derg. 2010;17(3):89-95.

Pizzulli L, Yang A, Martin JF, Luderitz B. Changes in platelet size and count in unstable angina compared to stable angina or non-cardiac chest pain. Eur Heart J. 1998;19(1):80-4. https://doi.org/10.1053/euhj.1997.0747 PMid:9503179 DOI: https://doi.org/10.1053/euhj.1997.0747

Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol. 2008;102(6):653-7. https://doi.org/10.1016/j.amjcard.2008.05.006 PMid:18773982 DOI: https://doi.org/10.1016/j.amjcard.2008.05.006

Endler G, Klimesch A, Sunder-Plassmann H, Schillinger M, Exner M, Mannhalter C, et al. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease. Br J Haematol. 2002;117(2):399-404. https://doi.org/10.1046/j.1365-2141.2002.03441.x PMid:11972524 DOI: https://doi.org/10.1046/j.1365-2141.2002.03441.x

Cabala M, Gajdosz R. The role of serum amyloid A in the early diagnosis of acute coronary syndrome. Przegl Lek. 2005;62(1):13-6. PMid:16053213

De Luca G, Santagostino M, Secco GG, Cassetti E, Giuliani L, Franchi E, et al. Mean platelet volume and the extent of coronary artery disease: Results from a large prospective study. Atherosclerosis. 2009. 206(1):292-7. https://doi.org/10.1016/j.atherosclerosis.2009.02.008 PMid:19426979 DOI: https://doi.org/10.1016/j.atherosclerosis.2009.02.008

Davi G. Carlo P. Platelet activation and atherothrombosis. N Engl J Med. 2007;357(24):2482-94. https://doi.org/10.1056/nejmra071014 PMid:18077812 DOI: https://doi.org/10.1056/NEJMra071014

Nigam PK. Biochemical markers of myocardial injury. Indian J Clin Biochem. 2007;22(1):10-7. PMid:23105645 DOI: https://doi.org/10.1007/BF02912874