Association Between The Serum Levels Of PTX-3 And GDF-15 In Patients With Acute Coronary Syndrome And GRACE Risk Core

OBJECTIVETo explore the association between the serum levels of pentraxin-3(PTX-3) and growth differentiation factor-15(GDF-15) in patients with acute coronary syndrome(ACS) and Global registry of acute coronary events(GRACE) risk score.BACKGROUNDGuidelines for the management of acute coronary syndrome (ACS) emphasize the importance of risk stratification to match the intensity of therapy with an individual patient’s risk. The guidelines recommend a standardized approach that uses scoring systems such as GRACE score to calculate risk and guide therapy. Because score reflects only some disease dimensions related to outcome of ACS, biomarkers addressing separate aspects of ACS pathophysiology may provide additional information.PTX-3 is a inflammation marker and GDF-15 is a stress-responsive marker, which might aid in the risk stratification of people with ACS.METHODSThe serum levels of PTX-3 and GDF-15 in 70 patients with ACS and 26 healthy people were determined using antibody-sandwich enzyme-linked immunosorbent assay (ELISA) and compared among 3 patients group with different GRACE score.RESULTS(1) The serum levels of PTX-3 in patients with ACS were significantly higher than those healthy people (7.18 ± 1.28 ng/ml vs 2.91 ± 1.58ng/ml,P<0.01).PTX-3 levels on admission increased in proportion to increasing risk defined by GRACE risk stratification. Compared with the other three quartiles, the GRACE risk score was the highest in the fourth quartile (P<0.05).The serum levels of PTX-3 in patients with ACS showed a significant positive correlation to GRACE risk score (r=0.60,P<0.05)(2) The serum levels of GDF-15 in patients with patients were significantly higher than those healthy people (1099.98±259.44pg/ml vs 640.26± 223.45pg/m,P<0.01).GDF-15 levels on admission increased in proportion to increasing risk defined by GRACE risk stratification. According to GDF-15 levels, patients were stratified into four groups by quartile. Compared with the other three quartiles, the GRACE risk score was the highest in the fourth quartile (P<0.01). The serum levels of GDF-15 in patients with ACS showed a significant positive correlation to GRACE risk score (r=0.65,P<0.01).(3) The serum levels of PTX-3 in patients with ACS showed a significant correlation with that of GDF-15 (r=0.58,P<0.05).CONCLUSIONSPTX-3 and GDF-15 are newborn markers of ACS,which may indicate risk stratification information and provide evidence for clinical treatment.