AYNUR ŞAHİN, Süha TÜRKMEN, AHMET MENTEŞE, Süleyman Caner KARAHAN, MÜCAHİT GÜNAYDIN, Süleyman TÜREDİ, ABDÜLKADİR GÜNDÜZ

Angina Pektoris Nedeniyle Acile Başvuran Hastaların Tanısında Scube1’in Değeri

Amaç: Bu çalışmanın amacı göğüs ağrısı nedeniyle acil servise başvuran hastalarda Signal peptide-CUB-EGF Domain-containing Protein 1 (SCUBE 1)’in angina pektoris tanısındaki değerini araştırmaktır.Gereç ve Yöntemler: Bu çalışma prospektif, kesitsel, tek merkezli bir klinik çalışma olarak planlandı. Etik kurul onayının alınmasından itibaren toplam 5 ay süreyle acil servise iskemik göğüs ağrısı şikayetiyle başvuran hastalar dahil edildi. İskemik göğüs ağrısı ile başvuran hastalar etyolojilerine göre stabil angina pektoris (SAP), unstabil angina pektoris (UAP), ST elevasyonu olmayan myokard infarktüsü (NSTEMI), ST elevasyonlu myokard infarktüsü (STEMI) olmak üzere gruplara ayrıldı. Klinik, laboratuar ve demografik özellikleri kayıt altına alındı. Her bir gruptan ölçülen serum SCUBE 1 düzeyleri istatistiksel olarak analiz edilerek sağlıklı kontrol grubuyla karşılaştırılarak analiz edildi.Bulgular: Çalışmanın dahil etme kriterlerine uygunluk gösteren 78 hasta ile 40 sağlıklı kontrol olmak üzere toplam 118 kişi çalışmaya alındı. Hastaların yaş ortalaması 54.36±14.03 olup % 88.5’i (n=69) tanesi erkekti. Hastaların risk faktörleri incelendiğinde HT(%59) ve sigara (%62) diğer risk faktörlerine göre daha ağırlıktaydı. İskemik göğüs ağrısı şikayetiyle çalışmaya dahil ettiğimiz hastalarda en sık etken NSTEMI olarak tespit edildi (%46.1). Hastaların başvuru anında, 6.saat ve 12. saat serum SCUBE-1 değerleri kontrol grubu ile karşılaştırıldığında istatiksel olarak anlamlı fark bulunmadı (p>0.05).Sonuç: Çalışmamızın bulgularına göre SCUBE 1, iskemik göğüs ağrısı etiyolojilerinin tanısında değeri bulunmamaktadır.

Anahtar Kelimeler:

SCUBE1, Angina pektoris

THE DIAGNOSTIC VALUE OF SCUBE1 IN PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT DUE TO ANGINA PECTORIS

Objective: The purpose of this study was to investigate the value of signal peptide-CUB-EGF domain-containing protein 1 (SCUBE1) in the diagnosis of angina pectoris in patients presenting to the emergency department.Material and Methods: This prospective research was planned as a cross-sectional, single-center clinical study. Patients presenting to the emergency department with angina pectoris symptoms over a period of five months from receipt of ethical committee approval were included. Patients presenting with ischemic chest pain were divided on the basis of etiology into stable angina pectoris (SAP), unstable angina pectoris (UAP), non-ST elevation myocardial infarction (NSTEMI), and ST segment elevation myocardial infarction (STEMI) groups. Clinical, laboratory and demographic characteristics were recorded. SCUBE1 levels from each group were compared with a healthy control group.Results: 118 individuals were enrolled in the study, 78 patients meeting the inclusion criteria and 40 healthy controls. Patients’ mean age was 54.36 ± 14.03 years, and 88.5% (n=69) were male. Hypertension (59%) and smoking (62%) predomination over other risk factors. NSTEMI was the most common factor (46.1%) in patients enrolled due to ischemic chest pain. No statistically significant difference was determined between patients’ serum SCUBE1 levels at time of presentation and at 6 h and 12 h and the control group (p>0.05).Conclusion: On the basis of our study findings, SCUBE1 is of no value in the diagnosis of ischemic chest pain etiologies.

Keywords:

Angina pectoris SCUBE1, acute coronary syndrome,

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1. Pope JH, Ruthazer R, Beshansky JR, Griffith JL, Selker HP. Clinical Features of Emergency Department Patients Presenting with Symptoms Suggestive of Acute Cardiac Ischemia: A Multicenter Study. J Thromb Thrombolysis. 1998;6(1):63.
2. Ibáñez B, Heusch G, Ovize M, Van de Werf F. Evolving therapies for myocardial ischemia/reperfusion injury. J Am Coll Cardiol. 2015;65(14):1454-71.
3. Vedanthan R, Seligman B, Fuster V. Global perspective on acute coronary syndrome: a burden on the young and poor. Circ Res. 2014;114(12):1959-75.
4. Tu CF, Yan YT, Wu SY, Djoko B, Tsai MT, Cheng CJ, et al. Domain and functional analysis of a novel platelet-endothelial cell surface protein, SCUBE1. J Biol Chem. 2008;283:12478-88.
5. Peacock WF. Will SCUBE1 solve the ischemia marker deficit? J Am Coll Cardiol. 2008;51:2181-3.
6. Turkmen S, Sahin A, Gunaydin M, Sahin S, Mentese A, Turedi S, et al. The value of signal peptide-CUB-EGF domain-containing protein-1 (SCUBE1) in the diagnosis of pulmonary embolism: a preliminary study. Acad Emerg Med. 2015;22(8):922-6.
7. Turedi S, Tatli O, Alver A, Karaguzel E, Karaca Y, Turkmen S, et al. The Diagnostic Value of Plasma SCUBE1, a Novel Biomarker of Platelet Activation, in Testicular Torsion: A Randomized, Controlled, Experimental Study. Urology. 2015;86(3):516-20.
8. Hamm CW, Bassand JP, Agewall S, Bax J, Boersma E, Bueno H, et al. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J. 2011;32(23):2999-3054.
9. Braunwald E, Antman EM, Beasley JW. ACC/AHA guidelines for themanagement of patients with unstable angina and non–ST-segment elevation myocardial infarction: executive summary and recommendations: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Committee on Management of Patients with Unstable Angina. Circulation. 2000;102:1193-209.
10. Yeniocak S, Saraç F, Karadana GA, Olgaç V, Kalkan A, Düz ME, et al. Diagnostic Value of Signal Peptide, CUB (Complement C1r/C1s, Uegf, and Bmp1), EGF (Epidermal Growth Factor)-Like Domain-Containing Protein 1 (SCUBE1) and Chemerin in Experimental Testicular Torsion. Eurasian J Emerg Med. 2017;16:48-53.
11. Dai DF, Thajeb P, Tu CF, Chiang FT, Chen CH, Yang RB, et al. Diagnostic Value of Signal Peptide, CUB (Complement C1r/C1s, Uegf, and Bmp1), EGF (Epidermal Growth Factor)-Like Domain-Containing Protein 1 (SCUBE1) and Chemerin in Experimental Testicular Torsion. Eurasian J Emerg Med. 2017;16:48-53.
12. Sarma J, Laan CA, Alam S, Jha A, Fox KA, Dransfield I. Increased platelet binding to circulating monocytes in acute coronary syndromes. Circulation. 2002;105:2166–71
13. Furman MI, Benoit SE, Barnard MR, Valeri CR, Borbone ML, Becker RC et al. Increased platelet reactivity and circulating monocyte-platelet aggregates in patients with stable coronary artery disease. J Am Coll Cardiol. 1998;31:352–8.