The presented study was carried to evaluate the role of YKL-40 and myeloperoxidase in prediction of coronary events as well as to analyze the relationship between YKL-40,myeloperoxidase,highly sensitive C-reactive protein and lipoprotein (a) in the coronary events.
The study was conducted on eighty subjects divided into the
following groups:
Group I : 30 patients with myocardial infarction who subdivided to :
A- 15 patients with D.M.
B- 15 patients with out D.M.
Group II : 30 , patients with stable angina with medical treatment who
Subdivided to :
A- 15 patients with D.M.
B- 15 patients with out D.M.
Group III : 20 , apparently healthy individuals
The subjects under the study were subjected to the following:
1- Through history and clinical examination.
2- ECG
3- Echocardiography
4- Laboratory investigations:
* Determination of YKL-40
* Determination of Myeloperoxidase
* Determination of Highly sensitive C-reactive protein
* Determination of Lipoprotien (a)
* Determination of Fasting blood sugar
* Liver function tests
* Kidney function tests
* Determination of Lipid profile and
*CBC
The results of the present study revealed :
-- Significant increase in the serum YKL-40 concentrations in patients with myocardial infarction when compared with patients with stable angina and control group.
-- Significant increase in the serum YKL-40 concentrations in patients with stable angina when compared with control group.
-- Significant increase in the serum myeloperoxidase concentrations in patients with myocardial infarction when compared with control group,and no significant difference was found between patients with myocardial infarction and patients stable angina .
-- Significant increase in the the myeloperoxidase concentrations in patients with stable angina when compared with control group.
-- Significant increase in the serum lipoprotein (a) concentrations in patients with myocardial infarction when compared with control group,and no significant difference was found between patients with myocardial infarction and patients stable angina .
-- Significant increase in the serum lipoprotein (a) concentrations were in patients with stable angina when compared with control group.
-- Significant increase in the serum hjghly sensitive C-reactive protein concentrations in patients with myocardial infarction when compared with patients with stable angina and control group.
-- significant high levels of its concentrations in patients with stable angina than in control group
* When trying to determine the diagnostic performance in myocardial infarction the results of this work revealed that:
1-For YKL-40
the best cutoff value is 78.8 ng/ml, at this point the sensitivity was 80% and the specificity was 70%.The area under the curve was 0.81
2-for myeloperoxidase revealed that the best cutoff value is 110.5ng/ml, at this point the sensitivity was 93.3% and the specificity was 70%.The area under the curve was 0.81
3-for lipoprotein(a) revealed that the best cutoff value is 103.1mg/dl, at this point the sensitivity was 80% and the specificity was 60%.The area under the curve was 0.68
4-for hs CRP revealed that the best cutoff value is 9.54mg/l, at this point the sensitivity was 80% and the specificity was 64%.The area under the curve was 0.81
* Receiver operator characteristic curve in stable angina
1- for YKL-40 revealed that the best cutoff value is 66.3ng/ml, at this point the sensitivity was 70% and the specificity was 52%.The area under the curve was 0.59
2-for myeloperoxidase revealed that the best cutoff value is 96 ng/ml, at this point the sensitivity was 50% and the specificity was 54%.The area under the curve was 0.58
3- for lipoprotein(a) revealed that the best cutoff value is 93 mg/dl, at this point the sensitivity was 60% and the specificity was 64%.The area under the curve was 0.60
4- for hs CRP revealed that the best cutoff value is 8.1mg/l, at this point the sensitivity was 60% and the specificity was 58%.The area under the curve was 0.57
Spearman’s correlation coefficient between YKL-40 and the studied variables
Group I showed
**significant positive correlations between serum YKL-40 concentration and :
1- Cholesterol concentration.
2- TG concentration.
3- LDL-C concentration .
4- WBCs.
**significant negative correlation between serum YKL-40 concentration and HDL-C
Spearman’s correlation in group II showed
** significant positive correlations between serum YKL-40 concentration and :
1-Myeloperoxidase
2-hs CRP
3- Cholesterol concentration
4- TG concentration
5- LDL-C concentration
** significant negative correlations between serum YKL-40 concentration and:
1- HDL-C
2- Hb
3- PCV
4- WBCs .
Spearman’s correlation in group III showed
** significant positive correlation between serum YKL-40 concentration and
1- platelets count
**significant negative correlation between serum YKL-40 concentration and
1-albumin concentration
Spearman’s correlation coefficient between myeloperoxidase and the studied variables
Group I showed
** significant positive correlations between serum Myeloperoxidase concentration and:
1- Cholesterol concentration
2- TG concentration .
Spearman’s correlation in group II showed
** significant positive correlations between serum Myeloperoxidase concentration and:
1- LP(a)
2- hsCRP
3- Cholesterol concentration
4- TG concentration
5- LDL-C concentration .
** significant negative correlation between serum Myeloperoxidase concentration and:
1- HDL-C .
Spearman’s correlation in group III showed
** significant positive correlation between serum Myeloperoxidase concentration and:
1- total bilirubin.
Spearman’s correlation coefficient between lipoprotien (a) and the studied variables
group I showed
**significant negative correlation between serum LP(a) concentration and
1-albumin concentration.
Spearman’s correlation coefficient between hs CRP and the studied variables
In group II showed
** significant positive correlations between serum hs CRP concentration and :
1- Urea concentration
2- LDL-C concentration ,
** significant negative correlations between serum hsCRP concentration and:
1- T.bilirubin concentration
2- HDL-C concentration
Spearman’s correlation in group III showd significant positive correlation between serum hsCRP concentration and :
1- Uric acid concentration
2- Urea concentration
3- LDL-C concentration . |
