INTRODUCTION: Acute coronary syndrome (ACS) is a major cause of mortality and morbidity worldwide, thus early diagnosis is very important. The most common cause of ACS is the rupture of vulnerable atherosclerotic plaque in the coronary artery in which inflammation plays a key role. The aim of the present study is to investigate visfatin, as a proinflammatory biomarker in the early diagnosis and monitoring of ACS and to compare visfatins relationship with troponin T,tumor necrosis factor-alpha (TNF-α), and creatine kinase-MB (CK-MB).
METHODS: Sixty ACS patients and thirty control subjects were recruited to this study. From controls one, from ACS patients three blood samples were obtained at intervals 0-6 (T0), 6-12 (T1) and 12-24 (T2) hours from the start of the chest pain. Serum visfatin, TNF-α, troponin T and CK-MB were assessed. Visfatin and TNF-α levels were assessed by ELISA, troponin-T by chemiluminescence and CK-MB by enzymatic methods.
RESULTS: Serum TNF-α, troponin T and CK-MB levels in T0 blood samples were statistically significantly higher in ACS patients compared to controls (p=0.004, p<0.001, p<0.001 respectively). We found a significant positive correlation between visfatin and troponin T (r=0.290,p=0.007) in T0. Visfatin concentrations were decreased in T0, T1 and T2 samples [4.01±6.23ng/ml, 1.80±3.47 ng/ml and 1.72±2.67ng/ml, (p=0.005) respectively, T0>(T1=T2)].
DISCUSSION AND CONCLUSION: Visfatin shows a significant positive correlation with troponin T. Visfatin did not demonstrate a rise and fall pattern like the standart biomarkers in terms of monitoring of ACS patients evolution, because it shows a significant decrease after first 6 hours. Although visfatin has no superiority to troponin, since its increase is correlated, its efficiency in a multimarker panel needs investigation. The role of visfatin in the early phase pathophysiological mechanisms needs to be elucidated.