IMPACT OF SERUM AMYLOID A IN EARLY DETECTION OF ENDOTHELIAL ENGARY BY PERCUTANEOUS CORONARY INTERVENTION

Abstract

Background: Evidence of elevated serum levels of inflammatory and restenosis markers afterpercutaneous coronary intervention (PCI), including balloon angioplasty and stenting has been reported in various population. The utility of serum amyloid A in early diagnosis of endothelial cell damage of coronary arteries by cardiac ballooning and stenting still uncertain.The aim of the present study was to determine the validity of serum amyloid A in early diagnosis of endothelial cell damage of coronary arteries by cardiac ballooning and stenting.Methods Serum amyloid A and high sensitive c-reactive protein (Hs-CRP) was determined in a sample of 137 patients attended diagnostic cardiac angiography unite at Sulaimaniyah Center of Heart disease,68 cases were previously diagnosed with coronary artery lesions, underwent coronary ballooning and stenting, and 69 patients with chest pain underwentdiagnostic angiography, free of coronary artery lesion participated in this study. The alteration in serum amyloid A and Hs-CRP levels was estimated before and after 4 hours from procedure.Results: The comparison between cases and controls showed that the 2 groups did not differ significantly with respect to age, gender, ethnicity, hypertension, diabetes mellitus and smoking.The pre- and post-operative mean values of Hs-CRP were similar in cases and controls. The post-operative cases exhibited significantly higher serum amyloid A levels than controls and the difference was statistically significant (p=0.001).The usefulness of serum amyloid as a screening test for endothelial injury was assessed by calculating its validity with regard to cut-off point of Hs-CRP. The post-operative cases with Hs-CRP > 3 mg/l had a higher prevalence 54.0% of amyloid A compared with those of Hs-CRP <3 mg/l. ( 46.0%, p=0.001).Conclusions: It is evident from this study that post-operative cases underwent coronary ballooning and stenting had high serum amyloid Aproteinlevels. It thus indicates the needs for determining serum amyloid A in patients at risk of early coronary endothelial injury.