Circulating endothelial cell count as a diagnostic marker for non-ST-elevation acute coronary syndromes
Circulating endothelial cell count as a diagnostic marker for non-ST-elevation acute coronary syndromes
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DOI：
10.1161/01.cir.0000142295.85740.98
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发表时间：
2004-09-21
期刊：
影响因子：
37.8
通讯作者：
Dignat-George, F
中科院分区：
文献类型：
--
作者：
Quilici, J;Banzet, N;Dignat-George, F
背景-内皮细胞从受损的内皮脱落到血液中发生在多种血管疾病中。本研究的目的是评估循环内皮细胞（CEC）计数作为非ST段抬高急性冠状动脉综合征（ACS）的诊断标志物的效用。方法和结果- CEC计数在发病后即刻（H 0）、4小时（H4）、在60例有记录的非ST段抬高ACS患者和40例无冠状动脉疾病证据的对照患者中，在入院后8小时（H8）进行了研究。ACS组共有32例患者CEC计数升高（> 3个细胞/mL），与早期入院和单次胸痛有关。对照组患者CEC计数正常。CEC的胸痛发作和升高之间的间隔显著短于肌钙蛋白I。两种标记物之间无相关性。有趣的是，一个亚组的ACS患者与最初正常的肌钙蛋白I水平有较高的CEC计数，从而允许在30%以上的情况下早期诊断。在H 0时，CEC计数的平均受试者工作特征曲线下面积显著高于肌钙蛋白I水平。在H4和H8，联合使用CEC和肌钙蛋白作为ACS的标志物明显优于CEC单独或肌钙蛋白I单独。结论-这项研究表明，CEC计数可以作为一个早期的，具体的，独立的非ST段抬高ACS的诊断标志物。联合使用CEC计数和肌钙蛋白I水平可以提供有效的诊断工具。
Background - Shedding of endothelial cells from damaged endothelium into the blood occurs in a variety of vascular disorders. The purpose of this study was to evaluate the utility of circulating endothelial cell (CEC) count as a diagnostic marker of non - ST-elevation acute coronary syndromes (ACSs).Methods and Results - CEC counts were determined immediately (H0), 4 hours (H4), and 8 hours (H8) after admission in 60 patients with documented non -ST-elevation ACS and 40 control patients with no evidence of coronary artery disease. A total of 32 patients in the ACS group had elevated CEC counts ( > 3 cells/mL) in relation to early admission and single-episode chest pain. Patients from the control group had normal CEC counts. The interval between the chest pain episode and elevation was significantly shorter for CEC than troponin I. No correlation was found between the 2 markers. Interestingly, a subgroup of ACS patients with initially normal troponin I levels had high CEC counts, thus allowing early diagnosis in 30% more cases. At H0, the mean area under the receiver operating characteristic curve was significantly higher with the CEC count than with the troponin I level. At H4 and H8, the combined use of CEC and troponin was significantly better as a marker of ACS than CEC alone or troponin I alone.Conclusions - This study demonstrates that CEC count can be used as an early, specific, independent diagnostic marker for non - ST-elevation ACS. A combined strategy using CEC count and troponin I level could provide an effective diagnostic tool.