Utilisation of Glykogen Phosphorylase BB measurement in the diagnosis of acute coronary syndromes in the event of chest pain

Česká verzia

Authors: B. Lačňák ¹; D. Stejskal ^1,2; L. Jedelský ²; M. Karpíšek ³; L. Šprongl ⁴
Authors place of work: Interní oddělení nemocnice Šternberk, přednosta prim. MUDr. Bořek Lačňák ¹; Oddělení laboratorní medicíny nemocnice Šternberk, přednosta doc. MUDr. David Stejskal, Ph. D. ²; Ústav humánní farmakologie a toxikologie Farmaceutické fakulty Veterinární a farmaceutická univerzity Brno, vedoucí Ing. Michal Karpíšek ³; Centrální laboratoře Šumperské nemocnice, a. s., Šumperk, přednosta Ing. Luděk Šprongl ⁴
Published in the journal: Vnitř Lék 2007; 53(11): 1164-1169
Category: Original Contributions

Summary

Introduction:
Glykogen Phosphorylase BB is considered a timely and specific marker of acute coronary syndrome. A kit for measuring Glykogen Phosphorylase BB in routine diagnosis has been released recently.

Objective of the study:
To test the utilisation of Glykogen Phosphorylase BB measurement in the diagnosis of acute coronary syndrome.

Method:
70 patients with suspected acute coronary syndrome were tested. A final diagnosis of acute coronary syndrome/non-coronary difficulties was made according to ESC/ACC/AHA criteria. Measurements of troponin I, myoglobin and GPBB in venous plasma (heparin-lithium) were taken for all probands on admission and two and six hours later.

Results:
Individuals with acute coronary syndrome (n = 52) had significantly higher levels of Glykogen Phosphorylase BB on admission and 2 hours after admission (21.9 vs 6.2; 18.7 vs 5.9 μg/l; p < 0.01). Levels of Glykogen Phosphorylase BB had a greater diagnostic effectiveness for the presence of acute coronary syndrome than levels of troponin I (threshold below ROC curve 0.89 vs. 0.78; 0.87 vs. 0.67). In the first two hours after admission, only levels of Glykogen Phosphorylase BB were included as independent variables in the regression model for the incidence of acute coronary syndrome (p<0.05). When the group of patients with myocardial necrosis (n = 39; acute myocardial infarction without ST elevations on ECG; NSTEMI) is removed from the group with acute coronary syndrome, it was found that only GPBB and cTnI were independent variables in the regression model on initial testing and after two hours. After adjusting GPBB to cTnI, significantly higher levels of GPBB adjusted to troponin I were found in persons with NSTEMI (14.5 vs –48.0; p < 0.01).

Conclusion:
Measurement of Glykogen Phosphorylase BB has excellent effectiveness independently of troponin in the first hours after the onset of acute coronary syndrome and should ensure the correct diagnosis of acute coronary syndrome in combination with troponin.

Key words:
Glykogen Phosphorylase – acute coronary syndromes – non-STEMI – coronary markers

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