Background: Acute coronary
syndrome (ACS) is a potentially life
threatening manifestation of coronary
artery disease (CAD). Apoptotic
microparticles
are responsible for almost
all tissue factor activity of the
plaque
lipid core. The elevated levels
of procoagulant microparticles
could
also circulate in the peripheral
blood
of patients with recent clinical
signs
of plaque disruption and thrombosis. Subjects and Methods: The
present study included 60 acute coronary
syndrome (ACS) adult patients
selected
from Cardiology Department
in Mansoura Specialized Hospital,
Mansoura University during the
period
between February 2013 to
November
2013. Group < br />I: comprised 30 diabetic patients presented with
ACS. Group II: comprised 30 nondiabetic
patients presented with ACS
and
25 healthy subjects as a control
group.
ACS patients were further
classified
according to laboratory
and
radiological findings (Troponin
test
and ECG) into: Group < br />A: comprised
16 ST segment elevation
myocardial
infarction (STEMI) patients. Group B: comprised 19 non
ST segment elevation myocardial infarction
(NSTEMI) patients. Group < br />C:
comprised
25 unstable angina patients.
Traditional laboratory investigations
and special laboratory assessment
of CD144 FITC by flow
cytometry
were done. Results:
the
present
study revealed highly elevated
CD144 percentages in diabetic ACS patients compared to healthy
controls (P= <0.0001), highly elevated
CK-MB, fasting sugar, total cholesterol
(TC), triglyceride (TG), and
LDL
cholesterol (P=0.0001,
P=0.0001,
P=0.0002, P=0.0002 and
P=0.0001
respectively). In contrast,
non
diabetic ACS patients had significantly
elevated CD144, CK-MB, TC,
TG
and LDL (P=0.0001, P=0.0001,
P=0.0001,
P=0.0021 and P=0.0021
respectively)
while fasting blood sugar
and HbA1c were non significantly
changed.
On the other hand group B
(NSTEMI)
patients had significantly
elevated
CD144 percent in comparison
to patients with unstable angina
(group < br />c) (P=0.05) but patients with
group < br />A (STEMI) had significantly elevated
CK-MB compared to patients
with
unstable angina (group c)
(P=0.02).
Conclusion:
The
high levels
of CD144 circulating microparticles
of endothelial origin are increased
in diabetic patients with
coronary
artery disease (CAD) suggesting
an important role for endothelial
injury in prediction of ACS.
Hyperglycemia
in acute coronary
syndrome
is associated with enhanced
local thrombin generation
and
platelet activation, as well as unfavorably
altered clot features in patients
with and without a previous