Serum endocan levels in non-ST segment elevation myocardial infarction patients.

BACKGROUND

Endothelial dysfunction and inflammation play a key role in the pathophysiology of acute coronary syndrome (ACS). Endocan has emerged as a novel biomarker reflecting endothelial activation.

OBJECTIVE

To investigate serum endocan levels in patients with non-ST-segment elevation myocardial infarction (NSTEMI) and their association with coronary stenosis severity.

METHODS

This prospective observational study included 81 NSTEMI patients undergoing coronary angiography. Patients were classified into clinically significant coronary stenosis and non-significant coronary stenosis groups. Serum endocan levels were measured at admission.

RESULTS

Patients who underwent coronary angiography (n = 81) were divided into two groups as those with clinically significant coronary stenosis (n = 40) and non-significant coronary stenosis (n = 41). Serum endocan levels were significantly higher in the group with clinically significant coronary stenosis (p < 0.001). Mean age and body mass index (BMI) were higher and statistically significant in the group with clinically significant coronary stenosis (p = 0.038, p = 0.042). Inflammation parameters C-reactive protein (CRP), White Blood Cell (WBC) and Neutrophil Lymphocyte ratio (NLR) were higher in the group with clinically significant coronary stenosis (p < 0.001, p = 0.011, p = 0.038). In multivariate logistic regression analysis, endocan (p < 0.001, 95% CI: 1.010-1.035), BMI (p = 0.020, 95% CI: 1.070-2.237), and CRP (p = 0.039, 95% CI: 1.003-1.099) were independently associated with clinically significant coronary stenosis. In Receiver operating curve (ROC) analysis performed to discriminate between patients with and without clinically significant coronary stenosis, the endocan cut-off value was determined as > 393.1 ng/L [p < 0.001, The Area Under the Curve (AUC) = 0.826, 95% CI = 0.732-0.919, Likelihood Ratio + = 7.65, LR - = 0.28].

CONCLUSION

Endocan levels are elevated in NSTEMI patients with clinically significant coronary stenosis and may reflect endothelial dysfunction and atherosclerotic burden.