Plasma β-globin DNA as a prognostic marker in chest pain patients

Abstract

Background: Acute coronary syndrome may involve cell death and the release of nucleic acids into the circulation. We thus investigated whether plasma DNA concentrations are increased and determined its prognostic significance in patients with ACS. Methods: Real-time polymerase chain reaction was used to quantitatively measure the β-globin gene from blood samples taken from patients presenting to an emergency department with chest pain of probable cardiac cause. Results: Samples from 58 patients with chest pain, and from 21 age- and sex-matched healthy control subjects were analysed. Compared with the control group, median plasma DNA concentrations were increased 1.5-fold in patients with minor cardiac injury, were increased further in patients with STEA and STEMI, and were the highest in those patients who died within 2 years (P = 0.0005; post-hoc Dunn's, P < 0.05). Median plasma DNA concentrations were higher in patients who later developed heart failure (1060 vs. 500 kGE/l; P = 0.0095); higher in patients who later reinfarcted (1000 vs. 530 kGE/l; P = 0.0298); higher in patients who had a cardiac arrest in that admission (1350 vs. 525 kGE/l; P = 0.04); and were higher in patients who were readmitted within 6 months of discharge (725 vs. 475 kGE/l; P = 0.04). Conclusion: Plasma DNA is a potential marker for post-ACS complications. © 2005 Elsevier B.V. All rights reserved.