m in predicting severity of Coronary artery disease

Background: Coronary artery disease is the principal cause of disability and mortality worldwide. Its prevalence is increasing around world. It is about 75% of deaths occurring in developing countries like Bangladesh. It is very important to know about the inflammatory risk factors of coronary artery disease for early assessment of coronary artery disease. Serum β2-microglobulin (22m) is a newly identified biomarker that has been found to increase in patients with coronary artery disease. Aims: To determine the role of β2m in predicting the severity of coronary artery disease. Methods: This cross-sectional study was carried out in Department of Cardiology and Laboratory Medicine, BSMMU, Shahbag, Dhaka during March 2017 to February 2018. Total seventy four patients who underwent coronary angiography as per criteria where included in this study. Serum β2-microglobulin (22m)was done before angiography procedure by indirect ELISA method and severity of coronary artery disease was assessed by extent of diseased coronary vessels and SYNTAX score. Results: β2-microglobulin level was found higher (≥3/ml) in coronary artery disease patients which was statistically significant (p<0.001). β2-microglobulin was also correlated with number of diseased coronary vessels (r=0.562, p<0.001). Mean β2m level was found 4.48±0.95 μg/ml with range from 3-6.1 μg/ml and the mean SYNTAX score was found 16.27±08.99 with the range from 1 to 44. Pearson’s correlation coefficient was done between β2m level and SYNTAX score. Then the result is r=0.547 and p<0.001. Therefore, there was a positive correlation between β2m level and SYNTAX score. The area under the receiver-operator characteristic (ROC) curves 22m cut off value of 3.6 with 81.4% sensitivity and 86.7% specificity as the value for identifying the coronary artery disease. Conclusion: Our study revealed that β2-microglobulin effectively correlates with the severity of coronary artery disease. So it may be used as a reliable marker for assessment of coronary artery disease severity. Keyword: Coronary artery disease, Severity of coronary artery disease, β2-microglobulin. University Heart Journal 2020; 16(1): 22-27 University Heart Journal Vol. 16, No. 1, January 2020 Received: 10 October, 2019 Accepted: 01 December, 2019

[1]  P. K. Sharma Atherosclerosis. , 2020, The Journal of the Association of Physicians of India.

[2]  Wei-Jei Wang,et al.  Associations among Serum Beta 2 Microglobulin, Malnutrition, Inflammation, and Advanced Cardiovascular Event in Patients with Chronic Kidney Disease , 2017, Journal of clinical laboratory analysis.

[3]  W. Cui,et al.  High levels of serum β2-microglobulin predict severity of coronary artery disease , 2017, BMC Cardiovascular Disorders.

[4]  A. Majumder,et al.  Coronary artery disease in Bangladesh: a review. , 2013, Indian heart journal.

[5]  S. Sharp,et al.  Usefulness of the addition of beta-2-microglobulin, cystatin C and C-reactive protein to an established risk factors model to improve mortality risk prediction in patients undergoing coronary angiography. , 2013, The American journal of cardiology.

[6]  R. Garrick Novel Markers of Kidney Function as Predictors of ESRD, Cardiovascular Disease, and Mortality in the General Population , 2012 .

[7]  O. Wagner,et al.  Beta 2 Microglobulin and the Risk for Cardiovascular Events in Patients With Asymptomatic Carotid Atherosclerosis , 2011, Stroke.

[8]  J. Kals,et al.  β2-microglobulin, a novel biomarker of peripheral arterial disease, independently predicts aortic stiffness in these patients , 2011, Scandinavian journal of clinical and laboratory investigation.

[9]  T. Palvannan,et al.  Beta-2 microglobulin as an immunological marker to assess the progression of human immunodeficiency virus infected patients on highly active antiretroviral therapy. , 2011, Clinica chimica acta; international journal of clinical chemistry.

[10]  J. Manson,et al.  Novel proteins associated with risk for coronary heart disease or stroke among postmenopausal women identified by in-depth plasma proteome profiling , 2010, Genome Medicine.

[11]  S. Hidaka,et al.  Differences in associated factors between aortic and mitral valve calcification in hemodialysis , 2010, Hypertension Research.

[12]  Y. Fujiwara,et al.  2-Microglobulin for Risk Stratification of Total Mortality in the Elderly Population Comparison With Cystatin C and C-Reactive Protein , 2008 .

[13]  Fujun Zhang,et al.  &bgr;2-Microglobulin as a Biomarker in Peripheral Arterial Disease: Proteomic Profiling and Clinical Studies , 2007 .

[14]  J. Mehta,et al.  Inflammatory markers, angiographic severity of coronary artery disease, and patient outcome. , 2007, The American journal of cardiology.

[15]  M. Haberal,et al.  Cardiac troponin I and beta 2 microglobulin as risk factors for early‐onset atherosclerosis in patients on haemodialysis , 2005, Nephrology.

[16]  Y. Saijo,et al.  Relationship of β2-Microglobulin to Arterial Stiffness in Japanese Subjects , 2005, Hypertension Research.

[17]  C. Kluft Identifying patients at risk of coronary vascular disease: the potential role of inflammatory markers , 2004 .

[18]  J. Sabio,et al.  Salivary and serum beta2-microglobulin and gamma-glutamyl-transferase in patients with primary Sjögren syndrome and Sjögren syndrome secondary to systemic lupus erythematosus. , 2003, Clinica chimica acta; international journal of clinical chemistry.

[19]  Q. Yi,et al.  Beta2-microglobulin as a potential initiator of inflammatory responses. , 2003, Trends in immunology.

[20]  B. Barlogie,et al.  β2‐microglobulin as a negative growth regulator of myeloma cells , 2002, British journal of haematology.

[21]  P. Heinrich,et al.  Regulation of beta2-microglobulin expression in different human cell lines by proinflammatory cytokines. , 1999, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[22]  M. Makuuchi,et al.  Biologic significance of angiopoietin-2 expression in human hepatocellular carcinoma. , 1999, The Journal of clinical investigation.

[23]  S. Thompson,et al.  Production of C-reactive protein and risk of coronary events in stable and unstable angina , 1997, The Lancet.

[24]  J. Chanard,et al.  Kinetics of 125I-beta 2-microglobulin turnover in dialyzed patients. , 1992, Kidney international.

[25]  D. Wiley,et al.  Refined structure of the human histocompatibility antigen HLA-A2 at 2.6 A resolution. , 1991, Journal of molecular biology.

[26]  R. Walker,et al.  β2‐Microglobulin in non‐malignant and malignant human breast: A feature of differentiation , 1984, The Journal of pathology.

[27]  L. Solberg,et al.  Risk factors and atherosclerotic lesions. A review of autopsy studies. , 1983, Arteriosclerosis.

[28]  F. Karlsson,et al.  beta 2-Microglobulin in clinical medicine. , 1980, Scandinavian journal of clinical and laboratory investigation. Supplementum.