Evaluation of patients with acute chest pain with microalbuminuria, C-reactive protein and total cholesterol score

The present study was planned to further explore the diagnostic value of microalbuminuria, and C-reactive proteins (CRP) in a scenario of cardiovascular events in patients in the Himalayan region of Northern India. Furthermore, lipid profiles were correlated with CRP and microalbumin in patients in the acute chest pain. Fifty clinically age-and-sex matched healthy volunteers and 100 patients admitted to the Medicine (A&E)/Medicine wards of the Shri Mahant Indiresh Hospital, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand were included in this study. The patients were further divided into two groups, each consisting of 50 patients presenting with acute chest pain caused by cardiovascular diseases and 50 patients presenting with acute chest pain secondary to cases other than cardiovascular diseases. This study included three groups: group A-50 clinically healthy age-and-sex matched healthy subjects; group B-50 patients with acute chest pain caused by cardiovascular diseases; and group C-50 patients of acute chest pain due to secondary causes other than cardiovascular diseases, like pneumothorax, lung cancer and pneumonia. Patients with respiratory diseases, like pulmonary embolism, pulmonary tuberculosis and pleurisy, with gastro-esophageal disease such as gall bladder, gastric and/or duodenal ulcer and ulceration, as well as diabetes mellitus, hypertension and acute infections, were excluded from group B. Six-ml venous blood samples were collected from the anticubital vein under aseptic conditions. Serum was separated and necessary routine investigations were done. Serum CRP was measured by a quantiutative turbidometric methods whereas microalbumin concentrations were measured using an immuneturbidometric procedure. Total cholesterol score was estimated by calculation. Gender differentiation was found in cardiovascular diseases as the number of male patients was almost double than female counterparts. Mean CRP concentrations differed significantly among the three groups as shown by 1-way ANOVA. Pair-wise comparisons using Tukey’s post hoc test also showed that mean serum CRP differed between groups A and B (p < 0.001) and between groups A and C (p < 0.001) but not between groups B and C (p = 0.32). There were significant differences in mean urinary albumin concentrations between healthy volunteers and ACP patients with cardiovascular diseases (p < 0.001) and ACP patients in group C (p < 0.001). Here again the elevation was more marked in female patients of either group in comparison to healthy counterparts. One-way ANOVA also showed a highly significant difference among the three groups in urinary microalbumin concentration. This difference was further confirmed on the basis of pair-wise comparisons, using Tukey’s post hoc test among the three groups. Total cholesterol score was also calculated in this study to know its preference over microalbuminuria and CRP in ACP patients. There was a significant difference in mean TCS concentrations between healthy volunteers and ACP patients with cardiovascular diseases (p < 0.001) and ACP patients in group C (p < 0.001). One-way ANOVA showed a highly significant difference among the three groups in total cholesterol score. This difference was further confirmed on the basis of pair-wise comparisons, using Tukey’s post hoc test among the three groups. Studied biomarkers may be helpful for clinical decision making and further management. Whether the aforementioned less expensive putative biomarkers prove useful is still up for debate and more clinical trials are necessary to establish their validity. Nonetheless, new biomarkers are sure to play a critical role in both clinical practice and research, and a deep understanding of the benefits and limitations of these biomarkers will be crucial for clinicians and researchers alike.