Value of platelet protein kinase C epsilon in risk stratification of acute chest pain in elderly with normal troponin levels
Hao Cuijun
Wang Rui
Hong Yang
Li Xiaoying
Han Shaojie
Li Fangjiang
Abstract：Objective To investigate the role of additional platelet protein kinase C epsilon(PKCε)assay in risk stratification and additional diagnostic testing in elderly patients with acute chest pain and normal hypersensitive cardiac troponin I(hs-cTnI)level.Methods A prospective trial was conducted on 220 consecutive elderly patients with angina-like acute chest pain and normal hs-cTnI level in our hospital from April 2022 to April 2023.According to whether major adverse cardiovascular events(MACE)occurred during the 1-year follow-up period,they were assigned in-to MACE group(24 cases)and non-MACE group(196 cases).Their general clinical data and platelet PKCε expression were compared between the two groups.Kaplan-Meier survival curve was plotted to analyzed the event-free time between the platelet PKCε expression＜2.05％group and the≥2.05％group.Multivariate Cox regression analysis was used to investigate the impact of baseline data on the occurrence of MACE during the 1-year follow-up period.Decision tree model was employed to analyze the influencing factors for MACE.Results During 1-year follow-up,24 patients(10.91％)developed MACE.The platelet PKCε expression was significantly higher in the MACE group than the non-MACE group[9.25％(6.60％,15.25％)vs 1.70％(0.80％,3.25％),Z=-7.596,P＜0.01].Kaplan-Meier survival curve analysis showed that the patients in the PKCε＜2.05％group had no events within 360 d,while those in the ≥2.05％group had an average event-free time of 297.13±12.77 d,with a statistical difference(log rank Chi-square=27.051,P=0.000).Multivariate Cox regression analysis showed that highly suspicious angina,hs-cTnI and platelet PKCε were independent risk factors for MACE within 1 year of follow-up(HR=3.011,95％CI:1.049-8.641,P=0.040;HR=1.216,95％CI:1.044-1.418,P=0.012;HR=1.160,95％CI:1.104-1.218,P=0.000).In the decision tree model,the 1-year incidence of MACE was notably higher in the platelet PKCε≥2.05％group than the＜2.05％group(P=0.011).The probability of severe coronary artery stenosis or myocardial ischemia in the platelet PKCε≥2.05％group was remarkably higher than the＜2.05％group(P=0.006).Conclusion In elderly patients suffering from acute chest pain with normal hs-cTnI level,additional platelet PKCε detection appears to have a good prognostic gain.
Keywords：chest painblood plateletsprotein kinase C-deltatroponin
Publication Date：2025-02-14
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 159-163 )