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

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

First trimester screening test parameters for the high, intermediate and low risk pregnancies for cases meeting quality control criteria for chromosome Y assessment (N = 195).

<p>HR, high risk; IR, intermediate risk; LR, low risk.</p>a<p>IQR, interquartile range.</p>b<p>USG Scan Gest, gestational age based on ultrasonography scanning.</p>c<p>CRL, crown-rump length.</p>d<p>Free β-hCG MoM, multiples of the median of free β-subunit of human chorionic gonadotropin.</p>e<p>PAPP-A MoM, multiples of the median of pregnancy-associated plasma protein A.</p>f<p>NT MoM, multiples of the median of nuchal translucency.</p

Relationship of the z score with fetal DNA fractions in maternal plasma.

<p>Solid line marks the z score cutoff of 3 for detecting elevated proportions of chromosome 21. Dash line shows the correlation between the z score and fetal DNA fractions for the trisomy 21 cases.</p

Relationships between fetal DNA fractions with the first trimester screening parameters between pregnancy risk groups.

<p>Depicted are pregnancies at high risk (purple circles), intermediate risk (green diamonds) and low risk (blue triangles).</p

Frequency distributions of the range of fetal DNA fractions found in male euploid pregnancies.

<p>Fetal DNA fractions are compared among pregnancies at high or low risk for trisomy 21.</p