Publication: The Association Of Leucine-richglycoprotein-1 (Lrg-1) Level With Myocardial Perfusion Scan In Patients With Ischaemic Heart Disease
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Date
2019-11
Authors
Ab Rashid, Nisa Kamila
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Abstract
Over the last several decades, radionuclide myocardial perfusion imaging (MPI) with single photon emission tomography has been a mainstay for non-invasive imaging for the evaluation of patients with known or suspected coronary artery disease (CAD). However, subjecting the patient to radiation still needs justification. Hence, association with novel inflammatory markers like leucine rich glycoprotein (LRG-1) was studied as an adjunct to assist in decision making. Objective: Aim is of this study was to validate whether the level of LRG-1 was directly proportional with myocardial perfusion scan findings. This may reduce unnecessary radiation to patient by measuring the level of LRG-1 prior subjecting patient for myocardialperfusion test, and subsequently become an adjunct to prognosticate the patients. Methods: Patients referred for myocardial perfusion scan were recruited as participants. Myocardial perfusion scan was done following 2-days protocol.Serum LRG-1 level was measured with Human LRG Assay kit (IBL Technology) with ELISA method. Follow-up and the outcome of the treatment was determined at six months and one year. Clinical data was analysed using IBM SPSS software Version 24 and Stata SE Version 14. Results and Discussion: A total of 120 participants, predominantly male (63 patients) with the mean age of 63 years were recruited, where the majority of the participants consisted of Chinese (44.2%) ethnicity.The mean of LRG-1 level was 50.51 ng/ml. However, analysis indicated that there was no significant association between LRG-1 level and MPS results (p=0.739). Chinese ethnicity had 73% lower odds and presented with lower LRG-1 level compared to Malay ethnicity (OR=0.27, 95% CI: 0.07, 0.97). Apart from that, significant association between MPS results and outcome at 6 months and one year were demonstrated with p<0.001 for both occasions. Findings also indicated that the Chinese ethnicity had 60% lower odds to experience abnormal MPS results compared to Malay ethnicity (OR=0.40, 95% CI: 0.16, 1.00). Conclusion: Study showed there was no significant association between LRG-1 and MPS results in patient with CAD. However, observational case control study should be considered in future study. MPS results could prognosticate the outcome of patients at 6 months and a year. Besides that, ethnicity and female gender are the factors that contributed to lower abnormal MPS results.
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Keywords
Coronary artery disease , inflammatory marker , Nuclear Medicine , Radionuclide imaging , Myocardial Perfusion Imaging