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. 2021 Jul 23;11(8):733.
doi: 10.3390/life11080733.

Association of Dephosphorylated-Uncarboxylated Matrix Gla Protein and Risk of Major Bleeding in Patients Presenting with Acute Myocardial Infarction

Admira Bilalic  1 , Tina Ticinovic Kurir  2   3 , Josip A Borovac  1   2 , Marko Kumric  2 , Daniela Supe-Domic  4 , Marino Vilovic  2 , Dinko Martinovic  2 , Josko Bozic  2
Affiliations

Association of Dephosphorylated-Uncarboxylated Matrix Gla Protein and Risk of Major Bleeding in Patients Presenting with Acute Myocardial Infarction

Admira Bilalic et al. Life (Basel). .

Abstract

The "Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines" (CRUSADE) score emerged as a predictor of major bleeding in patients presenting with the acute coronary syndrome. On the other hand, previous studies established the association of dephosphorylated-uncarboxylated Matrix Gla protein (dp-ucMGP) and vitamin K, as well as their subsequent impact on coagulation cascade and bleeding tendency. Therefore, in the present study, we explored if dp-ucMGP plasma levels were associated with CRUSADE bleeding score. In this cross-sectional study, physical examination and clinical data, including plasma dp-ucMGP levels, were obtained from 80 consecutive patients with acute myocardial infarction (AMI). A significant positive correlation was found between CRUSADE bleeding score and both dp-ucMGP plasma levels (r = 0.442, p < 0.001) and risk score of in-hospital mortality (r = 0.520, p < 0.001), respectively. In comparing the three risk groups of risk for in-hospital bleeding, the high/very high-risk group had significantly higher dp-ucMGP levels from both very low/low group (1277 vs. 794 pmol/L, p < 0.001) and the moderate group (1277 vs. 941 pmol/L, p = 0.047). Overall, since higher dp-ucMGP levels were associated with elevated CRUSADE score and prolonged hemostasis parameters, this may suggest that there is a biological link between dp-ucMGP plasma levels and the risk of bleeding in patients who present with AMI.

Keywords: CRUSADE; acute coronary syndrome; bleeding; matrix Gla protein; myocardial infarction; vitamin K.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Comparison of dp-ucMGP plasma levels between three subgroups of risk for in-hospital major bleeding as estimated by the CRUSADE score. Abbreviations: dp-ucMGP: dephosphorylated-uncarboxylated Matrix Gla protein; CRUSADE: Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines. * Statistically significant values.
Figure 2
Figure 2
Univariate Pearson’s correlation analysis between dp-ucMGP and CRUSADE bleeding score. Abbreviations: dp-ucMGP: dephosphorylated-uncarboxylated Matrix Gla protein; CRUSADE: Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines.
Figure 3
Figure 3
Univariate Pearson’s correlation analysis between GRACE score and CRUSADE bleeding score. Abbreviations: GRACE: Global Registry of Acute Coronary Events; CRUSADE: Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines.
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