The N-terminal propeptide of type III procollagen in patients with acute coronary syndrome: a link between left ventricular end-diastolic pressure and cardiovascular events

Despite the usefulness of N-terminal propeptide of type III procollagen (PIIINP) in detecting enhanced collagen turnover in patients with congestive heart failure, the value added by PIIINP to the use of clinical variables and echocardiography in relation to directly measured left ventricular (LV) end-diastolic pressure (EDP) and the outcome of acute coronary syndrome (ACS) has not been clearly defined. This study involved 168 adult patients with ACS, who underwent echocardiography, measurement of serum PIIINP levels, and cardiac catheterization. Pulsed wave tissue Doppler imaging (PWTDI), which revealed mean peak systolic (s'), early (e'), and late diastolic (a') velocities, was carried out and the eas index of LV function was evaluated: e'/(a'×s'). The patients were divided into three study groups based on the degree of LVEDP--normal (30 mmHg) LVEDP. All patients were followed-up to determine cardiac-related death and revascularization. Patients with high LVEDP had significantly more PIIINP than those with intermediate or normal LVEDP (all post hoc p