The relation of autonomic biomarkers to the patient's outcome with acute coronary syndrome


  • Zana Abdi Directorate of General Health, Duhok, Ministry of Health, Kurdistan region, Iraq.
  • Hishyar MS Garmavy Hussein Department of Pharmacology, College of Pharmacy, University of Duhok, Duhok, Iraq.
  • Suzan Rasool Department of Clinical Pharmacy, College of Pharmacy, University of Duhok, Duhok, Iraq.



Autonomic biomarkers, Chromogranin A, Plasma and RBC Cholinesterase activity, Acute coronary syndrome


Objectives: This study aimed to evaluate the neurohormonal activity in patients with acute coronary syndrome and their relation to clinical outcomes by measuring plasma chromogranin A and plasma and RBC cholinesterase activity.

Methods: In this case-control study, cardiac and neurohormonal parameters were compared between fifty-one patients with acute coronary syndrome admitted to the cardiac center in Azadi teaching Hospital in Duhok-Iraq, and thirty comparable gender and age-healthy subjects.

Results: A significant increase in sympathetic activity was reported in patients with the acute coronary syndrome, reflected by the rise in the plasma chromogranin A compared to the control group (994.47 vs. 1203.95 ng/L, respectively, P<0.05). Meanwhile, cardiac troponin was significantly elevated in those patients compared to healthy subjects (0.17 vs. 4.82 ng/ml, respectively). However, the parasympathetic biomarkers (plasma and RBC cholinesterase activity) did not differ substantially between patients and healthy controls (0.83 vs. 0.92, P > 0.05 and 1.36 vs. 1.37, P>0.05, respectively). Serum troponin I was more valid than chromogranin A in differentiating acute coronary syndrome from healthy subjects. The area under the curve for troponin I was (0.989) compared to ( 0.724) for chromogranin A. Furthermore, plasma chromogranin A but not plasma and RBC cholinesterase activity was significantly increased in fatal cases compared to nonfatal patients (1166.68 vs. 3435.64 ng/L).

Conclusion: Plasma chromogranin A was less effective than troponin I in detecting acute coronary cases; however, it can be helpful as a prognostic marker in those patients. Parasympathetic biomarkers were not appreciable in diagnosing and detecting risky patients. 


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How to Cite

Abdi, Z., Hussein, H. M. G., & Rasool, S. . (2023). The relation of autonomic biomarkers to the patient’s outcome with acute coronary syndrome. Journal of Contemporary Medical Sciences, 9(1).