Carcinoembryonic antigen (CEA) is a tumour marker associated with various malignancies such as carcinoma colon, lung, and breast cancer. Nonneoplastic conditions such as obesity, ACS, inflammatory bowel disease, and chronic liver and kidney diseases are also associated with higher CEA levels. Hence, we focused on establishing the utility of Serum CEA level as a novel biomarker in ACS and Stable Angina. This was a single centre, Hospital-based Cross-Sectional Observational Study, over 1 year from November 2021 – November 2022, in the Department of Medicine at tertiary care hospital. The Institutional Ethics Committee (IEC) approved the present study protocol. The mean age of patients included in the study was 54.38 (SD± 11.53 years). Most patients (55%) belonged to the 51-70 years’ group, followed by 37% of patients in the age group 31-50 years. The highest mean values of CEA were noted in patients diagnosed with STEMI; the mean was 5.09 ng/mL (SD±0.59). Patients with stable angina had the lowest CEA mean values at 2.52 ng/mL, although the standard deviation was ±0.83. The descriptive statistics between the ACS and CPK-MB values subtypes were statistically significant. The CPK-MB mean values were the highest in patients diagnosed with STEMI & NSTEMI mean CPK-MB 7.376 ng/mL (SD 1.154). CEA is a robust, novel, and sensitive biomarker for early diagnosis of ACS. Its levels correlate with the severity of ACS.

References

1. Wang F, Yu Y, Mubarik S, Zhang Y, Liu X, Cheng Y, Yu C, Cao J. Global burden of ischemic heart disease and attributable risk factors, 1990–2017: A secondary analysis based on the global burden of disease study 2017. Clinical Epidemiology. 2021; 13:859.
2. Singh SS, Paul SK, Pal R, Thatkar PV. Acute coronary syndrome-related mortality audit in a teaching hospital at Port Blair, India. J Family Med Prim Care. 2017 Jul-Sep;6(3):502-508.
3. Kotecha T, Rakhit RD. Acute coronary syndromes. Clin Med (Lond). 2016 Dec;16(Suppl 6):s43-s48. doi: 10.7861/clinmedicine.16-6-s43.
4. Yeh RW. Sidney S. Chandra M, et al. Population trends in the incidence and outcomes of acute myocardial infarction. N Engl J Med. 2010; 362:2155–65.
5. Weston C, Gavalova L, Whittaker T, Van Leeven R. Annual Public Report April 2013 - March 2014. London: MINAP NICOR; 2014. Myocardial Ischaemia National Audit Project: how the NHS cares for patients with heart attack. www.ucl.ac.uk/nicor/audits/minap/documents/annual_reports/min ap-public-report-2014. [Accessed 9 November 2016].
6. Singh SS, Paul SK, Pal R, Thatkar PV. Acute coronary syndrome-related mortality audit in a teaching hospital at Port Blair, India. J Family Med Prim Care. 2017 Jul-Sep;6(3):502-508.
7. Bracey A, Meyers HP. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Aug 6, 2021. Posterior Myocardial Ischemia.
8. Voudris KV, Kavinsky CJ. Advances in Management of Stable Coronary Artery Disease: the Role of Revascularization? Curr Treat Options Cardiovasc Med. 2019 Mar 11;21(3):15.
9. Pop C, Matei C, Petris A. Anticoagulation in Acute Coronary Syndrome: Review of Major Therapeutic Advances. Am J Ther. 2019 Mar/Apr;26(2):e184-e197.
10. Singh A, Museedi AS, Grossman SA. Acute Coronary Syndrome. [Updated 2022 Jul 11]. In: StatPearls [Internet]. Treasure Island (FL): 101 StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459157.
11. Stevens DP, Mackay IR, Busselton Population Studies Group. Increased carcinoembryonic antigen in heavy cigarette smokers. Lancet 1973; 2:1238-9.
12. Ranga GS, Muktesh G, Sharma SB, Madhu SV. A study of carcinoembryonic antigen concentrations in patients with coronary artery disease. Journal of Acute Medicine. 2016 Mar 1;6(1):11-8.
13. Vassalle C, Pratalli L, Ndreu, R Battaglia D and Andreassi MG. Carcinoembryogenic antigen concentrations in patients with acute coronary syndrome. Clin Chem Lab Med 2010; 48:1339-43.
14. Stevens DP, Mackay IR, Busselton Population Studies Group. Increased carcinoembryonic antigen in heavy cigarette smokers. Lancet 1973; 2:1238-9.
15. .Al-Saif SM, Alhabib KF, Ullah A, Hersi A, Alfaleh H, Alnemer K, Tarabin A, Abuosa A, Kashour T, Al-Murayeh M. Age and its relationship to acute coronary syndromes in the Saudi Project for Assessment of Coronary Events (SPACE) registry: The SPACE age study. J Saudi Heart Assoc. 2012 Jan;24(1):9-16.
16. Granger C.B. Predictors of hospital mortality in the global registry of acute coronary events. Arch Intern Med. 2003;163:2345–2353.
17. Peterson E.D. The NCDR ACTION Registry-GWTG: transforming contemporary acute myocardial infarction clinical care. Heart. 2010;96:1798–1802.
18. Xavier D, P. Pais, P.J. Devereaux, et al. Treatment and outcomes of acute coronary syndromes in India (CREATE): a prospective analysis of registry data. Lancet, 371 (2008), pp. 1435-1442
19. Quyyumi AA. Women and ischemic heart disease: Pathophysiologic implications from the women's ischemia syndrome evaluation (WISE) study and future research steps. J Am Coll Cardiol. 2006;47: S66–S71.
20. Alexander KP, Peterson ED. Medical and surgical management of coronary artery disease in women. Am J Manag Care. 2001;7: 951–956.
21. Duan JG, Chen XY, Wang L, Lau A, Wong A, Thomas GN, Tomlinson B, Liu R, Chan JC, Leung TW, Mok V, Wong KS. Sex differences in epidemiology and risk factors of acute coronary syndrome in Chinese patients with type 2 diabetes: a long-term prospective cohort study. PLoS One. 2015 Apr 1;10(4):e0122031.
22. Claassen M, Sybrandy KC, Appelman YE, Asselbergs FW. Gender gap in acute coronary heart disease: Myth or reality? World journal of cardiology. 2012;4: 36–47.
23. Shaw LJ, Bairey Merz CN, Pepine CJ, Reis SE, Bittner V, Kelsey SF, et al. Insights from the nhlbi-sponsored women's ischemia syndrome evaluation (WISE) study: Part I: Gender differences in traditional and novel risk factors, symptom evaluation, and gender-optimized diagnostic strategies. J Am Coll Cardiol. 2006;47: S4–S20.