Multibiomarker analysis in patients with acute myocardial infarction

Eur J Clin Invest. 2017 Sep;47(9):638-648. doi: 10.1111/eci.12785. Epub 2017 Jul 28.

Abstract

Background: Novel biomarkers representing different pathobiological pathways and their role in patients with acute myocardial infarction (AMI) were studied.

Methods: We retrospectively analysed serum levels of soluble suppression of tumorigenicity (sST2), growth-differentiation factor-15 (GDF-15), soluble urokinase plasminogen activator receptor (suPAR), heart-type fatty acid-binding protein (H-FABP) and plasma fetuin A in blood of patients with AMI (STEMI, n = 61; NSTEMI, n = 57) compared to controls with excluded coronary artery disease (n = 76). Furthermore, detailed correlation analysis was performed.

Results: Compared with controls, in patients with STEMI and NSTEMI higher levels expressed as median of sST2 in pg/mL (STEMI: 13210·9, NSTEMI: 11989·1, control: 5248; P < 0·001), GDF-15 in pg/mL (STEMI: 818·8, NSTEMI 677·5, control 548·6; P < 0·001), suPAR in pg/mL (STEMI: 3461·1, NSTEMI: 3466·7, control: 2463·6; P < 0·001), H-FABP in ng/mL (STEMI: 5·8, NSTEMI: 5·4, control: 0·0; P < 0·001) and lower plasma fetuin A levels in μg/mL (STEMI: 95, NSTEMI: 54, control: 116·6; P < 0·001) were detected. Correlation analysis found clinical and biochemical parameters such as ejection fraction, length of hospital stay, creatine kinase, NT-proBNP and hs Troponin T levels as well as inflammatory markers (CRP, leucocytes) to be significantly correlated with novel biomarkers.

Conclusion: Plasma levels of novel biomarkers were significantly elevated (sST2, GDF-15, H-FABP, suPAR) or inversely downregulated (fetuin A) in patients with AMI compared to a control group with excluded coronary artery disease. Significant correlations with various clinical parameters and standard biochemical markers were found.

Keywords: Fetuin A; H-FABP; acute myocardial infarction; biomarkers; heart failure; left ventricular remodelling; risk stratification; sST2, GDF-15; suPAR.

MeSH terms

  • Aged
  • Biomarkers / blood
  • Biomarkers / metabolism
  • C-Reactive Protein / immunology
  • Case-Control Studies
  • Creatine Kinase / blood
  • Fatty Acid Binding Protein 3 / blood*
  • Female
  • Growth Differentiation Factor 15 / blood*
  • Humans
  • Interleukin-1 Receptor-Like 1 Protein / blood*
  • Length of Stay
  • Leukocyte Count
  • Male
  • Middle Aged
  • Myocardial Infarction / blood*
  • Myocardial Infarction / immunology
  • Myocardial Infarction / metabolism
  • Natriuretic Peptide, Brain / blood
  • Non-ST Elevated Myocardial Infarction / blood
  • Non-ST Elevated Myocardial Infarction / metabolism
  • Peptide Fragments / blood
  • Receptors, Urokinase Plasminogen Activator / blood*
  • ST Elevation Myocardial Infarction / blood
  • ST Elevation Myocardial Infarction / metabolism
  • Stroke Volume
  • Troponin T / blood
  • alpha-2-HS-Glycoprotein / metabolism*

Substances

  • Biomarkers
  • FABP3 protein, human
  • Fatty Acid Binding Protein 3
  • GDF15 protein, human
  • Growth Differentiation Factor 15
  • IL1RL1 protein, human
  • Interleukin-1 Receptor-Like 1 Protein
  • PLAUR protein, human
  • Peptide Fragments
  • Receptors, Urokinase Plasminogen Activator
  • Troponin T
  • alpha-2-HS-Glycoprotein
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain
  • C-Reactive Protein
  • Creatine Kinase