Author + information
- Minghui Cheng1,
- Gao Naijing1,
- Zhang Xiaolin1,
- Tian Xiaoxiang1,
- Yan Chenghui1,
- Han Yaling1 and
- Wang Shuang1
The diagnostic sensitivity of myocardial necrosis markers, such as creatine kinase-MB (CK-MB), cardiac troponins, myoglobin for the earliest stage of ST-elevation myocardial infarction (STEMI), remains insufficient. We compared a new biomarker of plaque vulnerability (receptor for advanced glycation end-products, S100A12) with other biomarker at the earliest stage of STEMI.
The study population comprised 250 subjects [150 STEMI, 50 non-STEMI (NSTEMI), 50 unstable angina pectoris (UAP) and 50 control]. S100A12, myoglobin, troponin T and CK-MB were determined on arrival, after 4h, 6h, 12h, 24h, 3d, 7d and 1 month. Receiver operating cures (ROC) for S100A12, myoglobin, troponin T and CK-MB were constructed at 2h, 4h and 6h after onset. Based on these curves, the area under curve (AUC), the sensitivity and specificity were calculated.
Plasma S100A12 levels were measured in 150 STEMI, 50 non-STEMI (NSTEMI), 50 unstable angina pectoris (UAP) and 50 control. At optimal cut-off value of 161.7 ng/ml, S100A12 discriminated STEMI from non- AMI with 81.6% sensitivity, 81.7% specificity and 0.859 AUC. Time-dependent changes in S100A12, myoglobin, troponin T and CK-MB were analyzed in 50 STEMI patients. Elevated plasma S100A12 levels persisted for 24h after onset, whereas other markers were not elevated at the time of onset and peaked at ≥ 2h thereafter. The diagnosis sensitivity of S100A12, myoglobin, troponin T and CK-MB for STEMI upon admission (98min after onset) was 85.2%, 72.3%, 61.1% and 42%, respectively.
Plasma S100A12 diagnosed the early stages of STEMI more accurately than myoglobin, troponin T and CK-MB.