Assessment of serum levels of bone morphogenetic proteins as sensitive biomarkers for early prediction of acute myocardial infarction.

Abstract

Although acute myocardial infarction (AMI) is a life-threatening disease, rapid diagnosis may reduce mortality risk. Despite being highly specific for AMI, cardiac troponin I (cTnI) does not distinguish between the etiologically diverse of myocardial injury that may be due to MI or non-MI causes. Bone morphogenetic proteins (BMPs), which are important modulators for cardiac morphogenesis, are members of the transforming growth factor-beta superfamily. This work intended to evaluate the utility of 2 members of BMPs (BMP2 and BMP4) as diagnostic biomarkers for AMI. This study included 110 AMI patients and 30 healthy volunteers. AMI patients were subdivided into 39 patients without hypercholesterolemia or diabetes mellitus (AMI without HC or DM), 33 patients with hypercholesterolemia (AMI with HC), and 38 patients with diabetes mellitus (AMI with DM). BMP2 and BMP4 levels were assessed in all subjects. The results showed that serum levels of both BMPs showed significant elevation in all AMI patients compared to healthy controls. In contrast, serum BMP2 level only was significantly elevated in AMI patients with DM compared to those without HC or DM and therefore was able to discriminate between the two subgroups. Notably, the diagnostic efficacy of the two BMPs was improved when combined. In conclusion, the two BMPs are good diagnostic biomarkers for AMI. Nevertheless, BMP2 had a higher diagnostic performance than BMP4 in discriminating AMI with DM from AMI without HC or DM with AUC 0.919 (p=0.001) and the highest PPV (100%), meanwhile, BMP4’s AUC is 0.891 (p=0.001) and a PPV (85.7%).