Abstract
Acute coronary syndrome (ACS) results from inadequate supply of blood flow from the coronary arteries to the heart or ischemia. ACS has an extremely high morbidity and mortality. The levels of biomarkers currently used for detection of ACS also increase in response to myocardial necrosis and other diseases and are not elevated immediately after symptoms appear, thus limiting their diagnostic capacity. Therefore, we aimed to discover new ACS diagnostic biomarkers with high sensitivity and specificity that are specifically related to ACS pathogenesis. Sera from 50 patients with ACS and healthy controls (discovery cohort) each were analyzed using mass spectrometry (MS) to identify differentially expressed proteins, and protein candidates were evaluated as ACS biomarkers in 120 people in each group (validation cohort). α-1-acid glycoprotein 1 (AGP1), complement C5 (C5), leucine-rich α-2-glycoprotein (LRG), and vitronectin (VN) were identified as biomarkers whose levels increase and gelsolin (GSN) as a biomarker whose levels decrease in patients with ACS. We concluded that these biomarkers are associated with the pathogenesis of ACS and can predict the onset of ACS prior to the appearance of necrotic biomarkers.
Highlights
Acute coronary syndrome (ACS) refers to the clinical symptoms of ischemia or restricted blood supply from the coronary arteries to the heart
Pooled serum sample data obtained through the information-dependent acquisition (IDA) mode and individual serum sample data obtained through the SWATH mode were matched
ACS is a disease with high morbidity and mortality but its current diagnostic biomarkers such as troponin cannot be detected at the early stages of ACS, and their levels may be elevated in other diseases that present with myocardial damage
Summary
Acute coronary syndrome (ACS) refers to the clinical symptoms of ischemia or restricted blood supply from the coronary arteries to the heart. Patients with ACS present with acute chest discomfort or pain owing to impaired blood flow to the myocardium [1] It includes unstable angina (UA), ST segment elevation myocardial infarction (STEMI), and non-STEMI (NSTEMI), according to electrocardiogram (ECG) variations of the ST segment [2,3]. Troponin levels may be elevated in coronary artery disease (CAD) such as ACS and in other diseases that cause myocardial damage [11]; its positive predictive value may be limited. These biomarkers may not be License 4.0 (CC BY)
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