Biomarker For Acute Coronary Syndrome Research Articles

Biomarkers in acute coronary syndromes: from the origins to the present

Acute coronary syndrome remains the leading cause of death in both patients with coronary artery disease and patients with other diseases (such as diabetes mellitus, chronic kidney disease, inflammatory diseases of various etiologies, and others). Early diagnosis of cardiomyocyte damage and necrosis opens up wide opportunities to improve the prognosis of patients with atherosclerotic lesions of the coronary arteries, and also makes it possible to discharge patients without acute cardiovascular pathology from intensive care units with a high degree of probability. The article discusses the evolution of the research and introduction into broad clinical practice of markers of myocardial damage and necrosis, which have largely improved modern clinical practice.

Single‑nucleotide polymorphisms in the promoter of the gene encoding for C‑reactive protein associated with acute coronary syndrome.

Acute coronary syndrome (ACS) is a leading cause of mortality worldwide. Several studies have shown that certain single nucleotide polymorphisms (SNPs) are linked to the development of ACS. In particular, C-reactive protein (CRP) has emerged as an important predictive biomarker for cardiovascular disease. The current study aimed to investigate four polymorphisms of the CRP gene as possible biomarkers for ACS in a sample of 252 individuals (114 patients with ACS and 138 healthy controls) from Southeastern Mexico. Multivariate analysis adjusted for clinical variables showed that the polymorphism 3872CT for the genotype CC/CT [adjusted Odds Ratio (AdOR)=3.78; 95% Confidence Interval (CI): 1.11-12.92; P=0.034] and the genotype GG/GC of the polymorphisms 2667CG (AdOR=4.82; 95% CI: 1.69-13.72; P=0.02) were associated with ACS. However, the polymorphisms 3006AC genotype AA/AC and 5237GA genotype GG/GC were not found to be associated in the multivariate analysis with ACS (P>0.05). These results suggested that 3872CC/CT and 2667CC/CG polymorphism of the CRP gene plays a significant role in the development of ACS.

MiR-223-5p serves as a diagnostic biomarker for acute coronary syndrome and its predictive value for the clinical outcome after PCI

BackgroundAcute coronary syndrome (ACS) is a serious cardiovascular disease that severely affects the quality of life and longevity of patients. MicroRNAs (miRNAs) play a key role in the progression of ACS with significant clinical value. The aim of this study was to examine the clinical value of miR-223-5p in ACS and on the occurrence of major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI).MethodsThe plasma expression of miR-223-5p was detected by RT-qPCR. The correlation of miR-223-5p and cTnI or Gensini score was shown by the Pearson method. Risk factors for the development of ACS were analyzed by multivariate logistic regression. The efficacy of miR-223-5p in identifying patients with ACS was shown by ROC curve. The predictive value of miR-223-5p for MACE development in ACS patients within 6 months after PCI was assessed by Kaplan-Meier curve and multivariate Cox regression.ResultsmiR-223-5p levels were markedly elevated in ACS patients. miR-223-5p was found to be positively related to cTnI or Gensini score. miR-223-5p was a risk factor for ACS and significantly identified patients with ACS. MACE was more likely to occur after PCI in patients with high miR-223-5p levels, and miR-223-5p was an independent prognostic indicator of MACE.ConclusionsmiR-223-5p had diagnostic value for ACS and predicted MACE after PCI.

Long non-coding RNA SNHG7 serves as a diagnostic biomarker for acute coronary syndrome and its predictive value for the clinical outcome after percutaneous coronary intervention

BackgroundAcute coronary syndrome (ACS) is one of the common causes of cardiovascular death. The related lncRNAs were novel approaches for early diagnosis and intervention. This paper focused on the clinical function of SNHG7 for patients after PCI.MethodsThe expression of SNHG7 was assessed in ACS patients. The predictive roles of SNHG7 were unveiled by the ROC curve. The relationship between SNHG7 and Gensini scores was judged by Pearson analysis. One-year follow-up was conducted and all patients were catalogued into different groups based on the prognosis. The qRT-PCR, K-M curve, and Cox regression analysis were performed to document the prognostic significance of SNHG7.ResultsSNHG7 was highly expressed in ACS and its three subtypes. SNHG7 showed a certain value in predicting ACS, UA, NSTEMI, and STEMI. Gensini is a closely correlated indicator of SNHG7. The declined expression of SNHG7 was observed in the non-MACE and survival groups. The risk of MACE and death was increased in the group with high expression of SNHG7. SNHG7 was an independent biomarker in patients with ACS after PCI.ConclusionsSNHG7 might be a diagnostic and prognostic tool for ACS patients.

Circulating miRNA-21 as a diagnostic biomarker for acute coronary syndrome: a systematic review and meta-analysis of diagnostic test accuracy study.

Both early detection and treatment for acute coronary syndrome (ACS) have positively affected prognosis. A microRNA, miRNA-21 (miR-21), may have additional diagnostic potential for ACS among the others. This systematic review and meta-analysis aimed to evaluate the potential role of miR-21 in identifying ACS. PubMed, EMBASE and CENTRAL databases were searched up to March 17, 2024, for case-control and cohort studies assessing the diagnostic value of circulating miR-21 in patients with ACS. The search was limited to studies published in either English or Chinese. The primary outcome was the discriminative ability to circulate miR-21 for ACS, represented by the area under the standard receiver operating characteristic curve (AUC) analysis. Meta-analyses combined the AUCs using a random-effects model. Heterogeneity among the studies was detected by the I2 and Q statistics. The quality of the studies included was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2. Publication bias analysis was assessed constructing by the Egger's test (PROSPERO: CRD42020209424). Eleven case-control studies containing a total of 2,413 subjects with 1,236 ACS cases and 1,177 controls were included. The mean age of participants in these studies ranges between 51.0 and 69.0 years. The meta-analysis showed an overall pooled AUC of 0.779 [95% confidence interval (CI): 0.715-0.843], with high heterogeneity noted between the studies (Q statistic =190.64, I2=94.23%, P<0.001). In subgroup analyses according to the subtypes of ACS, a pooled AUC of 0.767 (95% CI: 0.648-0.887) was derived from the studies focused on acute myocardial infarction cases only. The pooled AUC for unstable angina was 0.770 (95% CI: 0.718-0.822). In subgroup analyses according to the types of control groups, pooled AUC for ACS versus healthy controls was 0.779 (95% CI: 0.715-0.843), whereas the pooled AUC for ACS versus unhealthy controls was 0.740 (95% CI: 0.645-0.836). The quality assessment showed that the studies' overall quality was moderate. No evidence of publication bias was noted (P=0.49). Circulating miR-21 shows abilities to differentiate between ACS and non-ACS, suggesting its potential as a novel diagnostic biomarker for ACS. However, the evidence is weakened by high heterogeneity observed among the studies. Further research is essential before it can be applied in clinical practice.

The connection of hypovitaminose D and biomarkers of acute coronary syndrome in patients with COVID-19

The connection of hypovitaminose D and biomarkers of acute coronary syndrome in patients with COVID-19

Correlation of Plasmatic Amyloid Beta Peptides (Aβ-40, Aβ-42) with Myocardial Injury and Inflammatory Biomarkers in Acute Coronary Syndrome.

Background/Objective: Amyloid beta (β) -40 levels increase with age and inflammation states and appear to be associated with clinical manifestations of acute coronary syndrome (ACS). We investigated the correlation of Aβ peptides with myocardial injury and inflammation biomarkers in patients with or without ST elevation myocardial infarction (STEMI, NSTEMI). Methods: This singe-center, cross-sectional, observational, and correlation study included 65 patients with ACS (n = 34 STEMI, 29 males, age = 58 ± 12 years; n = 31 NSTEMI, 22 males, age = 60 ± 12 years) who were enrolled in the coronary care unit within 12 h after symptom onset from February 2022 to May 2023. Aβ peptide levels and biochemical parameters were assessed. Results: NSTEMI patients had a higher prevalence of hypertension (p = 0.039), diabetes (p = 0.043), smoking (p = 0.003), and prior myocardial infarction (p = 0.010) compared to STEMI patients. We observed a higher level of Aβ-42 in NSTEMI (p = 0.001) but no difference in Aβ-40 levels. We also found a correlation between age and NT-proBNP with both Aβ peptides (Aβ-40, Aβ-42) (p = 0.001, p = 0.002 respectively). Conclusions: Our results show that patients with NSTEMI had a higher prevalence of cardiovascular risk factors (hypertension, diabetes, smoking, and prior myocardial infarction). Considering these results, we propose that Aβ-42 can add value to risk stratification in NSTEMI patients.

Diagnostic and Prognostic Utility of FFAR2 Gene Expression in Peripheral Blood as a Potential Biomarker for Acute Coronary Syndrome

Diagnostic and Prognostic Utility of FFAR2 Gene Expression in Peripheral Blood as a Potential Biomarker for Acute Coronary Syndrome

Evaluation of The Utility of Serum Carcinoembryonic Antigen (Cea) Level as A Novel Biomarker in Acute Coronary Syndrome and Stable Angina

Evaluation of The Utility of Serum Carcinoembryonic Antigen (Cea) Level as A Novel Biomarker in Acute Coronary Syndrome and Stable Angina

The New Biomarkers for Acute Coronary Syndrome

We read your article prepared by Doğan and Taşlıdere, titled “Investigation of Panic Attack Patients Presenting to the Emergency Department of Bezmialem Vakıf University with Chest Pain” and published in the first issue of your magazine in 2023, with great interest. We would like to thank the authors and editorial board for this article, guides the effective use of resources in health. We would like to thank again to the authors for their efforts to clarify this situation, that is a clinical dilemma in the emergency department and that clinicians find difficult to manage We congratulate them. However, we would like to point out a few points that will contribute to the discussion of the study.

Circulating mir-483-5p as a novel diagnostic biomarker for acute coronary syndrome and its predictive value for the clinical outcome after PCI

BackgroundMicroRNA (miRNA) plays a critical function in the progression of acute coronary syndrome (ACS) and is associated with major adverse cardiovascular events (MACEs) after undergoing percutaneous coronary intervention (PCI). This research was designed to probe the diagnostic accuracy of miR-483-5p in patients with ACS and its predictive value of MACEs.Methods118 patients with ACS (40 with unstable angina pectoris [UAP] and 78 with acute myocardial infarction [AMI]) and 75 healthy controls were enrolled. Serum miR-483-5p was detected in the subjects by reverse transcription-quantitative real-time PCR (RT-qPCR). ROC curve and logistic regression models were employed to estimate the diagnosis. Patients were monitored for 6 months after PCI to document the occurrence of MACEs. Kaplan-Meier survival was conducted to explore the predictive significance of miR-483-5p for the MACEs.ResultsSerum miR-483-5p levels were higher in ACS patients and associated with SYNTAX score and Gensini score. miR-483-5p was effective in identifying ACS patients from healthy individuals (AUC = 0.919) and AMI patients from ACS patients (AUC = 0.867), demonstrating a high diagnostic value, proven by logistic regression (OR = 9.664, 95%CI = 4.462–20.928, P < 0.001). The prevalence of MACEs during follow-up were 24.58%, and a higher prevalence of MACEs were observed in patients with elevated miR-483-5p (P = 0.01). miR-483-5p was also an effective predictor of MACE occurrence (HR = 5.955, 95%CI = 1.928–18.389, P = 0.002).ConclusionExpression of serum miR-483-5p can be utilized as a non-invasive marker for diagnosing ACS and predicting the onset of MACE after PCI.

Comparison of Characteristics among Suspected ACS Patients by Normal and Elevated Hs-Troponin Levels

Background: Acute coronary syndrome (ACS) is a life-threatening condition that requires prompt diagnosis and treatment. However, some patients with ACS may have normal levels of high-sensitivity cardiac troponin (hs-cTn), a biomarker of myocardial injury, at presentation. This study aimed to compare the characteristics and outcomes of ACS patients with normal and elevated hs-cTn levels using different assays and thresholds. Material &amp; Methods: This 2-year retrospective observational study was conducted in Bangladesh, using data from hospital records of 420 suspected ACS patients. Patients were divided into two groups based on their Hs-Troponin levels, with group 1 having 60 patients with Hs-Troponin ≤0.014 ug/L, and group 2 having 360 patients with Hs-Troponin &gt;0.014 ug/L. Patients less than 18 years old and those with incomplete records were excluded. Ethical approval was obtained, and SPSS v.25 was used for analysis. Results: Group 1 had a significantly younger mean age of 41.8±14.3 compared to Group 2’s mean age of 68.4±12.6, with a p-value less than 0.001. Group 2 had a higher percentage of male patients (70.56%) compared to Group 1 (31.67%), with a p-value of less than 0.01. Group 2 had a significantly higher mean heart rate of 80.18±20.64 beats per minute compared to Group 1’s mean heart rate of 71.02±12.21, with a p-value less than 0.001. There were no significant differences between the two groups in terms of systolic blood pressure, diastolic blood pressure, BMI, history of smoking, history of AMI, hypertension, and diabetes mellitus. Group 1 had a significantly lower percentage of patients with hypercholesterolemia (55.00%), but a higher percentage of patients with a history of ACS (25.00%), and a family history of CAD (70.00%) compared to Group 2, with p-values less than 0.001. Group 2 had a significantly higher percentage of patients with known renal failure (21.67%) compared to Group 1 (1.67%), with a p-value less than 0.001. Creatinine levels were significantly higher in Group 2 (98±53 µmol/L) compared to Group 1 (76±17 µmol/L) with a p-value of less than 0.001, and eGFR was significantly lower in Group 2 (76±27 mL/min/1.73 m2) compared to Group 1 (97±23 mL/min/1.73 m2) with a p-value of less than 0.001. The cardiac Troponin T (cTnT) levels were significantly higher in Group 2 (0.28±1.68 ug/L) compared to Group 1 (0.01±0.01 ug/L) with a p-value of less than 0.001, indicating worse kidney function and cardiac damage in Group 2 compared to Group 1. Conclusion: The study found that very few patients presenting with ACS symptoms had normal Hs-Troponin levels, and ultimate diagnosis proved that they did not have ACS, indicating the usability of Hs-Troponin as a biomarker for ACS. Significant differences were observed in age, gender, heart rate, hypercholesterolemia, family history of ACS, family history of CAD, and renal failure between the two groups. The study also found a consistent association between elevated creatinine levels and lower eGFR with higher Hs-Troponin levels.

Analysis of the Ischemia-Modified Albumin as a Potential Biomarker for Cardiovascular Damage in Obstructive Sleep Apnea Patients with Acute Coronary Syndrome.

Obstructive sleep apnea (OSA) has been identified as a cardiovascular (CV) risk factor. The potential of OSA promoting the synthesis of CV biomarkers in acute coronary syndrome (ACS) is unknown. Ischemia-modified albumin (IMA) has been identified as a specific CV biomarker. The aim of this study was to evaluate the role of IMA as a potential biomarker for determining the impact of OSA in ACS patients. A total of 925 patients (15.5% women, age: 59 years, body mass index: 28.8 kg/m2) from the ISAACC study (NCT01335087) were included. During hospitalization for ACS, a sleep study for OSA diagnosis was performed and blood samples extraction for IMA determination were obtained. IMA values were significantly higher in severe OSA (median (IQR), 33.7 (17.2-60.3) U/L) and moderate (32.8 (16.9-58.8) U/L) than in mild/no OSA (27.7 (11.8-48.6) U/L) (p = 0.002). IMA levels were very weakly related to apnea-hypopnea index (AHI) as well as hospital and intensive care unit stay, although they only maintained a significant relationship with days of hospital stay after adjusting for sex, age and BMI (ß = 0.410, p = 0.013). The results of the present study would suggest a potentially weaker role of OSA in the synthesis of the CV risk biomarker IMA in patients with ACS than in primary prevention.

SERUM NT-PROBNP AND CRP AS A PROGNOSTIC MARKER IN ACUTE CORONARY SYNDROME IN A TERTIARY CARE HOSPITAL

Background: Coronary artery disease (CAD) continues to be a leading cause of morbidity and mortality worldwide. Although NT-proBNP is the preferred biomarker for heart failure (HF), several studies have suggested that NT-proBNP is also a risk marker for major adverse cardiovascular events (MACE) in the general population and in CAD patients. Numerous studies have shown that CRP has independent prognostic relevance for the risk of cardiovascular events in patients with CAD as well as in the apparently healthy population. This study evaluates the prognostic value of CRP and NT-ProBNP in predicting cardiovascular outcomes in patients presenting with acute coronary syndromes. Methods: This single-centered hospital-based observational study was conducted at the Department of General Medicine and Dept of Cardiology, SMCH from 1st January 2022 to 31st June 2022 for a period of 6 months. We evaluated the prognostic value of NT-proBNP and CRP for adverse outcomes in patients with acute coronary syndromes (ACS). 10 Results: 0 patients were included in the study, out of whom 42(42%) patients were having STEMI (28 male and &amp; 14 female), 48(48%) patients had NSTEMI (36 male, 12 female), and 10(10%) patients had Unstable angina (6 male and 4 female). The elevated levels of NT-proBNP and CRP levels were correlated and found to provide important information for risk stratification across the entire spectrum of ACS. NT proBNP and CRP are more commonly elevated in S Conclusion: TEMI than NSTEMI or Unstable Angina. NT proBNP and CRP are reliable prognostic biomarkers in ACS

The impact of circulating IGF-1 and IGFBP-2 on cardiovascular prognosis in patients with acute coronary syndrome.

While insulin-like growth factor 1 (IGF-1) exerts a cardioprotective effect in the setting of atherosclerosis, insulin-like growth factor binding protein 2 (IGFBP-2) is involved in metabolic syndrome. Although IGF-1 and IGFBP-2 are known to be predictors for mortality in patients with heart failure, their use in clinic as prognostic biomarkers for acute coronary syndrome (ACS) requires investigation. We evaluated the relationship between IGF-1 and IGFBP-2 levels at admission and the risk of major adverse cardiovascular events (MACEs) in patients with ACS. A total of 277 ACS patients and 42 healthy controls were included in this prospective cohort study. Plasma samples were obtained and analyzed at admission. Patients were followed for MACEs after hospitalization. Among patients who suffered acute myocardial infarction, plasma levels of IGF-1 and IGFBP-2 were lower and higher, respectively, as compared to healthy controls (both p < 0.05). The mean follow-up period was 5.22 (1.0-6.0) months and MACEs incidence was 22.4% (62 of 277 patients). Kaplan-Meier survival analysis revealed that patients with low IGFBP-2 levels had a greater event-free survival rate than patients with high IGFBP-2 levels (p < 0.001). Multivariate Cox proportional hazards analysis revealed IGFBP-2, but not IGF-1, to be a positive predictor of MACEs (hazard ratio 2.412, 95% CI 1.360-4.277; p = 0.003). Our findings suggest that high IGFBP-2 levels are associated with the development of MACEs following ACS. Moreover, IGFBP-2 is likely an independent predictive marker of clinical outcomes in ACS.

Association of Mean Platelet Volume with Acute Coronary Syndrome: A Case–Control Study

Abstract Background: Acute coronary syndrome (ACS) is a group of symptoms associated with acute myocardial ischemia and is one of the major causes of morbidity and mortality across the world. Its primary etiology is atherosclerosis which is crucially dependent on platelets, and hence, mean platelet volume (MPV) could be a new biomarker for predicting or diagnosing ACS. Our study aims to measure the MPV in patients of ACS and compares it with patients of noncardiac chest pain to evaluate its usefulness as a new marker for ACS. Materials and Methods: A case–control study with 50 cases and 50 controls was carried out in SSG Hospital, Vadodara, over a period of 1 year (November 2016–November 2017). ACS patients were identified according to inclusion and exclusion criteria and their MPV was compared to that of noncardiac chest pain patients. Results: The cases had a higher MPV as compared to the control group, with both males and females being affected, but a stronger association was seen in case of males. Conclusions: Raised MPV has shown significant association with ACS and the test has reasonable sensitivity and specificity, which warrants larger scale studies to confirm its utility as a biomarker for ACS.

Myeloperoxidase and global longitudinal strain in prognostication of clinical events after ST segment elevation myocardial infarction

Elevated levels of several inflammatory cytokines and chemokines, such as myeloperoxidase (MPO) and some characteristics of damaged myocardium such as myocardial deformation (global longitudinal strain — GLS) seem to be promising biomarkers for acute coronary syndrome, but their predictive ability for clinical outcomes amongst ST segment elevation myocardial infarction (STEMI) patients having obesity remained unclear.&#x0D; The aim of the study was to to determine the impact of MPO and GLS on prediction of 1‑year combined clinical events in STEMI patients successfully treated with primary percutaneous coronary intervention (PCI) depending on abdominal obesity presentation.&#x0D; Materials and methods. We prospectively enrolled 102 individuals with STEMI who were successfully treated with primary PCI. All patients gave their consent to participate in the study. The biomarkers (MPO, cardiac troponins), echocardiographic and Doppler parameters including global longitudinal strain (GLS) were evaluated at the baseline.&#x0D; Results. The MPO level in the entire population of patients with STEMI was 129.45 [48.48 — 179.70] ng/ml. The group was divided into two cohorts depending on the median level of MPO (≥ 98.34 ng/ml and &lt; 98.34 ng/ml). We observed 26 combined end‑points (10 and 17 in patients with MPO ³ 98.34 ng/ml and &lt; 98.34 ng/ml, respectively (F test = 0.064285; ε2 = 4.29; р = 0.046). Multivariate linear regression showed that the only GLS and MPO remained independent predictors for the clinical outcomes.&#x0D; Conclusions. Global longitudinal strain was the best predictor for 1‑year combined clinical outcomes in STEMI patients who were undergone successful primary PCI. Body fat accumulation seems to show borderline significance when compared with GLS, while it was sufficiently better than MPO.

Predicting protective gene biomarker of acute coronary syndrome by the circRNA-associated competitive endogenous RNA regulatory network.

Background: The mortality and disability rates of acute coronary syndrome (ACS) are quite high. Circular RNA (circRNA) is a competitive endogenous RNA (ceRNA) that plays an important role in the pathophysiology of ACS. Our goal is to screen circRNA-associated ceRNA networks for biomarker genes that are conducive to the diagnosis or exclusion of ACS, and better understand the pathology of the disease through the analysis of immune cells. Materials and methods: RNA expression profiles for circRNAs (GSE197137), miRNAs (GSE31568), and mRNAs (GSE95368) were obtained from the GEO database, and differentially expressed RNAs (DEcircRNAs, DEmiRNAs, and DEmRNAs) were identified. The circRNA-miRNA and miRNA-mRNA regulatory links were retrieved from the CircInteractome database and TargetScan databases, respectively. As a final step, a regulatory network has been designed for ceRNA. On the basis of the ceRNA network, hub mRNAs were verified by quantitative RT-PCR. Hub genes were validated using a third independent mRNA database GSE60993, and ROC curves were used to evaluate their diagnostic values. The correlation between hub genes and immune cells associated with ACS was then analyzed using single sample gene set enrichment analysis (ssGSEA). Results: A total of 17 DEcircRNAs, 229 DEmiRNAs, and 27 DEmRNAs were found, as well as 52 circRNA-miRNA pairings and 10 miRNA-mRNA pairings predicted. The ceRNA regulatory network (circRNA-miRNA-mRNA) was constructed, which included 2 circRNA (hsa_circ_0082319 and hsa_circ_0005654), 4 miRNA (hsa-miR-583, hsa-miR-661, hsa-miR-671-5p, hsa-miR-578), and 5 mRNA (XPNPEP1, UCHL1, DBNL, GPC6, and RAD51). The qRT-PCR analysis result showed that the XPNPEP1, UCHL1, GPC6 and RAD51 genes had a significantly decreased expression in ACS patients. Based on ROC curve analysis, we found that XPNPEP1 has important significance in preventing ACS occurrence and excluding ACS diagnosis. ACS immune infiltration analysis revealed significant correlations between the other 3 hub genes (UCHL1, GPC6, RAD51) and the immune cells (Eosinophils, T folliculars, Type 2T helper cells, and Imumature dendritic cells). Conclusion: Our study constructed a circRNA-related ceRNA network in ACS. The XPNPEP1 gene could be a protective gene biomarker for ACS. The UCHL1, GPC6 and RAD51 genes were significantly correlated with immune cells in ACS.

Platelet MicroRNA-484 as a Novel Diagnostic Biomarker for Acute Coronary Syndrome.

Platelet microRNAs (miRs) have been indicated as a diagnostic biomarker in various diseases, including acute coronary syndrome (ACS). This study aimed to investigate the expression of miR-223-5p, miR-126-5p, miR-484, and miR-130a-3p in individuals with coronary artery disease (CAD). Forty subjects with CAD and 13 healthy individuals were under study. The expression of miR-223-5p, miR-126-5p, miR-484, and miR-130a-3p was measured in platelets by quantitative reverse transcription-polymerase chain reaction. The relationship between miRNA expression and various parameters of the subjects was analyzed using analysis of variance and Spearman and t-tests. The miR-484 expression was significantly upregulated in the ACS subjects (P = .0097). Moreover, miR-484 had diagnostic value for screening subjects with unstable angina vs controls (area under the curve [AUC] = 0.978, 95% confidence interval [CI] 0.92-1, P = .0006) and NSTEMI patients versus controls (AUC = 0.910, 95% CI 0.74-1, P = .005). The results of this study indicate that the upregulated expression of miR-484 in ACS patients might be used as a diagnostic biomarker in ACS.

Serum Concentrations of Ischaemia-Modified Albumin in Acute Coronary Syndrome: A Systematic Review and Meta-Analysis.

The identification of novel circulating biomarkers of acute coronary syndrome (ACS) may improve diagnosis and management. We conducted a systematic review and meta-analysis of ischaemia-modified albumin (IMA), an emerging biomarker of ischaemia and oxidative stress, in ACS. We searched PubMed, Web of Science, and Scopus from inception to March 2022, and assessed the risk of bias and certainty of evidence with the Joanna Briggs Institute Critical Appraisal Checklist and GRADE, respectively. In 18 studies (1654 ACS patients and 1023 healthy controls), IMA concentrations were significantly higher in ACS (standard mean difference, SMD = 2.38, 95% CI 1.88 to 2.88; p < 0.001; low certainty of evidence). The effect size was not associated with pre-defined study or patient characteristics, barring the country where the study was conducted. There were no significant differences in effect size between acute myocardial infarction (MI) and unstable angina (UA), and between ST-elevation (STEMI) and non-ST-elevation MI (NSTEMI). However, the effect size was progressively larger in UA (SMD = 1.63), NSTEMI (SMD = 1.91), and STEMI (3.26). Our meta-analysis suggests that IMA might be useful to diagnose ACS. Further studies are warranted to compare the diagnostic performance of IMA vs. established markers, e.g., troponin, and to determine its potential utility in discriminating between UA, NSTEMI, and STEMI (PROSPERO registration number: CRD42021324603).