Department of Emergency Medicine, University of Health Sciences, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Turkey.
Eur Rev Med Pharmacol Sci. 2023 May;27(10):4481-4491. doi: 10.26355/eurrev_202305_32454.
Our aims were to determine whether the levels of plasma monocyte chemotactic protein-1 (MCP-1), fetuin-A, serum total antioxidant status (TAS), and serum total oxidant status (TOS) are cardiac biomarkers and to clarify their relationship with each other in acute myocardial infarction (AMI).
The study included 90 participants: 60 patients with AMI [30 with and 30 without ST-segment elevation myocardial infarction (STEMI)] and 30 cardiac patients without AMI. The diagnostic values of serum Hs-cTnT, MCP-1, fetuin-A, TAS, and TOS levels in predicting AMI were evaluated statistically.
Median levels of MCP-1 [120.10 ng/L (interquartile range: 76.94-230.54 ng/L)] and TOS [2.89 U/MI (IQR: 2.31-3.94 U/Ml)] were statistically higher, and median levels of fetuin-A [433.52 mg/L (IQR: 387.89-584.49 mg/L)] and TAS (3.10 ± 0.86 U/mL) were lower in patients with AMI than in controls. The parameter with the area under the curve (0.815), sensitivity (73.3%), and specificity (66.7%) closest to those of Hs-cTnT was fetuin-A, followed by MCP-1, TOS, and TAS, respectively. A one-unit increase in MCP-1 levels increased the probability of AMI by 1.023 times (p = 0.002). A one-unit increase in fetuin-A levels decreased the probability of AMI by 0.995 times (p = 0.003). A one-unit increase in serum TOS levels was 1.29 times more characteristic of STEMI than of NSTEMI (p = 0.044).
MCP-1, oxidative stress parameters, and fetuin-A might support Hs-cTnT levels in the early diagnosis of AMI. Fetuin-A and MCP-1 levels may be independent risk factors for AMI, whereas TOS could be used to distinguish STEMI from NSTEMI.
本研究旨在确定血浆单核细胞趋化蛋白-1（MCP-1）、胎球蛋白 A、血清总抗氧化状态（TAS）和血清总氧化状态（TOS）水平是否为急性心肌梗死（AMI）的心脏生物标志物，并阐明它们之间的关系。
本研究纳入了 90 名参与者：60 名 AMI 患者[30 名伴 ST 段抬高心肌梗死（STEMI）和 30 名不伴 STEMI]和 30 名非 AMI 心脏病患者。统计分析了血清 Hs-cTnT、MCP-1、胎球蛋白 A、TAS 和 TOS 水平对 AMI 的预测价值。
AMI 患者的 MCP-1[中位数 120.10ng/L（四分位距：76.94-230.54ng/L）]和 TOS[中位数 2.89U/MI（四分位距：2.31-3.94U/Ml）]水平显著高于对照组，而胎球蛋白 A[中位数 433.52mg/L（四分位距：387.89-584.49mg/L）]和 TAS（3.10±0.86U/ml）水平则显著低于对照组。与 Hs-cTnT 最接近的曲线下面积（0.815）、灵敏度（73.3%）和特异性（66.7%）的参数分别为胎球蛋白 A、MCP-1、TOS 和 TAS。MCP-1 水平每增加 1 单位，AMI 的发生概率增加 1.023 倍（p=0.002）。胎球蛋白 A 水平每增加 1 单位，AMI 的发生概率降低 0.995 倍（p=0.003）。血清 TOS 水平每增加 1 单位，STEMI 的特征性比 NSTEMI 增加 1.29 倍（p=0.044）。
MCP-1、氧化应激参数和胎球蛋白 A 可能有助于 Hs-cTnT 水平对 AMI 的早期诊断。胎球蛋白 A 和 MCP-1 水平可能是 AMI 的独立危险因素，而 TOS 可用于区分 STEMI 和 NSTEMI。
