Lu Ziyu, Liu Qinghua, Fan Yonghua, Xiao Qiang, Yin Deling, Li Yuanmin
Department of Cardiology The Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences Taian China.
Department of Clinical Laboratory The Second Affiliated Hospital, Shandong First Medical University Taian China.
J Am Heart Assoc. 2025 Feb 18;14(4):e038177. doi: 10.1161/JAHA.124.038177. Epub 2025 Feb 14.
Plasma protein alterations may occur in patients with acute myocardial infarction (AMI). In this study, we investigated the plasma proteomics of patients with first-onset AMI to identify a novel diagnostic target for myocardial infarction.
Using a case-control design, we recruited 6 patients with first-onset AMI and 6 age- and sex-matched healthy controls. Mass spectrometry was used to analyze their plasma proteomics. Additionally, we enrolled 156 patients with AMI and 232 healthy individuals to validate the differentially expressed proteins using ELISA.
A total of 58 differentially expressed proteins were identified between the 2 groups (<0.05, fold change ≥2 or ≤1/2), including 36 upregulated and 22 downregulated proteins. Notably, we discovered a clinically significant protein, thymosin β4 (TMSB4), which was subsequently validated by ELISA. Plasma TMSB4 levels were significantly elevated in patients with first-onset AMI compared with the control group (1093 [701-1608] ng/mL versus 421 [245-658] ng/mL; <0.001). Univariate and multivariate logistic regression analyses indicated that TMSB4 is a risk factor for first-onset AMI. The receiver operating characteristic curve yielded an area under the curve value of 0.849, with an optimal cutoff of 682 ng/mL, sensitivity of 0.808, and specificity of 0.793. A robust correlation was observed between TMSB4 and cardiac troponin I (=0.9044, <0.0001), and the κ test yielded a moderate concordance value (κ=0.590 [95% CI, 0.509-0.671]; <0.001).
TMSB4 holds diagnostic value for first-onset myocardial infarction and may therefore be considered a potential diagnostic marker for infarction.
URL: https://www.chictr.org.cn/; unique identifier: ChiCTR2300078144.
急性心肌梗死(AMI)患者可能会出现血浆蛋白改变。在本研究中,我们调查了首次发作AMI患者的血浆蛋白质组学,以确定心肌梗死的一种新型诊断靶点。
采用病例对照设计,我们招募了6例首次发作AMI患者和6例年龄及性别匹配的健康对照。使用质谱分析他们的血浆蛋白质组学。此外,我们纳入了156例AMI患者和232例健康个体,以使用酶联免疫吸附测定(ELISA)验证差异表达蛋白。
两组之间共鉴定出58种差异表达蛋白(<0.05,倍数变化≥2或≤1/2),包括36种上调蛋白和22种下调蛋白。值得注意的是,我们发现了一种具有临床意义的蛋白,胸腺素β4(TMSB4),随后通过ELISA进行了验证。与对照组相比,首次发作AMI患者的血浆TMSB4水平显著升高(1093 [701 - 1608] ng/mL对421 [245 - 658] ng/mL;<0.001)。单因素和多因素逻辑回归分析表明,TMSB4是首次发作AMI的危险因素。受试者工作特征曲线下面积值为0.849,最佳截断值为682 ng/mL,敏感性为0.808,特异性为0.793。观察到TMSB4与心肌肌钙蛋白I之间存在强相关性(=0.9044,<0.0001),并且κ检验得出中度一致性值(κ = 0.590 [95% CI,0.509 - 0.671];<0.001)。
TMSB4对首次发作心肌梗死具有诊断价值,因此可能被视为梗死的潜在诊断标志物。