Soluble lectin-like oxidized LDL receptor-1 and high-sensitivity troponin T as diagnostic biomarkers for acute coronary syndrome. Improved values with combination usage in emergency rooms.

Abstract

BACKGROUND:

Although highly sensitive assays for troponin T (hs-TnT) have been developed, the sensitivity and specificity of hs-TnT for diagnosing acute coronary syndrome (ACS) remains imperfect. We evaluated the diagnostic value of a new biomarker of plaque vulnerability (soluble lectin-like oxidized low-density lipoprotein receptor-1, sLOX-1) as compared with hs-TnT in the emergency room (ER).

METHODS AND RESULTS:

Plasma sLOX-1 and serum hs-TnT levels were measured in 200 consecutive patients presenting with chest symptoms and ECG abnormalities in the ER (116 ST elevation ACS [STEACS], 44 non-ST elevation ACS [NSTEACS], 40 non-ACS). The non-ACS group consisted of patients with cardiovascular diseases such as coronary spastic angina pectoris, pulmonary thromboembolism, perimyocarditis and takotsubo cardiomyopathy. Levels of sLOX-1 and hs-TnT were significantly higher in STEACS and NSTEACS than in non-ACS patients. The receiver-operating characteristic (ROC) curves of sLOX-1 and hs-TnT for detecting ACS, using the non-ACS patients as negative references, showed that the area under the curve (AUC) values of sLOX-1 and hs-TnT were 0.769 and 0.739, respectively. In the lower hs-TnT (<0.0205ng/ml) subgroup, the AUC value of the ROC curve of sLOX-1 for detecting ACS was 0.869.

CONCLUSIONS:

The diagnostic value for ACS was comparable between sLOX-1 and hs-TnT, and the accuracy of ACS diagnosis appeared to improve when sLOX-1 and hs-TnT were measured in combination.

• Authors: Nobuaki Kobayashi, Noritake Hata, Noriaki Kume, Takuro Shinada, Kazunori Tomita, Akihiro Shirakabe, Mitsunobu Kitamura, Ayaka Nozaki, Toru Inami, Yoshihiko Seino, Kyoichi Mizuno
• Journal: Circulation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 75 Issue 12 Pg. 2862-71 ( 2011) ISSN: 1347-4820 [Electronic] Japan
• PMID: 21937834 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• OLR1 protein, human
• Scavenger Receptors, Class E
• Troponin T

Topics

• Acute Coronary Syndrome (blood, diagnosis)
• Aged
• Biomarkers (blood)
• Emergency Medical Services (methods)
• Female
• Humans
• Male
• Middle Aged
• Scavenger Receptors, Class E (blood)
• Troponin T (blood)