Temporal biomarker concentration patterns during the early course of acute coronary syndrome
Kai M Eggers1,2, Gorav Batra1,2, Bertil Lindahl1,2
1Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Clinical Chemistry and Laboratory Medicine
|February 11, 2024
Summary
Temporal biomarker patterns in acute coronary syndrome (ACS) vary by biomarker type and patient sex. Considering time from symptom onset is crucial for accurate interpretation of cardiac biomarker results in ACS patients.
Area of Science:
- Cardiovascular Medicine
- Biomarker Discovery
- Clinical Diagnostics
Background:
- Biomarkers in acute coronary syndrome (ACS) offer insights into myocardial necrosis, hemodynamic stress, and inflammation.
- Limited data exists on early temporal biomarker patterns in ACS, especially for multiple biomarkers simultaneously.
Purpose of the Study:
- To investigate temporal concentration patterns of multiple biomarkers early during ACS.
- To explore associations between biomarker levels and time from symptom onset in ACS patients.
Main Methods:
- Measured high-sensitivity cardiac troponin T (hs-cTnT), hs-cTnI, NT-proBNP, CRP, and GDF-15 in ACS patients from the PLATO trial.
- Utilized linear regression and interaction analyses to model temporal biomarker patterns and their association with time from symptom onset.
Main Results:
- All biomarkers, except GDF-15, showed significant associations with time from symptom onset (p<0.001).
- Concentration increases were more pronounced in ST-elevation myocardial infarction (STEMI) than non-ST-elevation ACS (NSTE-ACS).
- Temporal patterns for hs-cTnT and hs-cTnI differed by sex, while other biomarkers showed similar patterns across age and sex cohorts.
Conclusions:
- Temporal biomarker patterns in early ACS reflect varying pathophysiological processes and myocardial injury.
- Time from symptom onset is a critical factor for interpreting biomarker results in ACS.
- Sex-specific temporal patterns exist for certain cardiac biomarkers in ACS.
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