Exploring the Diagnostic Utility of Serum Cofilin-1 and 2 Levels in Patients with Acute Coronary Syndrome: A...

Acute coronary syndrome (ACS) is caused by decreased blood flow to the heart muscle after plaque rupture and thrombus formation, leading to ischemia and infarction. Cofilins are the proteins involved in actin dynamics by severing and dissociating actin filaments. Abnormal cofilins are associated with myopathies, idiopathic dilated cardiomyopathies, etc. As ACS prevalence is increasing and there is a need to find specific biomarkers for ACS diagnosis, the study aimed to assess the diagnostic utility of serum cofilin-1 (CFL-1) and 2 (CFL-2) levels in ACS patients. Forty-five ACS patients as cases and 45 healthy participants as controls were recruited in a case-control pilot study. Collected blood was used to measure serum CFL-1, CFL-2 and heart-type fatty acid-binding protein (H-FABP, a marker of myocardial infarction) levels. Serum CFL-2 levels were significantly lower in cases compared to controls (2.93 [1.95-3.32] vs. 4.35 [3.4-6.61], p < 0.05). No significant difference was observed in serum CFL-1 levels between groups. Serum CFL-2 levels were negatively associated with creatine kinase-total, creatine kinase-MB, creatine kinase-MB relative index, troponin-T, and H-FABP (p < 0.05). Binary logistic regression showed lower CFL-2 levels were associated with a 2.45-fold increased ACS risk. ROC analysis showed no advantage of serum CFL-2 levels over serum H-FABP levels for ACS diagnosis (AUC: 0.120 Vs 0.710, p > 0.05). In conclusion, serum CFL-1 and 2 levels may not have greater significance in ACS diagnosis than traditional cardiac biomarkers. However, further cohort studies with a larger sample size must confirm the study's findings.