Related Experiment Videos
Plasma Proteins Associated With Incident Acute Myocardial Infarction in Asians With Type 2 Diabetes
Resham Lal Gurung1, Huili Zheng2, Jia Le Ivan Tan2
1Clinical Research Unit, Khoo Teck Puat Hospital, Singapore; Cardiovascular and Metabolic Disorders Signature Research Program, Duke-NUS Medical School, Singapore.
JACC. Asia
|August 12, 2026
Summary
Plasma proteomics identifies new proteins linked to acute myocardial infarction (AMI) risk in type 2 diabetes (T2D). An 8-protein panel significantly improves cardiovascular risk prediction in T2D patients.
Area of Science:
- Cardiovascular Medicine
- Metabolomics
- Proteomics
Background:
- Individuals with type 2 diabetes (T2D) face elevated risks of acute myocardial infarction (AMI).
- Conventional risk factors inadequately explain the heterogeneous cardiovascular risk in T2D, necessitating improved biological risk stratification.
- Identifying novel biomarkers is crucial for enhancing risk prediction in this population.
Purpose of the Study:
- To identify circulating proteins associated with incident AMI in individuals with T2D.
- To evaluate the incremental predictive value of these proteins for AMI risk.
- To explore potential causal relationships between identified proteins and AMI.
Main Methods:
- Prospective cohort study (SMART2D) of 1,830 adults with T2D, quantifying 1,457 plasma proteins using Olink assays.
- Follow-up for incident AMI over a median of 10.2 years, linked to the Singapore Myocardial Infarction Registry.
- Multivariable Cox regression, Harrell's C-statistic, LRTs, NRI, IDI, and two-sample Mendelian randomization were used for analysis.
Main Results:
- 223 participants (12.2%) developed AMI during follow-up.
- Seventeen proteins were independently associated with AMI, including NEFL, EDA2R, and CHRDL1.
- An 8-protein panel significantly improved AMI risk classification beyond clinical variables (e.g., IDI P = 0.002, NRI P = 0.008).
- Genetically predicted plasma FGF5 levels showed an association with myocardial infarction risk.
Conclusions:
- Plasma proteomics offers a valuable tool for improving AMI risk stratification in individuals with T2D.
- The protein FGF5 may play a role in cardiovascular risk, particularly in Asian populations.
- These findings support the development of novel protein-based biomarkers for cardiovascular risk assessment in T2D.
Related Concept Videos
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:26Type II Diabetes I: Introduction
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance, in which target tissues such as the liver, muscle, and adipose tissue respond poorly to insulin. It is also associated with inadequate compensatory insulin secretion, where pancreatic β-cells fail to produce sufficient insulin. Together, these abnormalities lead to persistent hyperglycemia.EtiologyT2DM develops through a complex interaction of genetic predisposition and environmental or...
01:30Acute Coronary Syndrome I: Introduction
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:25Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis
Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated hypertension...
01:27Myocarditis II: Clinical Features and Diagnostic Tests
Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...