Our experiences with measurement of new potential biomarkers in the diagnosis of latent forms of myocardial ischemia.
BACKGROUND
The need for a laboratory marker of myocardial ischemia has been alluded to for at least the last decade.


OBJECTIVE
The aim of this study was to evaluate the diagnostic importance of the myosin light chain-1 (MLC-1), clusterin and Reg-Ialpha in patients with suspected myocardial ischemia.


METHODS
A group of 176 at high-risk for myocardial ischemia subjects was evaluated and divided into two subgroups using myocardial SPECT (Single Photon Emission Computed Tomography) - individuals with and without signs of myocardial ischemia. Laboratory markers in venous blood were repeatedly examined in all subjects: a) immediately prior to SPECT: C-reactive protein, Haemoglobin, Hematocrite, Lactate, MLC-1, Clusterin, Reg-Ialpha b) at subjective maximum: Hb, Htc, lactate, MLC-1, Clusterin, Reg-Ialpha c) 30 min after stress levels reached their peak: MLC-1, Clusterin, Reg-Ialpha and d) 60 min after peak stress levels: MLC-1, Clusterin, Reg-Ialpha.


RESULTS
Patients were divided into subgroups according to their positive and negative SPECT results (positive: n = 37; negative: n = 139). MLC-1 values were different for all 4 blood collections. An increase in MLC-1 > 2.2 mg/l showed 64 % sensitivity and 88 % specificity for the diagnosed presence of myocardial ischemia (AUC 0.81; LR+ 5.9; PPV+ 68 % and NPV- 87 %). There was no significant difference between the groups in terms of Clusterin and Reg-Ialpha for any of the sampling periods.


CONCLUSIONS
High diagnostic efficacy of detectable MLC-1 was shown for the diagnosis of latent myocardial ischemia. Measurement of serum Clusterin or Reg-Ialpha did not sufficient for the diagnosis of latent myocardial ischemia.
Stejskal
David
D
Department of Laboratory Medicine and Internal Department, Sternberk Hospital, Czech Republic. david.stejskal@nemstbk.cz
Lacnak
Borek
B
Karpisek
Michal
M
Kaminek
Milan
M
D015415:Biomarkers / Q000097:blood*; D051152:Clusterin / Q000097:blood; D005260:Female; D006801:Humans; D051847:Lithostathine / Q000097:blood; D008297:Male; D017202:Myocardial Ischemia / Q000175:diagnosis*; D018994:Myosin Light Chains / Q000097:blood; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon
D015415:Biomarkers; D051152:Clusterin; D051847:Lithostathine; D018994:Myosin Light Chains; C497617:REG1A protein, human; C076659:myosin light chain I