title: Soluble lectin-like oxidized low-density lipoprotein receptor-1 as an early biomarker for ST elevation myocardial infarction: time-dependent comparison with other biomarkers: time-dependent comparison with other biomarkers.
abstract: BACKGROUND
  The diagnostic sensitivity of myocardial necrosis markers, such as creatine kinase-MB (CK-MB), cardiac troponins, myoglobin and heart-type fatty acid-binding protein (H-FABP) for the earliest stage of ST-elevation myocardial infarction (STEMI), remains insufficient. We compared a new biomarker of plaque vulnerability (soluble lectin-like oxidized low-density lipoprotein receptor-1, sLOX-1) with other biomarkers at the earliest stage of STEMI.
  
  
  RESULTS
  Plasma sLOX-1 levels were measured in 125 STEMI, 44 non-STEMI (NSTEMI) and 125 non-acute myocardial infarction (non-AMI) patients and were significantly (P < 0.0001) higher in the STEMI and NSTEMI than in the non-AMI patients (median, 25th and 75th percentiles: 241.0, 132.3 and 472.2 vs. 147.3, 92.9 and 262.4 vs. 64.3, 54.4 and 84.3 pg/ml, respectively). At the optimal cut-off value of 91.0 pg/ml, sLOX-1 discriminated STEMI from non-AMI with 89.6% sensitivity and 82.4% specificity. Time-dependent changes in sLOX-1, H-FABP, myoglobin, troponin T and CK-MB were analyzed in 27 STEMI patients. Elevated plasma sLOX-1 levels persisted for 24h after admission, whereas other markers were not elevated at the time of admission and peaked at ≥ 2h thereafter. The diagnostic sensitivity of sLOX-1, H-FABP, myoglobin, troponin T and CK-MB for STEMI upon admission (89 min after onset) was 93%, 78%, 70%, 56% and 33%, respectively.
  
  
  CONCLUSIONS
  Plasma sLOX-1 diagnosed the early stages of STEMI more accurately than H-FABP, myoglobin, troponin T and CK-MB.
authors.affiliation: Division of Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School, Inzai, Chiba 270-1694, Japan. s5047@nms.ac.jp
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Noritake
authors.initials: N
authors.lastname: Hata
authors.forename: Noriaki
authors.initials: N
authors.lastname: Kume
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Seino
authors.forename: Toru
authors.initials: T
authors.lastname: Inami
authors.forename: Shinya
authors.initials: S
authors.lastname: Yokoyama
authors.forename: Takuro
authors.initials: T
authors.lastname: Shinada
authors.forename: Kazunori
authors.initials: K
authors.lastname: Tomita
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Kaneshige
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Mizuno
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D052279:Creatine Kinase, MB Form / Q000097:blood; D042241:Early Diagnosis; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins / Q000097:blood; D005260:Female; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis*; D009206:Myocardium / Q000378:metabolism; D009211:Myoglobin / Q000097:blood; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D051127:Scavenger Receptors, Class E / Q000097:blood*; D012680:Sensitivity and Specificity; D013997:Time Factors; D020107:Troponin T / Q000097:blood; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; C493408:FABP3 protein, human; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins; D009211:Myoglobin; C495137:OLR1 protein, human; D051127:Scavenger Receptors, Class E; D020107:Troponin T; D052279:Creatine Kinase, MB Form