title: Low levels of soluble receptor for advanced glycation end products in non-ST elevation myocardial infarction patients.
abstract: BACKGROUND
  Interaction of the receptors for advanced glycation end products (RAGEs) with advanced glycation end products (AGEs) results in expression of inflammatory mediators (tumor necrosis factor-alpha [TNF-α] and soluble vascular cell adhesion molecule-1 [sVCAM-1]), activation of nuclear factor-kappa B and induction of oxidative stress - all of which have been implicated in atherosclerosis. Soluble RAGE (sRAGE) acts as a decoy for the RAGE ligand and is protective against atherosclerosis.
  
  
  OBJECTIVE
  To determine whether levels of serum sRAGE are lower, and whether levels of serum AGEs, TNF-α and sVCAM-1 are higher in non-ST elevation myocardial infarction (NSTEMI) patients than in healthy control subjects; and whether sRAGE or the ratio of AGEs to sRAGE (AGEs/sRAGE) is a predictor/biomarker of NSTEMI.
  
  
  METHODS
  Serum levels of sRAGE, AGEs, TNF-α and sVCAM-1 were measured in 46 men with NSTEMI and 28 age- and sex-matched control subjects. Angiography was performed in the NSTEMI patients.
  
  
  RESULTS
  sRAGE levels were lower, and levels of AGEs, TNF-α, sVCAM-1 and AGEs/sRAGE were higher in NSTEMI patients than in control subjects. sRAGE levels were negatively correlated with the number of diseased coronary vessels, serum AGEs, AGEs/sRAGE, TNF-α and sVCAM-1. The sensitivity of the AGEs/sRAGE test is greater than that of the sRAGE test, while the specificity and predictive values of the sRAGE test are greater than those of the AGEs/sRAGE test for identifying NSTEMI patients.
  
  
  CONCLUSIONS
  Serum levels of sRAGE were low in NSTEMI patients, and were negatively correlated with extent of lesion, inflammatory mediators, AGEs and AGEs/sRAGE. Both sRAGE and AGEs/sRAGE may serve as biomarkers/predictors for identifying NSTEMI patients.
authors.affiliation: Department of Pathology;
authors.forename: Erick D
authors.initials: ED
authors.lastname: McNair
authors.forename: Calvin R
authors.initials: CR
authors.lastname: Wells
authors.forename: A Mabood
authors.initials: AM
authors.lastname: Qureshi
authors.forename: Rashpal S
authors.initials: RS
authors.lastname: Basran
authors.forename: Colin
authors.initials: C
authors.lastname: Pearce
authors.forename: Jason
authors.initials: J
authors.lastname: Orvold
authors.forename: Jacobus
authors.initials: J
authors.lastname: Devilliers
authors.forename: Kailash
authors.initials: K
authors.lastname: Prasad