title: Increased monomeric CRP levels in acute myocardial infarction: a possible new and specific biomarker for diagnosis and severity assessment of disease.
abstract: BACKGROUND
  Monomeric CRP (mCRP) plays an important role in the process of atherosclerotic plaque rupture. Recently, it has been reported that mCRP was associated with acute myocardial infarction (AMI).
  
  
  OBJECTIVE
  The aim of this study was to examine whether mCRP is increased in AMI patients and to investigate the possibility of using circulating mCRP as a biomarker for AMI diagnosis and severity assessment of disease.
  
  
  METHODS
  A mCRP monoclonal antibody was generated and verified for its specificity. Immunofluorescence was used to assess the localization of mCRP in the infarcted myocardium. Furthermore, 101 AMI, 38 unstable angina pectoris (UAP) and 41 stable angina pectoris (SAP) patients were enrolled, and 43 healthy volunteer were recruited as controls in the study. Venous blood samples were collected to measure the circulating mCRP, cardiac Troponin T and hs-CRP levels.
  
  
  RESULTS
  Significantly increased mCRP levels were observed in the infarcted myocardium of model mice. In addition, significantly increased plasma mCRP levels were also detected in AMI patients (20.96 ± 1.64 ng/ml) compared to those with UAP, SAP or in control patients (all 0 ng/ml, p < 0.001). ROC analysis revealed that circulating mCRP had considerable diagnostic accuracy for AMI with an AUC of 0.928 (95% confidence interval 0.887-0.969). Furthermore, nine patients (9/101, 8.91%) in AMI group died before the 30-day follow-up, and their plasma mCRP concentration was significantly higher than those in surviving patients (36.70 ± 10.26 vs. 19.41 ± 1.43 ng/ml, P = 0.002).
  
  
  CONCLUSIONS
  These results indicate that mCRP is increased in AMI and that circulating mCRP might be a potential biomarker for diagnosis and severity assessment of disease in AMI.
authors: Department of Gerontology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, PR China.
authors: Junhong
authors: J
authors: Wang
authors: Vazyme Biotechnology Company, Nanjing 210004, PR China.
authors: Bo
authors: B
authors: Tang
authors: Department of Pathogen Biology, Nanjing Medical University, Nanjing 210029, PR China.
authors: Xinjian
authors: X
authors: Liu
authors: Department of Clinical Laboratory Medicine, BenQ Medical Center, Nanjing 210019, PR China.
authors: Xin
authors: X
authors: Wu
authors: Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, PR China.
authors: Hui
authors: H
authors: Wang
authors: Department of Gerontology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, PR China.
authors: Di
authors: D
authors: Xu
authors: Department of Gerontology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, PR China. Electronic address: cnjjh2000@aliyun.com.
authors: Yan
authors: Y
authors: Guo
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000503:physiopathology; D000818:Animals; D000911:Antibodies, Monoclonal / Q000737:chemistry; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D051379:Mice; D008807:Mice, Inbred BALB C; D008810:Mice, Inbred C57BL; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis*; D009206:Myocardium / Q000378:metabolism; D058226:Plaque, Atherosclerotic / Q000503:physiopathology; D011379:Prognosis; D012372:ROC Curve; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D015415:Biomarkers; D002097:C-Reactive Protein
keywords: Acute myocardial infarction (AMI); Diagnosis; Monomeric CRP (mCRP); Prognosis