Serum Mitsugumin-53 Level as a Diagnostic Marker in Patients With Acute Coronary Syndrome: A Case-Control Study

BACKGROUND: The high incidence of acute coronary syndrome (ACS) warrants the search for new cardiac biomarkers. Mitsugumin-53 (MG-53) is a myokine involved in cell membrane repair and essential for the function and survival of cardiomyocytes. Therefore, the study assessed the utility of serum MG-53 levels in ACS diagnosis and prognosis. METHOD: We enrolled 120 ACS patients as cases and 40 healthy controls as per the inclusion and exclusion criteria in this case-control study. The demographics, present and past history, and physical characteristics were recorded. The chemistry analyzer analyzed routine blood investigations. Serum MG-53 and heart-type fatty acid binding protein (H-FABP as a myocardial injury marker) levels were measured using enzyme-linked immunosorbent assay (ELISA) kits. The Statistical Package for the Social Sciences (SPSS) program (version 26.0, IBM Corp., Armonk, NY) was used for statistical analysis, such as independent t-test, chi-squared test, Pearson's and Spearman's correlation, receiver operating characteristic (ROC) curve, and univariate and multivariate logistic regression. A p-value <0.05 was considered statistically significant. RESULTS: Patients with ACS as cases had higher serum MG-53 and H-FABP levels than controls (p < 0.001). Serum MG-53 level was significantly positively correlated with serum troponin-I (correlation coefficient (r) = 0.520, p < 0.001), creatine kinase-MB (r = 0.298, p = 0.001), and H-FABP (r = 0.792, p < 0.001). The ROC curve showed that the serum MG-53 level had an area under the curve of 0.846 (95% CI: 0.781-0.911, p < 0.001) and sensitivity and specificity of 70%. Multivariate logistic regression depicted that the serum MG-53 level (OR = 1.113, 95% CI: 1.028-1.297, p < 0.001) was significantly associated with ACS risk after adjusting for age, weight, systolic blood pressure, random blood glucose, and serum total cholesterol levels. Multivariate linear regression showed a significant positive association between serum MG-53 and H-FABP levels in patients with different ACS severity and vessel diseases (p < 0.001). Conclusion: The serum MG-53 level may be considered one of the diagnostic markers in ACS patients. However, further studies need to confirm our findings.