Key result
Circulating sLOX-1 levels diagnose the early stages of ST elevation myocardial infarction more accurately and peak earlier than traditional biomarkers such as troponin T and CK-MB.
This editorial discusses the potential of sLOX-1, a plaque-derived biomarker, for the very early diagnosis of acute myocardial infarction prior to the elevation of traditional necrosis markers.
diagnosis of acute myocardial infarction (AMI) is based prolonged chest pain, electrocardiographic changes elevated serum creatine kinase (CK) levels. Besides CK, serum levels of heart-type fatty acidbinding protein (H-FABP), myoglobin, troponin T or and CK-MB can also provide support for a diagnosis of AMI. These biomarkers are released from damaged cardiomyocytes into circulating blood and they are indicative of acute myocardial injury. The European Society of Cardiology and the American College of Cardiology Consensus group recently emphasized the diagnostic value of troponins as biomarkers of myocyte necrosis. 1 Although troponin T or I is a more sensitive and specific biomarker of myocardial necrosis than either CK or CK-MB, serum levels of troponin T or I start to increase between 2 and 4 h after AMI onset. Accordingly, blood samples obtained from patients with AMI upon arrival at an emergency department are occasionally negative for troponins. 2 Nonetheless, the appropriate treatment must be selected for patients with AMI as soon as possible in a clinical emergency. The appearance of earlier diagnostic biomarkers suggestive of AMI might allow cardiologists to apply expeditious reperfusion therapy under emergency circumstances. Since plaque rupture or erosion with subsequently occlusive thrombus formation is considered the main mechanism responsible for AMI, a novel biomarker derived from ruptured or erosive plaque might be useful for the very early diagnosis of AMI rather than a biomarker derived from the myocardium with ischemic damage. Since biomarkers derived from ruptured or erosive plaque are not direct indicators of myocardial necrosis, a diagnosis of AMI eventually requires an increase in the serum level of a biomarker derived from the necrotic myocardium.
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Takuroh Imamura (2011) conducted an editorial in Acute Myocardial Infarction. sLOX-1 vs. H-FABP, myoglobin, troponin T, and CK-MB was evaluated. Circulating sLOX-1 levels diagnose the early stages of ST elevation myocardial infarction more accurately and peak earlier than traditional biomarkers such as troponin T and CK-MB.
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