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September 8, 2026International Journal of Molecular SciencesOpen Access

Higher serum amyloid A predicts ~480% greater mortality and cardiac rupture in reperfused AMI.

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Why the study?

Are circulating amyloid and misfolded biomarkers associated with early myocardial injury and adverse cardiovascular events?

Population

30 studies in humans and animals, and in vitro

Comparison

Amyloid oligomer levels across acute myocardial infarction, type 2 diabetes, or coronary artery disease vs controls

Design

Systematic review and epistemic meta-analysis

Key result

Higher serum amyloid A concentration acted as an independent predictor of mortality in reperfused acute myocardial infarction (RR 5.8; 95% CI 1.3-27.7) and cardiac rupture.

Authors

FCFlorencio Alejandro Chable-GuerreroDRDiana Romero-ZertucheMRM. Revilla

Discussion

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Overview

Elevated SAA may flag higher-risk reperfused AMI patients for closer surveillance; leaves open its role as a routine biomarker pending prospective validation.

Key Points

  • To assess the association between circulating misfolded protein oligomers and early myocardial injury across preclinical and clinical investigations.
  • Conducted a systematic review following PRISMA guidelines and an epistemic meta-analysis across PubMed, BIREME, and Web of Science for English- and Spanish-language articles.
  • Screened and included 30 eligible studies comprising human cohorts, animal models, and in vitro experimental designs evaluating amyloid oligomers (including hIAPP, SAA, and Aβ variants).
  • Circulating amyloid oligomers showed consistent elevations in patients presenting with acute myocardial infarction, coronary artery disease, or type 2 diabetes relative to controls.
  • Higher serum amyloid A concentration independently predicted mortality in reperfused acute myocardial infarction (RR 5.8; 95% CI: 1.3–27.7) and correlated with cardiac rupture (OR 8.8; 95% CI: 1.7–25.6).

Study Design

Type

Meta-Analysis (n=30)

Structured PICO

Are circulating amyloid and misfolded biomarkers associated with early myocardial injury and adverse cardiovascular events?

P
Population
30 eligible studies in humans, animals, and in vitro investigating the association between misfolded protein oligomers and early myocardial injury.
E
Exposure
Circulating amyloid and misfolded biomarkers (hIAPP, SAA, Aβs)
C
Comparator
Controls
O
Outcome
Early myocardial injury and major adverse cardiovascular eventssurrogate

Main Result

Relative Risk: 5.8 (95% CI 1.3–27.7)

Circulating misfolded protein oligomers are elevated in cardiovascular and metabolic diseases and may serve as novel biomarkers for early myocardial injury and adverse outcomes.

Cite This Study

Chable-Guerrero et al. (2026) conducted a meta-analysis in Early myocardial injury (n=30). Misfolded protein oligomers (including serum amyloid A) vs. Controls was evaluated on Mortality in reperfused AMI (RR 5.8, 95% CI 1.3-27.7). Higher serum amyloid A concentration acted as an independent predictor of mortality in reperfused acute myocardial infarction (RR 5.8; 95% CI 1.3-27.7) and cardiac rupture.

synapsesocial.com/papers/6a9fd7d558e84d0ff5b46dcchttps://doi.org/10.3390/ijms27177956
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