Key result
Elevated sRAGE and Galectin-3 correlate with higher GRACE score and cardiac biomarkers in STEMI.
Why the study?
Acute myocardial infarction carries significant clinical repercussions that affect quality of life, motivating the search for circulating proteomic biomarkers focusing on the AGE/RAGE axis and Galectin-3 to characterize and improve the prognosis of STEMI.
Observational (n=108)
Elevated plasma levels of sRAGE and Galectin-3 within 24 hours of STEMI are associated with a proteomic profile of increased oxidative stress and cellular damage and correlate significantly with established clinical prognostic markers including GRACE score, peak troponin, and NT-proBNP.
May inform STEMI risk assessment; extends AGE/RAGE and Galectin-3 evidence but remains hypothesis-generating.
The aftermath that acute myocardial infarction patients have to face is one that includes significant clinical repercussions that affect their quality of life. Our objetive was to identify circulating proteomic biomarkers that characterize and improve the prognosis of ST-segment elevation myocardial infarction (STEMI), using a profiled panel of molecules with special focus on the advanced glycation end-products and their receptor (AGE/RAGE axis) and Galectin-3. 108 consecutive STEMI patients were classified according to relevant clinical variables. Blood samples were obtained within the first 24 hours post-AMI, and plasma proteins were quantified using SWATH mass spectrometry following trypsin digestion. Data analysis aimed to identify proteins differentially expressed between groups and the metabolic pathways involved, using open-source tools. Plasma sRAGE and Galectin-3 levels were measured by ELISA. Our results provide a molecular description of the patient, indicating which metabolic pathways gain greater relevance and which proteins emerge as potential biomarkers. The groups of worse clinical profile showed an increase in proteins related to the AGE/RAGE axis, particularly reflected in plasma sRAGE concentrations, which rose in parallel with Killip class. sRAGE and Galectin-3 measurements allowed stratification into quartiles, with the highest quartiles associated with a proteomic profile indicative of greater oxidative stress and cellular damage. Moreover, sRAGE and Galectin-3 correlated with validated clinical variables: GRACE (Galectin-3: r=0.288, p=0.017; sRAGE: r=0.354, p=0.004), troponin peak (Galectin-3: r=0.295, p=0.008; sRAGE: r=0.239, p=0.036) and NT-proBNP (Galectin-3: r=0.282, p=0.012; sRAGE: r=0.237, p=0.039). The findings align with previous knowledge regarding the AGE/RAGE axis and Galectin-3 and their roles in the pathophysiology of the post-STEMI setting, and they lay the groundwork for future studies aimed at validating and expanding their potential as prognostic and therapeutic tools at the AMI onset.Flowchart abstract
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Moar et al. (2026) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=108). Circulating proteomic biomarkers (sRAGE and Galectin-3) vs. Lower biomarker quartiles / better clinical profile groups was evaluated on Correlation of sRAGE and Galectin-3 with validated clinical prognostic variables (GRACE score, troponin peak, and NT-proBNP) (r=0.354 (sRAGE with GRACE); r=0.288 (Galectin-3 with GRACE), p=0.004). Plasma sRAGE and Galectin-3 correlated with GRACE score (sRAGE: r=0.354, p=0.004; Galectin-3: r=0.288, p=0.017), peak troponin, and NT-proBNP in STEMI patients.
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