Salivary and blood measurement of hs-cTnI and an adipokine panel in acute myocardial infarction: an exploratory paired-matrix study

Q: What are the key findings of this study?

Salivary and blood levels of hs-cTnI, Endoglin, and Irisin correlated strongly (rs 0.773-0.979, p<0.001), with higher Endoglin and lower Irisin in AMI patients vs controls (p<0.001).

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Acute myocardial infarction (STEMI and NSTEMI) (n=90). Intervention: Acute myocardial infarction (evaluated via paired salivary and blood hs-cTnI, Apelin, Elabela, Endoglin, Irisin, and IMA) vs. Healthy controls without cardiovascular disease, hypertension, or diabetes. Primary outcome: Salivary and blood biomarker levels (hs-cTnI, Endoglin, Irisin, Apelin, Elabela, IMA) and blood-saliva correlation (p=<0.001).

Q: What does this research mean for the field?

Salivary levels of hs-cTnI, Endoglin, and Irisin correlate strongly with blood concentrations, with Endoglin significantly elevated and Irisin significantly reduced in patients with acute myocardial infarction compared to healthy controls. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To assess whether high-sensitivity cardiac troponin I and a panel of adipokines generate measurable signals in saliva that correlate with blood concentrations in acute myocardial infarction.

Hüseyin Fatih Gül; Levent Şahi̇n; Turgut Dolanbay; Muammer Karakayalı; Ferhan Gi̇rgi̇n Sağın; Ali Guraslan; Umit Yasar Gul; İsmail CAN; Handan Çiftçi; Tahir Ataözden; Mehmet Alican Yurtseven; Burak Alagoz

doi:10.1038/s41598-026-77994-5

October 31, 2026Scientific ReportsOpen Access

Salivary and blood measurement of hs-cTnI and an adipokine panel in acute myocardial infarction: an exploratory paired-matrix study

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Key result

Salivary hs-cTnI, Endoglin, and Irisin strongly correlate with blood levels in acute MI.

P<0.001
n=90

Why the study?

Acute myocardial infarction requires rapid biochemical confirmation, and saliva offers a potential non-invasive alternative to venous sampling for measuring hs-cTnI and an adipokine panel.

Do salivary assay signals of hs-cTnI and an adipokine panel (Apelin, Elabela, Endoglin, Irisin, IMA) correlate with blood concentrations and differ between acute myocardial infarction patients and healthy controls?

Key Points

To assess whether high-sensitivity cardiac troponin I and a panel of adipokines generate measurable signals in saliva that correlate with blood concentrations in acute myocardial infarction.
Enrolled 60 acute myocardial infarction patients (30 STEMI and 30 NSTEMI) presenting within six hours of symptom onset alongside 30 healthy controls.
Measured paired blood and salivary levels of hs-cTnI, Apelin, Elabela, Endoglin, Irisin, and ischaemia-modified albumin using immunoassay kits.
Assessed between-group differences, matrix agreement via Spearman correlation and Bland–Altman analysis, and exploratory classification discrimination.
In saliva, Endoglin was significantly higher (median 2.30 vs 1.42 ng/mL, p < 0.001) and Irisin was significantly lower (median 9.46 vs 20.92 ng/mL, p < 0.001) in patients compared to controls, with both surviving Bonferroni correction and age adjustment.
Paired blood and saliva signals demonstrated strong correlations across all analytes (Spearman rs 0.773 to 0.979, all p < 0.001), but Bland–Altman analysis revealed proportional differences and wide limits of agreement.
Salivary hs-cTnI assay signals completely separated patients from controls (median 136.00 vs 5.06 ng/L, p < 0.001), although control values required extrapolation below assay detection limits and the adipokine panel showed no incremental benefit.

Study Design

Type

Cross-Sectional (n=90)

Multicenter

No

Structured PICO

Do salivary assay signals of hs-cTnI and an adipokine panel (Apelin, Elabela, Endoglin, Irisin, IMA) correlate with blood concentrations and differ between acute myocardial infarction patients and healthy controls?

P

Population

90 adults (60 AMI patients presenting within 6 hours of symptom onset and 30 healthy controls) with BMI <30 kg/m² and acceptable oral health evaluated in a cross-sectional paired blood and saliva study in Turkey.

E

Exposure

Paired venous blood and unstimulated whole saliva measurement of high-sensitivity cardiac troponin I (hs-cTnI), Apelin, Elabela, Endoglin, Irisin, and ischaemia-modified albumin (IMA) using commercial sandwich ELISA kits and chemiluminescence immunoassay collected at a median of 72-74 minutes after presentation.

C

Comparator

Healthy volunteers (n=30) with no history of cardiovascular disease, hypertension, or diabetes mellitus, normal 12-lead ECG, and serum cTnI below the 99th percentile URL.

O

Outcome

Between-group differences in blood concentrations and salivary assay-derived signals of hs-cTnI, Apelin, Elabela, Endoglin, Irisin, and IMA, and correlation/agreement between paired blood and salivary matrices.surrogate

Main Result

Absolute Event Rate: 136% vs 5.06%

p-value: p=<0.001

This exploratory study demonstrates that hs-cTnI, Endoglin, and Irisin generate measurable salivary signals that strongly correlate with blood concentrations in AMI patients, supporting future matrix validation for non-invasive diagnostics.

Limitations

No matrix-specific analytical validation (recovery, linearity, parallelism, or matrix-effect experiments) was performed in saliva for any of the six analytes.
Elevated serum hs-cTnI was a mandatory inclusion criterion for the AMI group, so hs-cTnI separation reflects case selection rather than diagnostic accuracy.
Control salivary hs-cTnI values fell below the manufacturer-stated working range (10 ng/L) and were obtained partly by extrapolation.
Significant age difference between AMI patients and healthy controls (mean 62.25 vs 46.63 years), and small sample size gathered via convenience sampling at a single center.
ELISA kits were validated for serum and plasma only, with no matrix-specific validation (recovery, linearity, parallelism) performed in saliva
Elevated serum hs-cTnI was an inclusion criterion for AMI cases, precluding unbiased assessment of hs-cTnI diagnostic accuracy
All 30 control salivary hs-cTnI values fell below the assay working range (10 ng/L) and relied on calibration curve extrapolation
Single-center convenience sample with significant age imbalance between AMI patients and healthy controls (62.25 vs 46.63 years)
Sample size was powered only for pairwise biomarker comparisons and not for multivariable modeling or ROC precision

Implication

Salivary hs-cTnI and adipokine signals may support non-invasive AMI detection; leaves open prospective validation before clinical adoption.

Abstract

Acute myocardial infarction (AMI) requires rapid biochemical confirmation, and saliva offers a non-invasive alternative to venous sampling. We measured high-sensitivity cardiac troponin I (hs-cTnI), Apelin, Elabela, Endoglin, Irisin and ischaemia-modified albumin (IMA) in paired blood and saliva from 60 selected AMI patients presenting within six hours of symptom onset and 30 healthy controls. In blood, Irisin, Elabela and Apelin were lower in patients and Endoglin higher (all p ≤ 0.020). In saliva, Endoglin was higher and Irisin lower (both p < 0.001), and only these differences survived Bonferroni correction and age restriction ( p ≤ 0.030); IMA differed in neither matrix. Blood and salivary values correlated strongly (Spearman rs 0.773–0.979, all p < 0.001), but Bland–Altman analysis showed proportional differences and wide limits of agreement. Salivary hs-cTnI assay signals completely separated the two groups; because elevated serum hs-cTnI was an inclusion criterion and no salivary assay was matrix-validated, this reflects case selection rather than diagnostic accuracy. The adipokine panel did not demonstrate an improvement over hs-cTnI in an exploratory cross-validation analysis. These findings provide preliminary evidence that the six analytes generate measurable assay signals in saliva and support further investigation, including matrix-specific validation and prospective evaluation in undifferentiated chest pain.

Discussion

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Cite This Study

Gül et al. (2026) conducted a cross-sectional in Acute myocardial infarction (STEMI and NSTEMI) (n=90). Acute myocardial infarction (evaluated via paired salivary and blood hs-cTnI, Apelin, Elabela, Endoglin, Irisin, and IMA) vs. Healthy controls without cardiovascular disease, hypertension, or diabetes was evaluated on Salivary and blood biomarker levels (hs-cTnI, Endoglin, Irisin, Apelin, Elabela, IMA) and blood-saliva correlation (p=<0.001). Salivary and blood levels of hs-cTnI, Endoglin, and Irisin correlated strongly (rs 0.773-0.979, p<0.001), with higher Endoglin and lower Irisin in AMI patients vs controls (p<0.001).

synapsesocial.com/papers/6ae7d421edffb49629410479 https://doi.org/10.1038/s41598-026-77994-5

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Salivary and blood measurement of hs-cTnI and an adipokine panel in acute myocardial infarction: an exploratory paired-matrix study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Salivary and blood measurement of hs-cTnI and an adipokine panel in acute myocardial infarction: an exploratory paired-matrix study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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