Abstract 13190: Soluble Lectin-like Oxidized LDL Receptor-1 and High Sensitivity Troponin T as Diagnostic Biomarkers for Acute Coronary Syndrome: Improved Values by Combination Usage in Emergency Rooms
Background: Although highly sensitive assays for troponin T (hs-TnT) have been developed, the sensitivity and specificity of hs-TnT for diagnosing acute coronary syndrome (ACS) remains imperfect. We evaluated the diagnostic value of a new biomarker of plaque vulnerability (soluble lectin-like oxidized LDL receptor-1, sLOX-1) compared with hs-TnT in the emergency room (ER) .
Methods and results: Plasma sLOX-1 and serum hs-TnT levels in the ER were measured in 200 consecutive patients (116 ST elevation ACS; STEACS, 44 non-ST elevation ACS; NSTEACS, and 40 non-ACS) presenting with chest symptoms and electrocardiographic abnormalities. Non-ACS group consisted of patients with cardiovascular diseases, such as coronary spastic angina pectoris, pulmonary thromboembolism, perimyocarditis and takotsubo cardiomyopathy. Levels of sLOX-1 and hs-TnT were significantly higher in STEACS and NSTEACS than in non-ACS patients. The ROC curves of sLOX-1 and hs-TnT for detecting ACS in the ER, by use of the non-ACS patients as negative references, showed that the area under the curve (AUC) values of sLOX-1 and hs-TnT were 0.769 and 0.739, respectively (Figure A). In the lower hs-TnT (less than 0.0205 ng/mL) subgroup, the AUC value of the ROC curve of sLOX-1 for detecting ACS was 0.869 (Figure B). In the lower sLOX-1 (less than 131.7 pg/mL) subgroup, the AUC value of the ROC curve of hs-TnT for detecting ACS was 0.798 (Figure C).
Conclusion: The diagnostic values for ACS were comparable between sLOX-1 and hs-TnT, and the accuracy of ACS diagnosis appeared to improve when sLOX-1 and hs-TnT were measured in combination.
- © 2011 by American Heart Association, Inc.