Proteomic analysis of adverse outcomes in patients with acute coronary syndromes.

ABSTRACT

BACKGROUND: Most biomarkers lack clinical sensitivity and specificity for predicting adverse outcomes in patients with acute coronary syndromes (ACS). We identified potential predictors through proteomic analysis. METHODS: Serum proteomic analysis was performed by surface-enhanced laser desorption/ionization protein chip technology in 409 patients with ACS. The primary endpoints were 30-day and 3-year occurrence of major adverse cardiovascular events (cardiac death, non-fatal myocardial infarction and target lesion revascularization). RESULTS: A m/z 4174.39 peak was associated with an increased incidence of 3-year events. In multivariate analysis, the m/z 4174.39 peak showed an independent correlation with 3-year (over 30-day) events (hazard ratio, 2.33; 95% confidence interval (CI), 1.23 to 4.39; P=0.009 for the fourth versus first quartile), while the creatine kinase MB fraction (CK-MB) and troponin T levels were associated with 30-day events ((ln CK-MB hazard ratio, 1.36; 95% CI, 1.07 to 1.73; P=0.013); (ln troponin T hazard ratio, 1.36; 95% CI, 1.12 to 1.64; P=0.002)). CONCLUSIONS: The m/z 4174.39 peak is a strong marker for predicting the long-term outcomes, and may correspond to a new biomarker, such as a member of the CXC chemokine family, and provide additional prognostic value in ACS.