Serum Concentrations of Matrix Metalloproteinase‐1 and Procollagen Type I Carboxy Terminal Propeptide Discriminate Infarct‐Like Myocarditis and Non−ST‐Segment−Elevation Myocardial Infarction
Background Biomarkers simplifying the diagnostic workup by discriminating between non–ST‐segment–elevation myocardial infarction (NSTEMI) and infarct‐like myocarditis are an unmet clinical need. Methods and Results A total of 105 subjects were categorized into groups as follows: ST‐segment−elevation...
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Wiley
2024-07-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.034194 |
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| author | Lucas Bacmeister Ersin Cavus Sebastian Bohnen Enver Tahir Hanna Wolf Annette Buellesbach Adrian Heidenreich Virginia K. Haacke Susanne Weber Ingo Hilgendorf Tanja Zeller Francisco Ojeda Ulf K. Radunski Gunnar K. Lund Gerhard Adam Stefan Blankenberg Dirk Westermann Kai Muellerleile Diana Lindner |
| author_facet | Lucas Bacmeister Ersin Cavus Sebastian Bohnen Enver Tahir Hanna Wolf Annette Buellesbach Adrian Heidenreich Virginia K. Haacke Susanne Weber Ingo Hilgendorf Tanja Zeller Francisco Ojeda Ulf K. Radunski Gunnar K. Lund Gerhard Adam Stefan Blankenberg Dirk Westermann Kai Muellerleile Diana Lindner |
| author_sort | Lucas Bacmeister |
| collection | DOAJ |
| description | Background Biomarkers simplifying the diagnostic workup by discriminating between non–ST‐segment–elevation myocardial infarction (NSTEMI) and infarct‐like myocarditis are an unmet clinical need. Methods and Results A total of 105 subjects were categorized into groups as follows: ST‐segment−elevation myocardial infarction (n=36), NSTEMI (n=22), infarct‐like myocarditis (n=19), cardiomyopathy‐like myocarditis (n=18), and healthy control (n=10). All subjects underwent cardiac magnetic resonance imaging, and serum concentrations of matrix metalloproteinase‐1 (MMP‐1) and procollagen type I carboxy terminal propeptide (PICP) were measured. Biomarker concentrations in subjects presenting with acute coronary syndrome and non‐ST‐segment‐elevation, for example NSTEMI or infarct‐like myocarditis, categorized as the non−ST‐segment−elevation acute coronary syndrome−like cohort, were of particular interest for this study. Compared with healthy controls, subjects with myocarditis had higher serum concentrations of MMP‐1 and PICP, while no difference was observed in individuals with myocardial infarction. In the non−ST‐segment−elevation acute coronary syndrome−like cohort, MMP‐1 concentrations discriminated infarct‐like myocarditis and NSTEMI with an area under the receiver operating characteristic curve (AUC) of 0.95 (95% CI, 0.89−1.00), whereas high‐sensitivity cardiac troponin T performed inferiorly (AUC, 0.74 [95% CI, 0.58−0.90]; P=0.012). Application of an optimal MMP‐1 cutoff had 94.4% sensitivity (95% CI, 72.7%−99.9%) and 90.9% specificity (95% CI, 70.8%−98.9%) for the diagnosis of infarct‐like myocarditis in this cohort. The AUC of PICP in this context was 0.82 (95% CI, 0.68−0.97). As assessed by likelihood ratio tests, incorporating MMP‐1 or PICP with age and C‐reactive protein into composite prediction models enhanced their diagnostic performance. Conclusions MMP‐1 and PICP could potentially be useful biomarkers for differentiating between NSTEMI and infarct‐like myocarditis in individuals with non−ST‐segment−elevation acute coronary syndrome‐like presentation, though further research is needed to validate their clinical applicability. |
| format | Article |
| id | doaj-art-9ec00bcf7e8646a5b0bc00a1e9e82330 |
| institution | DOAJ |
| issn | 2047-9980 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | Wiley |
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| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-9ec00bcf7e8646a5b0bc00a1e9e823302025-08-20T03:10:10ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-07-01131410.1161/JAHA.124.034194Serum Concentrations of Matrix Metalloproteinase‐1 and Procollagen Type I Carboxy Terminal Propeptide Discriminate Infarct‐Like Myocarditis and Non−ST‐Segment−Elevation Myocardial InfarctionLucas Bacmeister0Ersin Cavus1Sebastian Bohnen2Enver Tahir3Hanna Wolf4Annette Buellesbach5Adrian Heidenreich6Virginia K. Haacke7Susanne Weber8Ingo Hilgendorf9Tanja Zeller10Francisco Ojeda11Ulf K. Radunski12Gunnar K. Lund13Gerhard Adam14Stefan Blankenberg15Dirk Westermann16Kai Muellerleile17Diana Lindner18Department of Cardiology and Angiology, Medical Centre, Faculty of Medicine University Heart Centre Freiburg‐Bad Krozingen, University of Freiburg GermanyClinic of Cardiology University Heart and Vascular Centre Hamburg, University Medical Center Hamburg‐Eppendorf Hamburg GermanyClinic of Cardiology University Heart and Vascular Centre Hamburg, University Medical Center Hamburg‐Eppendorf Hamburg GermanyDepartment of Diagnostic and Interventional Radiology University Medical Center Hamburg‐Eppendorf Hamburg GermanyDepartment of Cardiology and Angiology, Medical Centre, Faculty of Medicine University Heart Centre Freiburg‐Bad Krozingen, University of Freiburg GermanyDepartment of Cardiology and Angiology, Medical Centre, Faculty of Medicine University Heart Centre Freiburg‐Bad Krozingen, University of Freiburg GermanyDepartment of Cardiology and Angiology, Medical Centre, Faculty of Medicine University Heart Centre Freiburg‐Bad Krozingen, University of Freiburg GermanyDepartment of Cardiology and Angiology, Medical Centre, Faculty of Medicine University Heart Centre Freiburg‐Bad Krozingen, University of Freiburg GermanyDepartment of Cardiology and Angiology, Medical Centre, Faculty of Medicine University Heart Centre Freiburg‐Bad Krozingen, University of Freiburg GermanyDepartment of Cardiology and Angiology, Medical Centre, Faculty of Medicine University Heart Centre Freiburg‐Bad Krozingen, University of Freiburg GermanyClinic of Cardiology University Heart and Vascular Centre Hamburg, University Medical Center Hamburg‐Eppendorf Hamburg GermanyClinic of Cardiology University Heart and Vascular Centre Hamburg, University Medical Center Hamburg‐Eppendorf Hamburg GermanyClinic of Cardiology University Heart and Vascular Centre Hamburg, University Medical Center Hamburg‐Eppendorf Hamburg GermanyDepartment of Diagnostic and Interventional Radiology University Medical Center Hamburg‐Eppendorf Hamburg GermanyDepartment of Diagnostic and Interventional Radiology University Medical Center Hamburg‐Eppendorf Hamburg GermanyClinic of Cardiology University Heart and Vascular Centre Hamburg, University Medical Center Hamburg‐Eppendorf Hamburg GermanyDepartment of Cardiology and Angiology, Medical Centre, Faculty of Medicine University Heart Centre Freiburg‐Bad Krozingen, University of Freiburg GermanyClinic of Cardiology University Heart and Vascular Centre Hamburg, University Medical Center Hamburg‐Eppendorf Hamburg GermanyDepartment of Cardiology and Angiology, Medical Centre, Faculty of Medicine University Heart Centre Freiburg‐Bad Krozingen, University of Freiburg GermanyBackground Biomarkers simplifying the diagnostic workup by discriminating between non–ST‐segment–elevation myocardial infarction (NSTEMI) and infarct‐like myocarditis are an unmet clinical need. Methods and Results A total of 105 subjects were categorized into groups as follows: ST‐segment−elevation myocardial infarction (n=36), NSTEMI (n=22), infarct‐like myocarditis (n=19), cardiomyopathy‐like myocarditis (n=18), and healthy control (n=10). All subjects underwent cardiac magnetic resonance imaging, and serum concentrations of matrix metalloproteinase‐1 (MMP‐1) and procollagen type I carboxy terminal propeptide (PICP) were measured. Biomarker concentrations in subjects presenting with acute coronary syndrome and non‐ST‐segment‐elevation, for example NSTEMI or infarct‐like myocarditis, categorized as the non−ST‐segment−elevation acute coronary syndrome−like cohort, were of particular interest for this study. Compared with healthy controls, subjects with myocarditis had higher serum concentrations of MMP‐1 and PICP, while no difference was observed in individuals with myocardial infarction. In the non−ST‐segment−elevation acute coronary syndrome−like cohort, MMP‐1 concentrations discriminated infarct‐like myocarditis and NSTEMI with an area under the receiver operating characteristic curve (AUC) of 0.95 (95% CI, 0.89−1.00), whereas high‐sensitivity cardiac troponin T performed inferiorly (AUC, 0.74 [95% CI, 0.58−0.90]; P=0.012). Application of an optimal MMP‐1 cutoff had 94.4% sensitivity (95% CI, 72.7%−99.9%) and 90.9% specificity (95% CI, 70.8%−98.9%) for the diagnosis of infarct‐like myocarditis in this cohort. The AUC of PICP in this context was 0.82 (95% CI, 0.68−0.97). As assessed by likelihood ratio tests, incorporating MMP‐1 or PICP with age and C‐reactive protein into composite prediction models enhanced their diagnostic performance. Conclusions MMP‐1 and PICP could potentially be useful biomarkers for differentiating between NSTEMI and infarct‐like myocarditis in individuals with non−ST‐segment−elevation acute coronary syndrome‐like presentation, though further research is needed to validate their clinical applicability.https://www.ahajournals.org/doi/10.1161/JAHA.124.034194biomarkercardiac troponinmatrix metalloproteinase‐1NSTEMIprocollagen type I carboxy terminal propeptide |
| spellingShingle | Lucas Bacmeister Ersin Cavus Sebastian Bohnen Enver Tahir Hanna Wolf Annette Buellesbach Adrian Heidenreich Virginia K. Haacke Susanne Weber Ingo Hilgendorf Tanja Zeller Francisco Ojeda Ulf K. Radunski Gunnar K. Lund Gerhard Adam Stefan Blankenberg Dirk Westermann Kai Muellerleile Diana Lindner Serum Concentrations of Matrix Metalloproteinase‐1 and Procollagen Type I Carboxy Terminal Propeptide Discriminate Infarct‐Like Myocarditis and Non−ST‐Segment−Elevation Myocardial Infarction Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease biomarker cardiac troponin matrix metalloproteinase‐1 NSTEMI procollagen type I carboxy terminal propeptide |
| title | Serum Concentrations of Matrix Metalloproteinase‐1 and Procollagen Type I Carboxy Terminal Propeptide Discriminate Infarct‐Like Myocarditis and Non−ST‐Segment−Elevation Myocardial Infarction |
| title_full | Serum Concentrations of Matrix Metalloproteinase‐1 and Procollagen Type I Carboxy Terminal Propeptide Discriminate Infarct‐Like Myocarditis and Non−ST‐Segment−Elevation Myocardial Infarction |
| title_fullStr | Serum Concentrations of Matrix Metalloproteinase‐1 and Procollagen Type I Carboxy Terminal Propeptide Discriminate Infarct‐Like Myocarditis and Non−ST‐Segment−Elevation Myocardial Infarction |
| title_full_unstemmed | Serum Concentrations of Matrix Metalloproteinase‐1 and Procollagen Type I Carboxy Terminal Propeptide Discriminate Infarct‐Like Myocarditis and Non−ST‐Segment−Elevation Myocardial Infarction |
| title_short | Serum Concentrations of Matrix Metalloproteinase‐1 and Procollagen Type I Carboxy Terminal Propeptide Discriminate Infarct‐Like Myocarditis and Non−ST‐Segment−Elevation Myocardial Infarction |
| title_sort | serum concentrations of matrix metalloproteinase 1 and procollagen type i carboxy terminal propeptide discriminate infarct like myocarditis and non st segment elevation myocardial infarction |
| topic | biomarker cardiac troponin matrix metalloproteinase‐1 NSTEMI procollagen type I carboxy terminal propeptide |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.034194 |
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