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Background <p>Copeptin, mid-regional pro-adrenomedullin (MR-pro ADM), and mid-regional pro-atrial natriuretic peptide (MR-pro ANP) are hemodynamic stress markers released into the circulation in acute coronary syndrome (ACS) patients. As the ACS prevalence in type 2 diabetes (T2D) is increasing, we need specific biomarkers that can help in the ACS diagnosis and prognosis.</p> Objectives <p>The study compared hemodynamic stress biomarkers in T2D patients with and without ACS and investigated their association with&#xa0;markers of myocardial necrosis [heart-type fatty acid binding protein (H-FABP) &amp; troponin-T], myocardial stress (galectin-3), plaque instability [myeloperoxidase (MPO) &amp; pregnancy-associated plasma protein-A (PAPP-A)], and major adverse cardiac events (MACEs) at 30 days.</p> Methods <p>Forty T2D with ACS were enrolled as cases, and 40 T2D without ACS as controls. Personal and family histories were recorded. The collected blood from study participants was used to measure routine biochemical investigations and biomarkers.</p> Results <p>Cases had significantly higher serum copeptin, MR-pro ADM, and MR-pro ANP levels than controls (<i>p</i> &lt; 0.05). Serum copeptin, MR-pro ADM, and MR-pro ANP levels were positively associated with duration of T2D, serum troponin-T, creatinine kinase-MB, H-FABP, galectin-3, PAPP-A, and MPO levels in cases (<i>p</i> &lt; 0.05). Binary logistics regression showed that serum MR-pro ADM and H-FABP levels were significantly related to the ACS risk in T2D patients. Cox-regression analyses revealed that serum copeptin and H-FABP levels were related to a higher risk of 30-day MACEs.</p> Conclusion <p>Serum copeptin, MR-pro ADM, and MR-pro ANP levels are significant for ACS diagnosis in T2D patients. Further cohort or multi-centre studies with larger sample sizes are recommended to validate these findings.</p>

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Diagnostic utility and association of hemodynamic stress biomarkers with biomarkers of myocardial necrosis and plaque instability in type 2 diabetes with acute coronary syndrome: A case–control study

  • 期刊论文

  • 发表日期：

    2025年2月12日

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  • Amaravathi Uthayakumar,
  • Prashant Shankarrao Adole,
  • Kolar Vishwanath Vinod,
  • Balamurugan Nathan

摘要

Background

Copeptin, mid-regional pro-adrenomedullin (MR-pro ADM), and mid-regional pro-atrial natriuretic peptide (MR-pro ANP) are hemodynamic stress markers released into the circulation in acute coronary syndrome (ACS) patients. As the ACS prevalence in type 2 diabetes (T2D) is increasing, we need specific biomarkers that can help in the ACS diagnosis and prognosis.

Objectives

The study compared hemodynamic stress biomarkers in T2D patients with and without ACS and investigated their association with markers of myocardial necrosis [heart-type fatty acid binding protein (H-FABP) & troponin-T], myocardial stress (galectin-3), plaque instability [myeloperoxidase (MPO) & pregnancy-associated plasma protein-A (PAPP-A)], and major adverse cardiac events (MACEs) at 30 days.

Methods

Forty T2D with ACS were enrolled as cases, and 40 T2D without ACS as controls. Personal and family histories were recorded. The collected blood from study participants was used to measure routine biochemical investigations and biomarkers.

Results

Cases had significantly higher serum copeptin, MR-pro ADM, and MR-pro ANP levels than controls (p < 0.05). Serum copeptin, MR-pro ADM, and MR-pro ANP levels were positively associated with duration of T2D, serum troponin-T, creatinine kinase-MB, H-FABP, galectin-3, PAPP-A, and MPO levels in cases (p < 0.05). Binary logistics regression showed that serum MR-pro ADM and H-FABP levels were significantly related to the ACS risk in T2D patients. Cox-regression analyses revealed that serum copeptin and H-FABP levels were related to a higher risk of 30-day MACEs.

Conclusion

Serum copeptin, MR-pro ADM, and MR-pro ANP levels are significant for ACS diagnosis in T2D patients. Further cohort or multi-centre studies with larger sample sizes are recommended to validate these findings.