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<p>Acute coronary syndrome (ACS) presents sex-based differences in pathophysiology. Variations in biomarker patterns post-ACS, reflecting myocardial injury, vascular inflammation, and remodeling, may indicate critical differences in cardiovascular disease mechanisms and outcomes. We analyzed biomarker patterns in 787 patients (22% females) from the BIOMArCS study, all without re-ACS during the study period. We tracked levels of hs-cTnT, NT-proBNP, hs-CRP, GDF-15, and additional biomarkers in a subcohort of 191 patients over one year. Serial blood samples were collected to compare acute-phase (first month after ACS) and stabilized-phase (2–12&#xa0;months post-ACS) biomarker trajectories between sexes, adjusting for age, BMI, and kidney function using linear mixed-effects models. Females showed significantly lower hs-cTnT levels (mean 386&#xa0;pg/mL versus 559&#xa0;pg/mL in males, p = 0.002 acute phase; 8.5&#xa0;pg/mL versus 10.8&#xa0;pg/mL, p &lt; 0.001 at 180&#xa0;days). NT-proBNP levels were higher in females (mean 70&#xa0;pmol/L vs. 47&#xa0;pmol/L, p &lt; 0.001 acute phase; 30&#xa0;pmol/L vs. 19&#xa0;pmol/L, p &lt; 0.001 at 180&#xa0;days). Hs-CRP levels were also elevated in females (mean 1.8&#xa0;mg/L vs. 1.5&#xa0;mg/L, p = 0.02 at 180&#xa0;days). Galectin-3 levels remained higher in females (22.8&#xa0;ng/mL vs. 18.6&#xa0;ng/mL, p = 0.03).&#xa0;This study provides the first comprehensive analysis of sex-specific biomarker trajectories following ACS. Distinct differences in hs-cTnT, NT-proBNP, and inflammatory markers suggest that sex-specific diagnostic thresholds and personalized treatment strategies after ACS may be warranted, although their clinical value still needs confirmation in larger prospective studies.</p>

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Sex-based differences in biomarker trajectories in acute coronary syndrome patients from the BIOMArCS study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月10日

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  • Christiane Gärtner,
  • Monique E. ten Haaf,
  • K. Martijn Akkerhuis,
  • Rohit M. Oemrawsingh,
  • Ron H. van Schaik,
  • Yolanda B. de Rijke,
  • Isabella Kardys,
  • Yolande Appelman,
  • Eric Boersma

摘要

Acute coronary syndrome (ACS) presents sex-based differences in pathophysiology. Variations in biomarker patterns post-ACS, reflecting myocardial injury, vascular inflammation, and remodeling, may indicate critical differences in cardiovascular disease mechanisms and outcomes. We analyzed biomarker patterns in 787 patients (22% females) from the BIOMArCS study, all without re-ACS during the study period. We tracked levels of hs-cTnT, NT-proBNP, hs-CRP, GDF-15, and additional biomarkers in a subcohort of 191 patients over one year. Serial blood samples were collected to compare acute-phase (first month after ACS) and stabilized-phase (2–12 months post-ACS) biomarker trajectories between sexes, adjusting for age, BMI, and kidney function using linear mixed-effects models. Females showed significantly lower hs-cTnT levels (mean 386 pg/mL versus 559 pg/mL in males, p = 0.002 acute phase; 8.5 pg/mL versus 10.8 pg/mL, p < 0.001 at 180 days). NT-proBNP levels were higher in females (mean 70 pmol/L vs. 47 pmol/L, p < 0.001 acute phase; 30 pmol/L vs. 19 pmol/L, p < 0.001 at 180 days). Hs-CRP levels were also elevated in females (mean 1.8 mg/L vs. 1.5 mg/L, p = 0.02 at 180 days). Galectin-3 levels remained higher in females (22.8 ng/mL vs. 18.6 ng/mL, p = 0.03). This study provides the first comprehensive analysis of sex-specific biomarker trajectories following ACS. Distinct differences in hs-cTnT, NT-proBNP, and inflammatory markers suggest that sex-specific diagnostic thresholds and personalized treatment strategies after ACS may be warranted, although their clinical value still needs confirmation in larger prospective studies.