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Copeptin, miRNA-208, and miRNA-499 as New Biomarkers for Early Detection of Acute Coronary Syndrome

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Abstract

cTn and CK-MB are gold standard biomarkers for acute coronary syndrome (ACS) but are less sensitive in the first 3 h after onset of symptoms. A need thus exists for novel biomarkers for early detection of ACS. We evaluated circulating copeptin, miRNA-208, and miRNA-499 as possible biomarkers for early detection of unstable angina (UA) and non-ST-segment elevation myocardial infarction (NSTEMI). Sixty-five patients with probable ACS that presented within 4 h of the onset of chest pain (23 UA and 42 NSTEMI) and 25 apparently healthy individuals were studied. Two sets of blood samples collected in the first 3 h and at 6 h after onset were analyzed for copeptin levels via ELISA and miRNA-208 and miRNA-499 expression via real-time PCR. Copeptin, miRNA-208, and miRNA-499 expression levels were significantly increased in UA and NSTEMI patients compared with controls (p < 0.001) and in NSTEMT compared with UA patients (p < 0.001). Levels were also significantly elevated in UA and NSTEMI patients with negative cardiac troponin in the first 3 h (p < 0.001). ROC curves displayed AUC for prediction of ACS of 0.96 for copeptin, 0.97 for miRNA-208, and 0.97 for miRNA-499. Their combination improved AUC to 0.98. Copeptin and miRNA-208 and miRNA-499 expression are promising biomarkers for UA and NSTEMI that present in the first 3 h of pain onset. A combination of these markers with cTn may increase the accuracy of diagnosis by avoiding the gray zone of cTn as a biomarker.

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Acknowledgements

We would like to thank the entire participants in this study, particularly the patients, nurses, and medical biochemistry lab workers.

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Authors and Affiliations

  1. Medical Biochemistry Department, Faculty of Medicine, Assiut University, Assiut, Egypt

    Marwa A. Gaber, Sahar E. M. El-Deek & Abdel-Raheim M. A. Meki

  2. Assiut International Center of Nanomedicine, El-rajhy liver Hospital, Assiut University, Assiut, Egypt

    Omnia H. M. Omar

  3. Cardiology Department, Faculty of Medicine,, Assiut University, Assiut, Egypt

    Ayman K. M. Hassan & Marwan S. Mahmoud

  4. iochemistry Department, Faculty of Pharmacy, Sphinx University, New Assiut, Egypt Corresponding author: Assistant Professor Marwa A Gaber, Medical Biochemistry Department, Faculty of Medicine, Assiut University, Assiut, Egypt

    Abdel-Raheim M. A. Meki

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  1. Marwa A. Gaber
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Contributions

Marwa A Gaber and Omnia HM Omar conceptualized and designed the study protocol development, assessment, and writing of the manuscript. Ayman KM Hassan and Marwan S Mahmoud performed clinical assessments and selection of all cases and revised the manuscript. Marwa A Gaber and Omnia HM Omar performed all lab investigations. Sahar EM El-Deek and Abdel-Raheim MA Meki revised the manuscript. All authors approved the final manuscript as submitted and agreed to be responsible for all aspects of the work.

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Correspondence to Marwa A. Gaber.

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The study protocol was approved by the institutional ethics committee (IRB local approval number 17101364) and explained to all participants, and only those who gave informed written consent were included in the study.

Guarantor: Marwa A Gaber.

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The authors declare no competing interests.

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Gaber, M.A., Omar, O.H.M., El-Deek, S.E.M. et al. Copeptin, miRNA-208, and miRNA-499 as New Biomarkers for Early Detection of Acute Coronary Syndrome. Appl Biochem Biotechnol 194, 1193–1205 (2022). https://doi.org/10.1007/s12010-021-03695-6

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