S100A12 As An Early Diagnosis Biomarker For ST-segment Elevation Myocardial Infarction

ObjectiveS100A12 is a new member of the S100 family of calcium-binding proteins predominantly expressed and secreted by granulocytes.S100A12 involved in the pathogenesis of the inflammatory response through the interaction with the receptor of advanced glycation endproducts(RAGE)to accelerate the aggregation and activation of inflammatory cells,it might play a crucial role in the development of atherosclerosis and accelerated the rupture of unstable plaque.The purpose of this study was to observe the changes of S100A12 in the early stage of ST segment elevation myocardial infarction(STEMI)and then evaluated the diagnostic value of plasma S100A12 for STEMI.Methods1005 participants with suspected acute myocardial infarction were consecutively enrolled in the study from June 2014 to December 2016.All of the participants were recruited at the General Hospital of Shenyang Military Region chest pain center.At the same time,according to the latest diagnostic guidelines of American heart association/European Society of Cardiology(ACC/ESC),the patients were divided into unstable angina pectoris(n = 214 cases);patients with Non ST segment elevation myocardial infarction(n = 251 cases);STEMI(n = 438 cases).The participants with acute non-cardiac chest pain were defined as the control group(n = 102).We measured the high-sensitivity cardiac troponin T(hscTnT),high-sensitivity C-reactive protein(hsCRP),creatine kinase isoenzyme(CK-MB),myoglobin and S100A12 in the participants.The concentration of plasma S100A12 was determined by ELISA immediately in each group.Subgroup analysis was performed for patients presenting early,defined as chest pain onset ? 2 h of presentation to the emergency department(n = 150).The ROC curve was used to analyze the diagnostic efficacy,sensitivity and specificity among the five biomarkers for STEMI patients.The intraplaque hemorrhage in coronary arteries and coronary artery thrombus of STEMI patients were investigated by immunohistochemistry and immunofluorescence.The coronary thrombus tissues from STEMI patients were obtained by aspiration catheter and the level of S100A12 was detected in the thrombus tissue.ResultsThe plasma levels of S100A12 in STEMI patients were significantly higher than the Control group,UAP group,and NSTEMI group.The plasma S100A12 concentration was significantly increased within 30 min of chest pain onset in STEMI patients,reaching a peak at 1–2 h after onset of myocardial infarction.In receiver operating characteristic curve(ROC)analysis,the area under the curve(AUC)of S100A12 was 0.959(cutoff value 214.9 ng/ml),predicting STEMI occurrence with 87.6% sensitivity and 93.1% specificity.S100A12 provided a better predictive value compared with the other biomarkers(AUCs: hscTnT = 0.789;CK-MB = 0.703;myoglobin = 0.663;hsCRP = 0.620).Immunohistochemistry and immunofluorescence showed that S100A12 expression in the coronary artery intraplaque hemorrhage and thrombus of STEMI patients was higher than the control group.Furthermore,we found that S100A12 concentration in thrombus tissues collected from the coronary artery of STEMI patients was far higher than the plasma level(77,710.7 ± 19,286.1 ng/ml vs 559.3 ± 192.8 ng/ml).ConclusionsHigh expression of S100A12 within 2 h in the onset of STEMI and it is a highly sensitive and specific biomarker for the early diagnosis of STEMI.