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The Role of Biomarkers in the Diagnosis and Risk Stratification...
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The Role of Biomarkers in the Diagnosis and Risk Stratification of Acute Coronary Syndrome

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (31 October 2021) | Viewed by 2199

Special Issue Editor

Prof. Dr. Alfredo Bardaji

E-Mail Website
Guest Editor
Cardiology Service, University Hospital of Tarragona Joan XXIII, Tarragona, Spain
Interests: acute coronary syndrome; myocardial injury, troponin; chronic ischemic heart disease; biomarkers

Special Issue Information

Dear Colleagues,

Biomarkers are currently attracting immense interest as they not only help with diagnosis and management but also help us to understand the pathophysiology of the disease process. The use of a large number of cardiovascular biomarkers, meant to complement the use of the electrocardiogram, echocardiography, cardiac imaging, and clinical symptom assessment, has become routine in clinical diagnosis, differential diagnosis, risk stratification, and prognosis and guides the management of patients with suspected cardiovascular diseases.

There is a broad consensus that cardiac troponin and natriuretic peptides are the preferred biomarkers in clinical practice for the diagnosis of acute coronary syndrome and heart failure, respectively, while the roles and possible clinical applications of several other potential biomarkers are still under study. We still need to identify more novel biomarkers to supplement ECGs or X-rays and provide more accurate and sensitive methods for cardiovascular disease diagnosis, risk stratification, and management. Although traditional biomarkers play a central role in the diagnosis, risk stratification, and management of coronary artery disease, they are unable to detect myocardial ischemia in the absence of necrosis, hemodynamic markers of heart failure, inflammatory markers, and a novel and innovative approach of a combination of these in a multimarker strategy.

This Special Issue aims to deepen the specific role of biomarkers in the diagnosis and risk stratification of acute coronary syndrome. We cordially invite researchers involved in basic research as well as translational studies to submit their original research, systematic reviews, and short communications to this Special Issue.

Prof. Alfredo Bardaji
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • biomarkers
  • acute coronary syndrome
  • prognosis
  • mortality
  • troponin

Published Papers (1 paper)

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Research

20 pages, 1295 KiB  
Article
Systemic Vulnerability, as Expressed by I-CAM and MMP-9 at Presentation, Predicts One Year Outcomes in Patients with Acute Myocardial Infarction—Insights from the VIP Clinical Study
by Diana Opincariu, Ioana Rodean, Nora Rat, Roxana Hodas, Imre Benedek and Theodora Benedek
J. Clin. Med. 2021, 10(15), 3435; https://doi.org/10.3390/jcm10153435 - 31 Jul 2021
Cited by 7 | Viewed by 1704
Abstract
(1) Background: The prediction of recurrent events after acute myocardial infarction (AMI) does not sufficiently integrate systemic inflammation, coronary morphology or ventricular function in prediction algorithms. We aimed to evaluate the accuracy of inflammatory biomarkers, in association with angiographical and echocardiographic parameters, in [...] Read more.
(1) Background: The prediction of recurrent events after acute myocardial infarction (AMI) does not sufficiently integrate systemic inflammation, coronary morphology or ventricular function in prediction algorithms. We aimed to evaluate the accuracy of inflammatory biomarkers, in association with angiographical and echocardiographic parameters, in predicting 1-year MACE after revascularized AMI. (2) Methods: This is an extension of a biomarker sub-study of the VIP trial (NCT03606330), in which 225 AMI patients underwent analysis of systemic vulnerability and were followed for 1 year. Hs-CRP, MMP-9, IL-6, I-CAM, V-CAM and E-selectin were determined at 1 h after revascularization. The primary end-point was the 1-year MACE rate. (3) Results: The MACE rate was 24.8% (n = 56). There were no significant differences between groups in regard to IL-6, V-CAM and E-selectin. The following inflammatory markers were significantly higher in MACE patients: hs-CRP (11.1 ± 13.8 vs. 5.1 ± 4.4 mg/L, p = 0.03), I-CAM (452 ± 283 vs. 220.5 ± 104.6, p = 0.0003) and MMP-9 (2255 ± 1226 vs. 1099 ± 706.1 ng/mL p = 0.0001). The most powerful predictor for MACE was MMP-9 of >1155 ng/mL (AUC-0.786, p < 0.001) even after adjustments for diabetes, LVEF, acute phase complications and other inflammatory biomarkers. For STEMI, the most powerful predictors for MACE included I-CAM > 239.7 ng/mL, V-CAM > 877.9 ng/mL and MMP-9 > 1393 ng/mL. (4) Conclusions: High levels of I-CAM and MMP-9 were the most powerful predictors for recurrent events after AMI for the overall study population. For STEMI subjects, the most important predictors included increased levels of I-CAM, V-CAM and MMP-9, while none of the analyzed parameters had proven to be predictive. Inflammatory biomarkers assayed during the acute phase of AMI presented a more powerful predictive capacity for MACE than the LVEF. Full article
(This article belongs to the Special Issue The Role of Biomarkers in the Diagnosis and Risk Stratification of Acute Coronary Syndrome)
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