Korean Circ J.  2013 Apr;43(4):246-254. 10.4070/kcj.2013.43.4.246.

Bedside-Friendly Prediction for Presence of Post-Myocardial lnfarction Systolic Dysfunction Using Multimarker Panel: Integrating Salivary Diagnostics into Clinical Practice

• Assareh A
• Haybar H
• Yoosefi H
• Bozorgmanesh M

• KMID: 2224947
• DOI: http://doi.org/10.4070/kcj.2013.43.4.246

Abstract

BACKGROUND AND OBJECTIVES
We investigated if a combination of plasma or salivary interleukin-2 (IL-2), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), transforming growth factor-beta (TGF-beta), and troponin can improve estimation of the pretest probability of the left ventricular systolic dysfunction (LVSD).
SUBJECTS AND METHODS
Eighty patients with newly-diagnosed myocardial infarction (MI) were echocardiographically examined for LVSD (ejection fraction < or =40%). Measurements included traditional MI risk factors, plasma and salivary concentrations of troponin, IL-2, IL-6, TNF-alpha, and TGF-beta. With the LVSD as the outcome variable, we developed logistic regression models, starting with a basic model incorporating traditional risk factors and consecutively adding salivary and plasma biomarkers. Models were compared using several criteria, including (but not limited to) C statistic (discrimination) and net reclassification improvement index (NRI).
RESULTS
Apart from troponin, plasma, and salivary values of the biomarkers were correlated: spearman's rho was 0.19 (p=0.088) for troponin, 0.36 (p=0.001) for IL-2, 0.74 (p<0.001) for IL-6, 0.61 (p<0.001) for TNF-alpha, and 0.65 (p<0.001) for TGF-beta. The predictive performances of the basic model for estimating the pretest probability of the presence of LVSD considerably improved when cytokines were added (salivary added: C-statistic from 0.77 to 0.82 and NRI 77%; plasma added: C-statistic to 0.80 and NRI 134%).
CONCLUSION
Multiple biomarkers added diagnostic value to the standard risk factors for predicting the presence of post-MI LVSD.

Keyword

Interleukins; Transforming growth factor-beta; Tumor necrosis factor-alpha; Saliva; Left ventricular dysfunction

MeSH Terms

Biomarkers
Cytokines
Humans
Interleukin-2
Interleukin-6
Interleukins
Logistic Models
Myocardial Infarction
Plasma
Risk Factors
Saliva
Transforming Growth Factor beta
Troponin
Tumor Necrosis Factor-alpha
Ventricular Dysfunction, Left
Cytokines
Interleukin-2
Interleukin-6
Interleukins
Transforming Growth Factor beta
Troponin
Tumor Necrosis Factor-alpha

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