RESEARCH ARTICLE
A Plaque Disruption Index Identifies Patients with Non-STE-Type 1 Myocardial Infarction within 24 Hours of Troponin Positivity Maha A. Al-Mohaissen1*, Ronald G. Carere2, G. B. John Mancini3, Karin H. Humphries2, Beth A. Whalen4, Terry Lee5, Frank X. Scheuermeyer6, Andrew P. Ignaszewski2 1 Department of Clinical Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia, 2 Department of Medicine, Division of Cardiology, St. Paul’s Hospital and the University of British Columbia, Vancouver, BC, Canada, 3 Department of Medicine, University of British Columbia, Vancouver, BC, Canada, 4 Centre for Heart Lung Innovation, St. Paul’s Hospital and University of British Columbia, Vancouver, BC, Canada, 5 Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital and University of British Columbia, Vancouver, BC, Canada, 6 Department of Emergency Medicine, St. Paul’s Hospital and the University of British Columbia, Vancouver, BC, Canada
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[email protected]
Abstract OPEN ACCESS Citation: Al-Mohaissen MA, Carere RG, Mancini GBJ, Humphries KH, Whalen BA, Lee T, et al. (2016) A Plaque Disruption Index Identifies Patients with Non-STE-Type 1 Myocardial Infarction within 24 Hours of Troponin Positivity. PLoS ONE 11(10): e0164315. doi:10.1371/journal. pone.0164315 Editor: Michael J Lipinski, Medstar Washington Hospital Center, UNITED STATES Received: July 4, 2016
Background Markers of plaque destabilization and disruption may have a role in identifying non-STEtype 1 Myocardial Infarction in patients presenting with troponin elevation. We hypothesized that a plaque disruption index (PDI) derived from multiple biomarkers and measured within 24 hours from the first detectable troponin in patients with acute non-STE- type 1 MI (NSTEMI-A) will confirm the diagnosis and identify these patients with higher specificity when compared to individual markers and coronary angiography.
Methods
Copyright: © 2016 Al-Mohaissen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
We examined 4 biomarkers of plaque destabilization and disruption: myeloperoxidase (MPO), high-sensitivity interleukin-6, myeloid-related protein 8/14 (MRP8/14) and pregnancy-associated plasma protein-A (PAPP-A) in 83 consecutive patients in 4 groups: stable non-obstructive coronary artery disease (CAD), stable obstructive CAD, NSTEMI-A (enrolled within 24 hours of troponin positivity), and NSTEMI-L (Late presentation NSTEMI, enrolled beyond the 24 hour limit). The PDI was calculated and the patients’ coronary angiograms were reviewed for evidence of plaque disruption. The diagnostic performance of the PDI and angiography were compared.
Data Availability Statement: All relevant data are within the paper.
Results
Accepted: September 22, 2016 Published: October 6, 2016
Funding: The author(s) received no specific funding for this work. Competing Interests: The authors have declared that no competing interests exist.
Compared to other biomarkers, MPO had the highest specificity (83%) for NSTEMI-A diagnosis (P
