A Novel Marker of Inflammation: Azurocidin in Patients with ST Segment Elevation Myocardial Infarction

Abstract

(1) To investigate the role of azurocidin, an antimicrobial protein, in patients with ST segment elevation myocardial infarction (STEMI). (2) This single-center prospective observational study included patients with STEMI and healthy age- and sex-matched control subjects. Baseline demographic, clinical and biochemical data were compared between the two groups. Azurocidin levels at baseline were determined using an enzyme-linked immunosorbent assay. Multivariate linear regression analysis with enter method was used to test the association between azurocidin and independent variables, such as the thrombolysis in myocardial infarction (TIMI) score, synergy between percutaneous coronary intervention with TAXUS and cardiac surgery score, global registry of acute coronary events score, Killip class, C-reactive protein (CRP), and creatinine kinase-myocardial band (CK-MB). (3) A total of 76 patients with STEMI and 30 healthy control subjects were enrolled in the study. Mean ± SD azurocidin levels were significantly higher in patients compared with healthy controls (18.07 ± 13.99 versus 10.09 ± 5.29 ng/mL, respectively). In a receiver-operating characteristic curve analysis, an azurocidin cut-off level of >11.46 ng/mL had 74% sensitivity and 58% specificity in predicting myocardial infarction. Azurocidin levels had a positive correlation with TIMI score (r = 0.651). In multivariate linear regression analysis, the TIMI score was an independent predictor of the azurocidin level. (4) Azurocidin is an infection marker that may be important in patients with STEMI.

Keywords: ST segment elevation myocardial infarction; azurocidine; inflammation.

Figure 1

Receiver-operating characteristic (ROC) curve analysis demonstrating the cut-off value of azurocidin for the diagnosis of myocardial infarction (MI) using data from 76 patients with ST segment elevation myocardial infarction and 30 healthy control subjects. The cut-off level of >11.46 ng/mL had 74% sensitivity and 58% specificity in predicting MI (ROC area under the curve (AUC), 0.713; p = 0.018).

Figure 2

Scatter plots showing the significant correlation between azurocidin levels and C-reactive protein (CRP), thrombolysis in myocardial infarction (TIMI) score, synergy between percutaneous coronary intervention with TAXUS and cardiac surgery (SYNTAX) score and global registry of acute coronary events (GRACE) score. The analysis included 76 patients and correlations were tested with Spearman’s rank correlation coefficient analysis. r: correlation coefficient, p < 0.01.