Proteomic analysis of adverse outcomes in patients with acute coronary syndromes.

Abstract Background Most biomarkers lack clinical sensitivity and specificity for predicting adverse outcomes in patients with acute coronary syndromes (ACS). We identified potential predictors through proteomic analysis. Methods Serum proteomic analysis was performed by surface-enhanced laser desorption/ionization protein chip technology in 409 patients with ACS. The primary endpoints were 30-day and 3-year occurrence of major adverse cardiovascular events (cardiac death, non-fatal myocardial infarction and target lesion revascularization). Results A m/z 4174.39 peak was associated with an increased incidence of 3-year events. In multivariate analysis, the m/z 4174.39 peak showed an independent correlation with 3-year (over 30-day) events (hazard ratio, 2.33; 95% confidence interval (CI), 1.23 to 4.39; P  = 0.009 for the fourth versus first quartile), while the creatine kinase MB fraction (CK-MB) and troponin T levels were associated with 30-day events ((ln CK-MB: hazard ratio, 1.36; 95% CI, 1.07 to 1.73; P  = 0.013); (ln troponin T: hazard ratio, 1.36; 95% CI, 1.12 to 1.64; P  = 0.002)). Conclusions The m/z 4174.39 peak is a strong marker for predicting the long-term outcomes, and may correspond to a new biomarker, such as a member of the CXC chemokine family, and provide additional prognostic value in ACS.