Multi-marker network in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention: When and what to measure

BackgroundData on the correlations between biomarkers to suggest cost-effective multi-marker (MM) panels predictive for ST-elevation myocardial infarction (STEMI) patients are lacking. We sought to explore the relationship between cardiac troponin I (cTnI), C-reactive protein (CRP), B-type natriuretic peptide (BNP), and chromogranin A (CgA) accounting for biomarkers' profiles detected within 48 h from successful primary percutaneous coronary intervention (PPCI).MethodsIn 73 STEMI patients cTnI, CRP, BNP, and CgA were measured before PPCI and 6, 24, and 48 h later. STATIS methods generalizing Principal Component Analysis on three-way data sets were employed to extract information about: 1) similarities between patients, 2) contribution of each time of sampling and 3) correlations between biomarkers' profiles.ResultsSTEMI patients who underwent successful PPCI emerged to have a homogeneous profile tailored on biomarkers' evaluation within 48 h. Their measurements at 24 h contributed the most variability and information both to patients' and to biomarkers' profiles.BNP and cTnI were highly correlated and explained the 40.1% of the total variance, whereas CgA resulted independent and explained the 26.3% of the total variance.ConclusionsMarkers' measurements at 24 h after PPCI contributed most information to the definition of patients' profile. BNP and cTnI resulted interchangeable in a MM panel for reporting about the extent of necrosis.

► We sought to optimize biomarker evaluation in myocardial infarction. ► BNP and chromogranin A contributed independent information on pathophysiology. ► Detections 24 h after treatment contributed most information to patients' profiles. ► Our findings are basic to promote cost-effective multi-marker panels.