Multidomain Biomarkers as Predictors of Cardiovascular Risk in Acute Coronary Syndrome: A Prospective Evaluation.

MACE occurred in 51.4% of ACS patients followed for 30 days in this prospective cohort.

• 103 patients admitted with confirmed ACS were included at a tertiary referral center in Mexico.
• MACE was defined as reinfarction, death, percutaneous coronary intervention, or bypass surgery.
• Follow-up duration was 30 days.
• Blood samples were collected upon admission to measure biomarker levels.

Patients who experienced MACE were significantly older and had longer hospital stays than those without adverse outcomes.

• The difference in age and hospital stay length between MACE and non-MACE groups was statistically significant (p < 0.05).
• This finding was identified in a prospective cohort of 103 ACS patients.
• Multivariate logistic regression adjusted for age, smoking, and comorbidities.

PF4 and hs-CRP demonstrated high sensitivity (98%) but low specificity as biomarkers for MACE in ACS patients.

• Both platelet factor 4 (PF4) and high-sensitivity C-reactive protein (hs-CRP) achieved 98% sensitivity.
• Despite high sensitivity, neither PF4 nor hs-CRP demonstrated high specificity for MACE prediction.
• These biomarkers were measured from blood samples collected upon hospital admission.
• Neither PF4 nor hs-CRP emerged as independent predictors in the multivariate logistic regression analysis.

IgG anti-β2-glycoprotein I was a significant independent predictor of MACE in multivariate analysis.

• IgG anti-β2-glycoprotein I reached statistical significance in multivariate logistic regression (p < 0.001).
• The analysis adjusted for age, smoking, and comorbidities.
• IgG anti-β2-glycoprotein I represents an autoimmune/antiphospholipid antibody marker.
• This finding suggests an autoimmune component to short-term cardiovascular risk in ACS.

D-dimer was a significant independent predictor of MACE in multivariate analysis.

• D-dimer reached statistical significance in multivariate logistic regression (p = 0.024).
• The analysis adjusted for age, smoking, and comorbidities.
• D-dimer represents a marker of coagulation/thrombosis activity.
• D-dimer was measured from blood samples collected upon hospital admission.

IgM isotypes of antiphospholipid antibodies did not show independent predictive value for MACE.

• IgM anticardiolipin and IgM anti-β2-glycoprotein I did not emerge as significant independent predictors in multivariate logistic regression.
• This contrasts with the IgG anti-β2-glycoprotein I isotype, which was a significant predictor (p < 0.001).
• The finding suggests isotype-specific differences in the prognostic relevance of antiphospholipid antibodies in ACS.

The study evaluated a multidomain biomarker panel combining inflammatory, coagulation, and autoimmune markers in ACS patients.

• Biomarkers measured included hs-CRP (inflammatory), PF4 (platelet/thrombotic), D-dimer (coagulation), anticardiolipin antibodies (IgG and IgM), and anti-β2-glycoprotein I antibodies (IgG and IgM).
• The study was conducted at a tertiary referral center in Mexico.
• The study design was a prospective cohort with 103 participants.
• The prognostic value of combining inflammatory and autoimmune biomarkers in ACS was described as 'understudied' prior to this work.