Myocardial infarction (MI) not only defines acute MI with obstructed coronary arteries (T1MI) but also myocardial necrosis caused by myocardial oxygen supply/demand mismatch as type 2 MI (T2MI); only T1MI patients benefit from an early invasive management. Myeloid-related protein(MRP)-8/14 is a biomarker described in various inflammatory diseases and in MI patients. Here we evaluate the potential of MRP-8/14 and high-sensitivity troponin I (hs-cTnI) to differentiate T2MI from T1MI. Patients with final diagnosis NSTEMI (n = 254; 33.1% female) enrolled in a prospective biomarker registry between 08/2011 and 10/2016 were analysed. Median baseline MRP-8/14 levels were higher in T2MI (n = 55; 3.37(1.88-6.48)μg/mL) than in T1MI (n = 199; 2.4 [1.4-3.79]μg/mL) (p = .013) patients, in contrast to hs-cTnI (T2MI:52[11.65-321.4]ng/L vs. T1MI:436.5 [61.25-1973.8]ng/L; p < .001). To detect the strength of this association odds ratios(OR) were calculated with MRP-8/14 yielding 2.13(1.16-3.92; p = .015) to predict T2MI and 0.47(0.26-0.87; p = .015) for T1MI. As expected, hs-cTnI yielded an OR of to predict T2MI 0.34(0.17-0.65; p = .001) and 2.98(1.53-5.81; p = .001) for T1MI. Both markers show comparable and independent results if adjust to hs-cTnI/MRP-8/14, TIMI risk score and CRP. T2MI is associated with higher MRP-8/14 and lower hs-cTnI concentrations than T1MI. Our data suggest that MRP-8/14 as a marker of inflammation might provide usable discriminatory information complementing hs-cTnI in a diagnostic procedure evaluating the type of MI directly upon hospital admission.

中文翻译：

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髓样相关蛋白8/14和高敏感性心肌肌钙蛋白I可以区分2型心肌梗塞。

心肌梗死（MI）不仅将急性MI定义为冠状动脉阻塞（T1MI），而且将因心肌供氧/需求不匹配引起的心肌坏死定义为2型MI（T2MI）。只有T1MI患者可以从早期侵入性治疗中受益。髓样相关蛋白（MRP）-8/14是在各种炎症性疾病和MI患者中描述的生物标志物。在这里，我们评估了MRP-8 / 14和高敏感性肌钙蛋白I（hs-cTnI）区分T2MI和T1MI的潜力。分析了在08/2011年至10/2016年之间纳入前瞻性生物标志物登记表的最终诊断为NSTEMI的患者（n = 254；女性33.1％）。T2MI（n = 55; 3.37（1.88-6.48）μg/ mL）中的基线MRP-8 / 14水平高于T1MI（n = 199; 2.4 [1.4-3.79]μg/ mL）（p = 0.013） ）患者，而不是hs-cTnI（T2MI：52 [11.65-321.4] ng / L与T1MI：436.5 [61.25-1973。8] ng / L；p <.001）。为了检测这种关联的强度，用MRP-8 / 14计算比值比（OR），得出2.13（1.16-3.92; p = .015）以预测T2MI，而预测T1MI为0.47（0.26-0.87; p = .015）。如预期的那样，hs-cTnI的OR值可以预测T1MI的T2MI为0.34（0.17-0.65; p = .001）和2.98（1.53-5.81; p = .001）。如果调整为hs-cTnI / MRP-8 / 14，TIMI风险评分和CRP，则两种标记均显示可比较且独立的结果。与T1MI相比，T2MI与更高的MRP-8 / 14和更低的hs-cTnI浓度有关。我们的数据表明，MRP-8 / 14作为炎症的标志物，可在诊断入院后直接评估MI类型的诊断程序中提供补充hs-cTnI的有用歧视性信息。16-3.92; p = .015）来预测T2MI，而预测T1MI为0.47（0.26-0.87; p = .015）。如预期的那样，hs-cTnI的OR为T1MI的T2MI预测为0.34（0.17-0.65; p = .001）和2.98（1.53-5.81; p = .001）。如果调整为hs-cTnI / MRP-8 / 14，TIMI风险评分和CRP，则两种标记均显示可比较且独立的结果。与T1MI相比，T2MI与更高的MRP-8 / 14和更低的hs-cTnI浓度相关。我们的数据表明，MRP-8 / 14作为炎症的标志物，可在诊断入院后直接评估MI类型的诊断程序中提供补充hs-cTnI的有用歧视性信息。16-3.92; p = .015）来预测T2MI，而预测T1MI为0.47（0.26-0.87; p = .015）。如预期的那样，hs-cTnI的OR值可以预测T1MI的T2MI为0.34（0.17-0.65; p = .001）和2.98（1.53-5.81; p = .001）。如果调整为hs-cTnI / MRP-8 / 14，TIMI风险评分和CRP，则两种标记均显示可比较且独立的结果。与T1MI相比，T2MI与更高的MRP-8 / 14和更低的hs-cTnI浓度有关。我们的数据表明，MRP-8 / 14作为炎症的标志物，可在诊断入院后直接评估MI类型的诊断程序中提供补充hs-cTnI的有用歧视性信息。如果调整为hs-cTnI / MRP-8 / 14，TIMI风险评分和CRP，则两种标记均显示可比较且独立的结果。与T1MI相比，T2MI与更高的MRP-8 / 14和更低的hs-cTnI浓度有关。我们的数据表明，MRP-8 / 14作为炎症的标志物，可在诊断入院后直接评估MI类型的诊断程序中提供补充hs-cTnI的有用歧视性信息。如果调整为hs-cTnI / MRP-8 / 14，TIMI风险评分和CRP，则两种标记均显示可比较且独立的结果。与T1MI相比，T2MI与更高的MRP-8 / 14和更低的hs-cTnI浓度有关。我们的数据表明，MRP-8 / 14作为炎症的标志物，可在诊断入院后直接评估MI类型的诊断程序中提供补充hs-cTnI的有用歧视性信息。