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Effect of combined testing of ceramides with high-sensitive troponin T on the detection of acute coronary syndrome in patients with chest pain in China: a prospective observational study

ObjectiveCeramides are associated with coronary plaque vulnerability. We aim to investigate the potential diagnostic value of ceramides for acute coronary syndrome (ACS) in Chinese patients with chest pain.DesignProspective observational survey.SettingShanghai, China, 2016–2017.ParticipantsA total o...

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Published in:BMJ open 2019-07, Vol.9 (7), p.e028211
Main Authors: Yao, Kang, Wang, Yanzhong, Xu, Demin, Liu, Xuebo, Shen, Chengxing, Hu, Wei, Wang, Zhe, Wu, Runda, Tang, Xianglin, Sun, Aijun, Zou, Yunzeng, Qian, Juying, Wu, Guangyu, Guo, Xin, Cheng, Xiaoliang, Ge, Junbo
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Language:English
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Summary:ObjectiveCeramides are associated with coronary plaque vulnerability. We aim to investigate the potential diagnostic value of ceramides for acute coronary syndrome (ACS) in Chinese patients with chest pain.DesignProspective observational survey.SettingShanghai, China, 2016–2017.ParticipantsA total of 2773 patients with chest pain from four hospitals in Shanghai, China, between August 2016 and October 2017.Main outcome measuresPerformance of metabolites model in detection of ACS cases including ST-elevation myocardial infarction (STEMI), non-STEMI (NSTEMI) and unstable angina.ResultsPlasma levels of 12 ceramide molecules and corresponding ratios were compared between patients diagnosed with ACS and those without. Cer(d18:1/24:1(15Z))/Cer(d18:1/24:0) ratio, Cer(d18:1/14:0) and Cer(d18:1/22:0) were independent predictors of ACS after adjustment of traditional risk factors and high-sensitivecardiac troponin T. Receiver operating characteristic curve analysis showed a significant improvement in detecting ACS in the multivariable model with ceramides compared with that without (0.865 (0.840 to 0.889) vs 0.808 (0.776 to 0.841), p
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2018-028211