Myeloid-related protein 8/14 complex is released by monocytes and granulocytes at the site of coronary occlusion: a novel, early, and sensitive marker of acute coronary syndromes

• Published in: European heart journal 2007-04, Vol.28 (8), p.941-948
• Main Authors: Altwegg, Lukas A., Neidhart, Michel, Hersberger, Martin, Müller, Simone, Eberli, Franz R., Corti, Roberto, Roffi, Marco, Sütsch, Gabor, Gay, Steffen, von Eckardstein, Arnold, Wischnewsky, Manfred B., Lüscher, Thomas F., Maier, Willibald
• Format: Article
• Language: English
• Subjects: Aged; Biomarkers - metabolism; Calgranulin A - metabolism; Calgranulin B - metabolism; Coronary Artery Disease - diagnosis; Coronary Thrombosis - diagnosis; Female; Granulocytes - metabolism; Humans; Immunohistochemistry; Leukocyte L1 Antigen Complex - metabolism; Male; Middle Aged; Monocytes - metabolism; Risk Factors; Syndrome
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/eurheartj/ehm078

Aims We investigated whether myeloid-related protein 8/14 complex (MRP8/14) expressed by infiltrating monocytes and granulocytes may represent a mediator and early biomarker of acute coronary syndromes (ACS). Methods and results Immunohistochemistry of coronary thrombi was done in 41 ACS patients. Subsequently, levels of MRP8/14 were assessed systemically in 75 patients with ACS and culprit lesions, with stable coronary artery disease (CAD), or with normal coronary arteries. In a subset of patients, MRP8/14 was measured systemically and at the site of coronary occlusion. Macrophages and granulocytes, but not platelets stained positive for MRP8/14 in 76% of 41 thrombi patients. In ACS, local MRP8/14 levels [22.0 (16.2-41.5) mg/L] were increased when compared with systemic levels [13.4 (8.1-14.7) mg/L, P = 0.03]. Systemic levels of MRP8/14 were markedly elevated [15.1 (12.1-21.8) mg/L, P = 0.001] in ACS when compared with stable CAD [4.6 (3.5-7.1) mg/L] or normals [4.8 (4.0-6.3) mg/L]. Using a cut-off level of 8 mg/L, MRP8/14 but not myoglobin or troponin, identified ACS presenting within 3 h from symptom onset. Conclusion In ACS, MRP8/14 is markedly expressed at the site of coronary occlusion by invading phagocytes. The occurrence of elevated MRP8/14 in the systemic circulation prior to markers of myocardial necrosis makes it a prime candidate for the detection of unstable plaques and management of ACS.