AUTHOR=Zhang Xiaolin , Cheng Minghui , Gao Naijing , Li Yi , Yan Chenghui , Tian Xiaoxiang , Liu Dan , Qiu Miaohan , Wang Xiaozeng , Luan Bo , Deng Jie , Wang Shouli , Tian Hongyan , Wang Geng , Ma Xinliang , Stone Gregg W. , Han Yaling 

TITLE=Utility of S100A12 as an Early Biomarker in Patients With ST-Segment Elevation Myocardial Infarction

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.747511

DOI=10.3389/fcvm.2021.747511

ISSN=2297-055X

ABSTRACT=IMPORTANCE: S100A12 is a calcium binding protein which is involved in inflammation and progression of atherosclerosis. 
OBJECTIVE: We sought to investigate the utility of S100A12 as a biomarker for the early diagnosis and prognostication of patients presenting with ST-segment elevation myocardial infarction (STEMI).
DESIGN, SETTING, AND PARTICIPANTS: S100A12 was measured in 1023 patients presenting to the emergency department with acute chest pain between June 2012 and November 2015. An independent cohort of 243 patients enrolled at 3 different hospitals served as a validation cohort.
MAIN OUTCOMES AND MEASURES: The primary clinical endpoint of interest was major adverse cardiac and cerebral events (MACCE) defined as a composite of all-cause death, MI, stroke or hospitalization for heart failure. 
RESULTS: A total of 438/1023 patients (42.8%) in the diagnosis cohort were adjudicated as STEMI, among whom plasma S100A12 levels increased within 30 minutes and peaked 1 to 2 hours after symptom onset. Compared with high-sensitivity cardiac troponin T and creatine kinase-MB isoenzyme, S100A12 more accurately identified STEMI, especially within the first 2 hours after symptom onset (area under the curve 0.963 compared with 0.860 for hscTnT and 0.711 for CK-MB, both P<0.05). These results were consistent in the 243-patient validation cohort. The 1-year rate of MACCE was greatest in patients in the highest peak S100A12 tertile, intermediate in the middle tertile and least in the lowest tertile (9.3% vs. 5.7% vs. 3.0% respectively, Ptrend=0.0006). By multivariable analysis the peak plasma concentration of S100A12 was an independent predictor of MACCE within 1 year after STEMI (HR, 1.001, 95%CI, 1.000-1.002; P=0.0104). Immunohistochemistry and immunofluorescence in STEMI patients showed macrophages infiltrating into ruptured coronary plaques and thrombi that stained strongly positive for S100A12 protein.
CONCLUSIONS AND RELEVANCE: S100A12 rapidly identified patients with STEMI, more accurately than other cardiac biomarkers, especially within the first 2 hours after symptom onset. The peak plasma S100A12 level was a strong predictor of 1-year prognosis after STEMI.