Multi-marker network in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention : When and what to measure

Background: Data on the correlations between biomarkers to suggest cost-effective multi-marker (MM) panels predictive for ST-elevation myocardial infarction (STEMI) patients are lacking. We sought to explore the relationship between cardiac troponin I (cTnI), C-reactive protein (CRP), B-type natriuretic peptide (BNP), and chromogranin A (CgA) accounting for biomarkers' profiles detected within 48 h from successful primary percutaneous coronary intervention (PPCI). Methods: In 73 STEMI patients cTnI, CRP, BNP, and CgA were measured before PPCI and 6, 24, and 48 h later. STATIS methods generalizing Principal Component Analysis on three-way data setswereemployed to extract information about: 1) similarities between patients, 2) contribution of each time of sampling and 3) correlations between biomarkers' profiles. Results: STEMI patients who underwent successful PPCI emerged to have a homogeneous profile tailored on biomarkers' evaluation within 48 h. Their measurements at 24 h contributed the most variability and information both to patients' and to biomarkers' profiles. BNP and cTnI were highly correlated and explained the 40.1% of the total variance, whereas CgA resulted independent and explained the 26.3% of the total variance. Conclusions: Markers' measurements at 24 h after PPCI contributed most information to the definition of patients' profile. BNP and cTnI resulted interchangeable in aMMpanel for reporting about the extent of necrosis.