Visfatin: A potential biomarker for the early diagnosis and monitoring of acute coronary syndrome

INTRODUCTION: Acute coronary syndrome (ACS) is a major cause of mortality and morbidity worldwide; thus, early diagnosis is very important. The most common cause of ACS is the rupture of a vulnerable atherosclerotic plaque in the coronary artery, an occurrence in which inflammation plays a key role. The aim of the present study was to investigate visfatin as a proinflammatory biomarker in the early diagnosis and monitoring of ACS and to compare visfatin’s relationship with troponin T, tumor necrosis factor-alpha (TNF-α), and creatine kinase-MB (CK-MB).
METHODS: Sixty ACS patients and 30 healthy control subjects were enrolled in this study. One blood sample was drawn from the control participants, and 3 were obtained from the ACS patients at intervals 0-6 hours (T0), 6-12 hours (T1), and 12-24 (T2) hours from the start of chest pain. Serum visfatin, TNF-α, troponin T, and CK-MB levels were assessed. Visfatin and TNF-α levels were assessed using enzyme-linked immunosorbent assay testing, troponin T was evaluated using chemiluminescence, and CK-MB by enzymatic methods.
RESULTS: Serum TNF-α, troponin T, and CK-MB levels in the T0 blood samples were statistically significantly higher in the ACS patients compared with the controls (p=0.004, p<0.001, p<0.001, respectively). A significant positive correlation was observed between visfatin and troponin T (r=0.290, p=0.007) in the T0 samples. Visfatin concentrations were lower in the ACS group in the T0, T1 and T2 samples [4.01±6.23ng/mL, 1.80±3.47 ng/mL, and 1.72±2.67ng/mL, respectively; p=0.005; T0 >(T1=T2)].
DISCUSSION AND CONCLUSION: Visfatin had a significant positive correlation with troponin T. Visfatin did not demonstrate a rise and fall pattern like the standard biomarkers in terms of monitoring the progress of ACS patients, as there was a significant decrease after the first 6 hours. Although visfatin did not demonstrate superiority to troponin, its efficiency in a multimarker panel merits further evaluation. The role of visfatin in the early phase of pathophysiological mechanisms requires additional investigation.