Clinical Utility of Soluble Lectin Type Oxidized Low-Density Lipoprotein Receptor as a Biomarker for Myocardial Infarction and Stable Angina

Radhakishan Narsini; Vijaya Bhaskar; Hajra Luqman; Sai Satish O; Shyam Sundar R Parupati; Ranga Reddy A B V; Iyyapu Krishna Mohan

doi:10.7759/cureus.50719

Clinical Utility of Soluble Lectin Type Oxidized Low-Density Lipoprotein Receptor as a Biomarker for Myocardial Infarction and Stable Angina

Cureus. 2023 Dec 18;15(12):e50719. doi: 10.7759/cureus.50719. eCollection 2023 Dec.

Authors

Radhakishan Narsini¹, Vijaya Bhaskar², Hajra Luqman², Sai Satish O³, Shyam Sundar R Parupati⁴, Ranga Reddy A B V⁵, Iyyapu Krishna Mohan²

Affiliations

¹ Biochemistry, Nizam's Institute Of Medical Sciences, Hyderabad, IND.
² Biochemistry, Nizam's Institute of Medical Sciences, Hyderabad, IND.
³ Cardiology, Nizam's Institute of Medical Sciences, Hyderabad, IND.
⁴ Cardiology, Krishna Institute of Medical Sciences (KIMS) Hospitals Kondapur, Kondapur, IND.
⁵ Cardiology, Apollo Hospitals, Hyderabad, IND.

Abstract

Background and objectives Endothelial soluble lectin-type oxidized low-density lipoprotein receptor 1 (sLOX-1) recognizes oxidized low-density lipoprotein (LDL) and triggers downstream signaling leading to atherosclerosis. The objective of this study was to demonstrate the utility of sLOX-1 as a biomarker for detecting acute myocardial infarction (MI) and stable angina (SA) and to develop a diagnostic algorithm for distinguishing coronary vasospasm from coronary plaque rupture. Methods We enrolled 62 patients who underwent diagnostic coronary angiography (CAG) and 30 healthy controls (21 men and nine women) and measured sLOX-1, troponin I, and cardiac myosin-binding protein C (c-MyBPC) using commercial kits. Results Patients with MI exhibited higher sLOX-1 levels (301.55 ± 196.16 pg/ml) than patients with stable angina (220.76 ± 103.65 pg/ml) and healthy controls (121.14 ± 77.10, F: 10.55, p<0.001). Although higher troponin I levels were detected in MI patients (263.00 ± 493.00 vs. 3.19 ± 2.15 ng/ml, p=0.0019), no significant elevation was observed in SA patients (1.91 ± 0.79 ng/ml). Plasma sLOX-1 levels showed a positive association with age (r=0.37, p=0.003), but not with gender (r=0.04, p=0.75). Troponin I showed no association with age (r=0.12, p=0.36) or gender (r=0.06, p=0.62). Receiver operating characteristic (ROC) curves revealed that among the three biomarkers, troponin-I showed a higher area under the curve (AUC) (AUC: 0.941), followed by sLOX-1 (AUC: 0.888), while c-MyBPC showed no clinical utility in the detection of MI (AUC: 0.666). Conclusions A marked elevation of sLOX-1 can detect MI and differentiate the presence or absence of plaque rupture, along with diagnosing stable angina.

Keywords: cardiac troponin; lectin type oxidized ldl receptor 1; myocardial infarction; plaque rupture; slox-1; soluble lectin-type oxidized low-density lipoprotein receptor 1; stable angina.