Screening preoperative peptide biomarkers for predicting postoperative myocardial infarction after coronary artery bypass grafting

PLoS One. 2014 Jun 30;9(6):e100149. doi: 10.1371/journal.pone.0100149. eCollection 2014.

Abstract

Postoperative myocardial infarction (PMI) is one of the most serious complications of cardiac surgeries. No preoperative biomarker is currently available for predicting PMI after cardiac surgeries. In the present study, we used a phage display peptide library to screen potential preoperative peptide biomarkers for predicting PMI after coronary artery bypass grafting (CABG) surgery. Twenty patients who developed PMI after CABG and 20 age-, sex-, and body mass index-matched patients without PMI after CABG were enrolled as a discovery cohort. Another 50 patients who developed PMI after CABG and 50 randomly selected patients without PMI after CABG were enrolled as a validation cohort to validate the potential peptide biomarkers identified in the discovery cohort. Fifty randomly selected healthy volunteers were also enrolled in the validation phase as a healthy control group. In the discovery/screening phase, 17 out of 20 randomly selected phage clones exhibited specific reaction with purified sera IgG from the PMI group, among which 11 came from the same phage clone with inserted peptide sequence GVIMVIAVSCVF (named PMI-1). In the validation phase, phage ELISA showed that serum IgG from 90% of patients in the PMI group had a positive reaction with PMI-1; in contrast, only 14% and 6% of patients in the non-PMI group and the healthy control group had a positive reaction with PMI-1, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the PMI-1 phage clone to preoperatively identify patients who would develop PMI after CABG were 90.0%, 86.0%, 86.5, 89.5% and 88.0%, respectively. The absorbance value of the PMI-1 phage clone showed statistically significant correlation with the peak postoperative serum cardiac troponin I level (r = 0.349, p = 0.012) in the PMI group. In conclusion, we for the first time identified a mimic peptide (PMI-1) with high validity in preoperative prediction of PMI after CABG.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Amino Acid Sequence
  • Biomarkers / blood
  • Case-Control Studies
  • Coronary Artery Bypass / adverse effects*
  • Female
  • Humans
  • Immunoglobulin G / blood*
  • Male
  • Middle Aged
  • Molecular Sequence Data
  • Myocardial Infarction / blood*
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / etiology
  • Myocardial Infarction / immunology
  • Peptide Library
  • Peptides / blood*
  • Peptides / immunology
  • Postoperative Complications*
  • Prognosis
  • Protein Binding
  • Sensitivity and Specificity
  • Troponin I / blood

Substances

  • Biomarkers
  • Immunoglobulin G
  • Peptide Library
  • Peptides
  • Troponin I

Grants and funding

This work was supported by Hunan Provincial Development and Reform Commission grant No. [2013]1199. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.