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European Heart Journal Advance Access originally published online on April 24, 2008
European Heart Journal 2008 29(11):1439-1445; doi:10.1093/eurheartj/ehn162
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Preliminary experience with the smooth muscle troponin-like protein, calponin, as a novel biomarker for diagnosing acute aortic dissection

Toru Suzuki1,*, Alessandro Distante2,3,16, Antonella Zizza3, Santi Trimarchi4, Massimo Villani5, Jorge Antonio Salerno Uriarte6, Luigi de Luca Tupputi Schinosa7, Attilio Renzulli8, Federico Sabino9, Richard Nowak10, Robert Birkhahn11, Judd E. Hollander12, Francis Counselman13, Eduardo Bossone14, Kim Eagle on behalf of the International Registry of Acute Aortic Dissection Substudy on Biomarkers (IRAD-Bio) Investigators15

1 Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
2 Istituto Scientifico Biomedico Euro Mediterraneo, Brindisi, Italy
3 Institute of Clinical Physiology, National Research Council, Lecce, Italy
4 IRCCS Policlinico San Donato, Milan, Italy
5 Vito Fazzi Hospital, Lecce, Italy
6 Università degli studi dell'Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
7 Policlinico Hospital, Bari, Italy
8 UMG, Catanzaro, Italy
9 ALIV Healthcare R&D, Forte dei Marmi, Italy
10 Henry Ford Hospital, Detroit, MI, USA
11 New York Methodist Hospital, Brooklyn, NY, USA
12 University of Pennsylvania, Philadelphia, PA, USA
13 Eastern Virginia Medical School, Norfolk, VA, USA
14 National Research Council, Lecce, Italy
15 University of Michigan, Ann Arbor, MI, USA
16 University Medical School, Pisa, Italy

Received 1 January 2008; revised 4 March 2008; accepted 27 March 2008; online publish-ahead-of-print 24 April 2008.

* Corresponding author. Tel: +81 3 5800 9846, Fax: +81 3 5800 9847, Email: torusuzu-tky{at}umin.ac.jp

Aims: The early diagnosis of acute aortic dissection (AD) remains challenging. We sought to determine the utility of the troponin-like protein of smooth muscle, calponin, as a diagnostic biomarker of acute AD.

Methods and results: Immunoassays against calponin (acidic, basic, and neutral isoforms) were developed and the levels were compared in a convenience sample of 59 patients with radiographically proven AD [34 males, age 59 ± 15 (SD) years] vs. 158 patients suspected of having AD at presentation (116 males, age 63 ± 15 years) but whose final diagnosis was not AD. Basic calponin, which is the most specific and abundant in smooth muscle, and acidic calponin, respectively, showed greater than two-fold and three-fold elevations in patients with acute AD. Diagnostic performance as determined by receiver-operating characteristics curve analysis showed that both acidic and basic calponin have the potential to detect AD in the first 24 h [respective areas under the curve (AUCs) 0.63 and 0.58], with superior performance of basic calponin (when compared with acidic) in the initial 6 h (respective AUCs 0.63 and 0.67).

Conclusion: Circulating calponin levels were elevated in acute AD compared with controls. These biomarkers have the potential for use as an early diagnostic biomarker for acute AD.

Key Words: Aortic dissection • Biomarker


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T. Suzuki, A. Distante, A. Zizza, S. Trimarchi, M. Villani, J. A. Salerno Uriarte, L. De Luca Tupputi Schinosa, A. Renzulli, F. Sabino, R. Nowak, et al.
Diagnosis of Acute Aortic Dissection by D-Dimer: The International Registry of Acute Aortic Dissection Substudy on Biomarkers (IRAD-Bio) Experience
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