Background: Several cardiac biomarkers are being studied to explore their potential in
the prognostication of Acute Coronary Syndrome (ACS). However, there are limited studies
exploring the relationship between these biomarkers and clinical, laboratory and demographic
Objective: We sought to determine the factors which influence the concentration of novel cardiac
biomarkers such as Galectin-3, suppression of tumorigenicity-2 (ST-2) and Matrix
Metallopeptidase-9 (MMP-9) in patients with ACS.
Methods: A total of 122 patients with ACS were enrolled in the study. The study patients were
categorized into two groups namely: STEMI (n=58) and NSTEMI/UA (n=64). Plasma samples
were used to determine the level of biomarkers, Galectin-3 and ST-2, and serum samples were used
to determine the levels of MMP-9 using the Enzyme-linked immunosorbent assay (ELISA). The
association between the plasma and serum levels of biomarkers and, demographic, clinical and
laboratory variables were determined. Statistical analyses for the study were performed using SPSS
16.0 software (SPSS Inc., Chicago, IL, USA).
Results: Elderly aged [0.107 (0.012-0.969); p=0.047] patients had higher ST-2. Galectin-3 was
higher among female patients [3.693(1.253-10.887); p=0.018] and patients with low left ventricular
ejection fraction [2.882 (1.041-7.978); p=0.042]. Patients with lower body mass index [3.385
(1.241-9.231); p=0.017], diabetes [3.650 (1.302-10.237); p=0.014] and high total leukocyte count
[2.900 (1.114-7.551; p=0.029] had higher MMP-9 levels.
Conclusion: The concentration of galectin-3, ST-2 and MMP-9 are independently influenced by
demographic, clinical and laboratory characteristics. It is estimated that these factors should be
accounted for when interpreting the results of the biomarker assays.