Decorin and meteorin like as differential biomarkers in acute myocardial infarction: diagnostic utility and subtype stratification of ST- elevation and non ST- elevation myocardial infarction

Background: Myokines are polypeptides or cytokines secreted by the striated muscles. This is because of both abnormal and typical physiological processes. Mounting evidence suggests that myokines are associated with the development of acute myocardial infarction (AMI).Objectives: To investigate the diagnostic potential of decorin (DCN) and meteorin-like protein (Metrnl) in distinguishing AMI from healthy controls and assess their ability to stratify AMI subtypes into ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction(NSTEMI).Materials and methods: The 94 patients diagnosed with AMI in the emergency department and 82 healthy controls were included in this study. The levels of Metrnl and DCN were analyzed using a sandwich-based Enzyme-Linked Immunosorbent Assay technique (ELISA) and other basic biochemical parameters in the study groups were analyzed using a sandwich-based electrochemiluminescence immunoassay technique and enzymatic methods.Results: Serum levels of Metrnl (486.98 ± 22.56 vs. 428.28 ± 7.68 pg/mL; P < 0.001) and DCN (92.68 ± 6.21 vs. 79.60 ± 2.12 ng/mL; P < 0.001) were significantly elevated in AMI patients versus controls. ROC analysis demonstrated high diagnostic accuracy: Metrnl (AUC 0.97, sensitivity 94%, specificity 97% at >439 pg/mL) and DCN (AUC 0.96, sensitivity 90%, specificity 97% at >83.2 ng/mL). STEMI patients exhibited higher Metrnl (492.5 ± 20.43 vs. 481.7 ± 23.45 pg/mL; P = 0.019) and DCN (94.25 ± 5.52 vs. 91.18 ± 6.52 ng/mL; P = 0.015) than NSTEM.Conclusion: This study revealed elevated serum DCN and Metrnl levels in patients with AMI compared to those in healthy individuals, with distinct differences between ST-elevation and non-ST-elevation subtypes. Higher concentrations were found in STEMI cases, which were linked to the severity of coronary occlusion and inflammation.