Salivary Biomarkers Of Myocardial Infarction: A Review
Salivary Biomarkers Of Myocardial Infarction: A Review
Moein Rast,1,*Donya Hatami,2Kiarash Ansari,3
1. Student of Medicine , School of Medicine ,Iran University Of Medical sciences 2. Student of Medicine , School of Medicine ,Iran University Of Medical sciences 3. Student of Medicine , School of Medicine ,Iran University Of Medical sciences
Introduction: Myocardial infarction is one of the presentations of the acute coronary syndrome(ACS). Myocardial infarction could be fatal and it can also cause long-term complications that decrease the patient's lifelong survival. According to the World health organization (WHO), the leading cause of death in 2019 was ischemic heart diseases, being responsible for 16% of the world's total death.
As we know, in diagnosing myocardial infarction “time is muscle”; Routinely, serum levels of cardiac biomarkers such as cardiac troponin (cTn), creatine phosphokinase (CK), and its MB isoenzyme are used for the diagnosis of myocardial infarction. Whole saliva, produced by salivary glands, consists of more than 1000 proteins and 19000 peptide sequences.
Using MI-related biomarkers in saliva as a diagnostic method has been a trending topic over the past several years. This method has several advantages such as being noninvasive and safe to collect, it’s affordable and serial monitoring is quite simple.
In this review, we went go through articles that focused on the salivary level of cardiac biomarkers in course of myocardial infarction and discuss the advantages and disadvantages of this method against the routine use of serum levels of the so-mentioned biomarkers.
Methods: Myocardial infarction is one of the presentations of the acute coronary syndrome(ACS). Myocardial infarction could be fatal and it can also cause long-term complications that decrease the patient's lifelong survival. According to the World health organization (WHO), the leading cause of death in 2019 was ischemic heart diseases, being responsible for 16% of the world's total death.
As we know, in diagnosing myocardial infarction “time is muscle”; Routinely, serum levels of cardiac biomarkers such as cardiac troponin (cTn), creatine phosphokinase (CK), and its MB isoenzyme are used for the diagnosis of myocardial infarction. Whole saliva, produced by salivary glands, consists of more than 1000 proteins and 19000 peptide sequences.
Using MI-related biomarkers in saliva as a diagnostic method has been a trending topic over the past several years. This method has several advantages such as being noninvasive and safe to collect, it’s affordable and serial monitoring is quite simple.
In this review, we went go through articles that focused on the salivary level of cardiac biomarkers in course of myocardial infarction and discuss the advantages and disadvantages of this method against the routine use of serum levels of the so-mentioned biomarkers.
Results: After reviewing 9 articles we went through each of these markers. Salivary cardiac troponin as a myocardial infarction biomarker was reported to be elevated significantly in three different studies. However, a study in 2013 reported that levels of salivary troponin could have a variety of patterns. Ischemia-modified albumin is another biomarker that was reported elevated in a study specifically on the first day after myocardial infarction. Moreover, a study reported that evaluating salivary biomarkers such as CKMB, TnI, and BNP in combination with symptoms and ECG resulted in better sensitivity and specificity in the diagnosis of MI. There is also a study regarding the use of salivary CKMB. It suggested that salivary CKMB could be used as an alternative to serum CKMB. An article in 2011 suggested that Salivary CPK can be used for the diagnosis and monitoring of myocardial infarction patients. Using cathepsin L as a cardiac biomarker was reported in a study however it was concluded that salivary levels of this biomarker would not help in the diagnosis of the acute coronary syndrome.
Conclusion: In this article, we conducted a brief review regarding the use of salivary cardiac biomarkers for diagnosis of myocardial infarction. The use of this method for the diagnosis of MI has several mentioned advantages such as ease of use, being noninvasive, and could be performed in a quick manner. Also these markers could be used in other fields such as evaluation of post-myocardial infarction complications, although further studies are required in these subjects. Overall it can be concluded that the use of these salivary biomarkers has a strong correlation with myocardial infarction and specifically combined together could yield a better result, however using this method as a routine for diagnosis of myocardial infarction in a clinical setting and specific and detailed technique for collection and interpretation of these markers in saliva requires further investigation.