Use of saliva-based nano-biochip tests for acute myocardial infarction at the point of care: A feasibility study

Pierre N. Floriano, Nicolaos Christodoulides, Craig S. Miller, Jeffrey L. Ebersole, John Spertus, Beate G. Rose, Denis F. Kinane, M. John Novak, Steven Steinhubl, Shelley Acosta, Sanghamitra Mohanty, Priya Dharshan, Chih Ko Yeh, Spencer Redding, Wieslaw Furmaga, John McDevitt

Research output: Contribution to journalArticle

Abstract

BACKGROUND: For adults with chest pain, the electrocardiogram (ECG) and measures of serum biomarkers are used to screen and diagnose myocardial necrosis. These measurements require time that can delay therapy and affect prognosis. Our objective was to investigate the feasibility and utility of saliva as an alternative diagnostic fluid for identifying biomarkers of acute myocardial infarction (AMI). METHODS: We used Luminex and lab-on-a-chip methods to assay 21 proteins in serum and unstimulated whole saliva procured from 41 AMI patients within 48 h of chest pain onset and from 43 apparently healthy controls. Data were analyzed by use of logistic regression and area under curve (AUC) for ROC analysis to evaluate the diagnostic utility of each biomarker, or combinations of biomarkers, in screening for AMI. RESULTS: Both established and novel cardiac biomarkers demonstrated significant differences in concentrations between patients with AMI and controls without AMI. The saliva-based biomarker panel of C-reactive protein, myoglobin, and myeloperoxidase exhibited significant diagnostic capability (AUC = 0.85, P <0.0001) and in conjunction with ECG yielded strong screening capacity for AMI (AUC = 0.96) comparable to that of the panel (brain natriuretic peptide, troponin-I, creatine kinase-MB, myoglobin; AUC = 0.98) and far exceeded the screening capacity of ECG alone (AUC approximately 0.6). En route to translating these findings to clinical practice, we adapted these unstimulated whole saliva tests to a novel lab-on-a-chip platform for proof-of-principle screens for AMI. CONCLUSIONS: Complementary to ECG, saliva-based tests within lab-on-a-chip systems may provide a convenient and rapid screening method for cardiac events in prehospital stages for AMI patients.

Original languageEnglish (US)
Pages (from-to)1530-1538
Number of pages9
JournalClinical Chemistry
Volume55
Issue number8
DOIs
StatePublished - Aug 1 2009

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Point-of-Care Systems
Biochips
Feasibility Studies
Biomarkers
Saliva
Myocardial Infarction
Electrocardiography
Lab-on-a-chip
Area Under Curve
Screening
Myoglobin
Chest Pain
MB Form Creatine Kinase
Troponin I
Brain Natriuretic Peptide
Time measurement
C-Reactive Protein
Peroxidase
Logistics
Assays

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Use of saliva-based nano-biochip tests for acute myocardial infarction at the point of care : A feasibility study. / Floriano, Pierre N.; Christodoulides, Nicolaos; Miller, Craig S.; Ebersole, Jeffrey L.; Spertus, John; Rose, Beate G.; Kinane, Denis F.; Novak, M. John; Steinhubl, Steven; Acosta, Shelley; Mohanty, Sanghamitra; Dharshan, Priya; Yeh, Chih Ko; Redding, Spencer; Furmaga, Wieslaw; McDevitt, John.

In: Clinical Chemistry, Vol. 55, No. 8, 01.08.2009, p. 1530-1538.

Research output: Contribution to journalArticle

Floriano, PN, Christodoulides, N, Miller, CS, Ebersole, JL, Spertus, J, Rose, BG, Kinane, DF, Novak, MJ, Steinhubl, S, Acosta, S, Mohanty, S, Dharshan, P, Yeh, CK, Redding, S, Furmaga, W & McDevitt, J 2009, 'Use of saliva-based nano-biochip tests for acute myocardial infarction at the point of care: A feasibility study', Clinical Chemistry, vol. 55, no. 8, pp. 1530-1538. https://doi.org/10.1373/clinchem.2008.117713
Floriano, Pierre N. ; Christodoulides, Nicolaos ; Miller, Craig S. ; Ebersole, Jeffrey L. ; Spertus, John ; Rose, Beate G. ; Kinane, Denis F. ; Novak, M. John ; Steinhubl, Steven ; Acosta, Shelley ; Mohanty, Sanghamitra ; Dharshan, Priya ; Yeh, Chih Ko ; Redding, Spencer ; Furmaga, Wieslaw ; McDevitt, John. / Use of saliva-based nano-biochip tests for acute myocardial infarction at the point of care : A feasibility study. In: Clinical Chemistry. 2009 ; Vol. 55, No. 8. pp. 1530-1538.
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T1 - Use of saliva-based nano-biochip tests for acute myocardial infarction at the point of care

T2 - A feasibility study

AU - Floriano, Pierre N.

AU - Christodoulides, Nicolaos

AU - Miller, Craig S.

AU - Ebersole, Jeffrey L.

AU - Spertus, John

AU - Rose, Beate G.

AU - Kinane, Denis F.

AU - Novak, M. John

AU - Steinhubl, Steven

AU - Acosta, Shelley

AU - Mohanty, Sanghamitra

AU - Dharshan, Priya

AU - Yeh, Chih Ko

AU - Redding, Spencer

AU - Furmaga, Wieslaw

AU - McDevitt, John

PY - 2009/8/1

Y1 - 2009/8/1

N2 - BACKGROUND: For adults with chest pain, the electrocardiogram (ECG) and measures of serum biomarkers are used to screen and diagnose myocardial necrosis. These measurements require time that can delay therapy and affect prognosis. Our objective was to investigate the feasibility and utility of saliva as an alternative diagnostic fluid for identifying biomarkers of acute myocardial infarction (AMI). METHODS: We used Luminex and lab-on-a-chip methods to assay 21 proteins in serum and unstimulated whole saliva procured from 41 AMI patients within 48 h of chest pain onset and from 43 apparently healthy controls. Data were analyzed by use of logistic regression and area under curve (AUC) for ROC analysis to evaluate the diagnostic utility of each biomarker, or combinations of biomarkers, in screening for AMI. RESULTS: Both established and novel cardiac biomarkers demonstrated significant differences in concentrations between patients with AMI and controls without AMI. The saliva-based biomarker panel of C-reactive protein, myoglobin, and myeloperoxidase exhibited significant diagnostic capability (AUC = 0.85, P <0.0001) and in conjunction with ECG yielded strong screening capacity for AMI (AUC = 0.96) comparable to that of the panel (brain natriuretic peptide, troponin-I, creatine kinase-MB, myoglobin; AUC = 0.98) and far exceeded the screening capacity of ECG alone (AUC approximately 0.6). En route to translating these findings to clinical practice, we adapted these unstimulated whole saliva tests to a novel lab-on-a-chip platform for proof-of-principle screens for AMI. CONCLUSIONS: Complementary to ECG, saliva-based tests within lab-on-a-chip systems may provide a convenient and rapid screening method for cardiac events in prehospital stages for AMI patients.

AB - BACKGROUND: For adults with chest pain, the electrocardiogram (ECG) and measures of serum biomarkers are used to screen and diagnose myocardial necrosis. These measurements require time that can delay therapy and affect prognosis. Our objective was to investigate the feasibility and utility of saliva as an alternative diagnostic fluid for identifying biomarkers of acute myocardial infarction (AMI). METHODS: We used Luminex and lab-on-a-chip methods to assay 21 proteins in serum and unstimulated whole saliva procured from 41 AMI patients within 48 h of chest pain onset and from 43 apparently healthy controls. Data were analyzed by use of logistic regression and area under curve (AUC) for ROC analysis to evaluate the diagnostic utility of each biomarker, or combinations of biomarkers, in screening for AMI. RESULTS: Both established and novel cardiac biomarkers demonstrated significant differences in concentrations between patients with AMI and controls without AMI. The saliva-based biomarker panel of C-reactive protein, myoglobin, and myeloperoxidase exhibited significant diagnostic capability (AUC = 0.85, P <0.0001) and in conjunction with ECG yielded strong screening capacity for AMI (AUC = 0.96) comparable to that of the panel (brain natriuretic peptide, troponin-I, creatine kinase-MB, myoglobin; AUC = 0.98) and far exceeded the screening capacity of ECG alone (AUC approximately 0.6). En route to translating these findings to clinical practice, we adapted these unstimulated whole saliva tests to a novel lab-on-a-chip platform for proof-of-principle screens for AMI. CONCLUSIONS: Complementary to ECG, saliva-based tests within lab-on-a-chip systems may provide a convenient and rapid screening method for cardiac events in prehospital stages for AMI patients.

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