Presepsin: Is troponin positive a new biomark in the diagnosis of acute coronary syndromes?

Presepsin is a biomarker that can be found in high concentrations in the blood as an indicator of immune response, and in recent years, it has been suggested to play a potential role in the diagnosis of various diseases. This study aimed to investigate the usability of Presepsin as a novel biomarker in the identification of troponin-positive acute coronary syndromes. This prospective, single-center study was conducted between February 13, 2025, and April 5, 2025, in the coronary intensive care unit of Fırat University Faculty of Medicine Hospital, following the approval of the ethics committee. Ninety patients diagnosed with Acute Coronary Syndrome and 30 healthy individuals as the control group were included in the study. The study was approved on February 13, 2025, by the Ethics Committee for Non-Interventional Research of Fırat University in accordance with ethical standards. As part of the study, venous blood samples were taken from patients and control subjects for analysis of routine parameters such as complete blood count, troponin, liver and kidney function tests, and low-density lipoprotein cholesterol. In addition, for the measurement of presepsin levels in the included cases, a single 2cc blood sample was drawn from a peripheral vein into an ethylenediaminetetraacetic acid (EDTA) tube after patient admission. Blood samples from both the patient and control groups were centrifuged at 4000 rpm for 5 minutes. The plasma portion was separated using a Pasteur pipette and stored in a -80˚C deep freezer for presepsin analysis. On the day of analysis, the samples were thawed at room temperature and then tested manually using the ELISA kit method, according to the manufacturer's (Sunred) instructions. The majority of study participants were male, with a mean age of 66.2 ± 12.1 years. Based on the clinical values of cardiac patients, average levels of various biochemical parameters including presepsin, troponin, hematocrit, hemoglobin, leukocyte count, platelet count, urea, creatinine, low-density lipoprotein cholesterol, alanine aminotransferase, and aspartate aminotransferase were determined. A strong positive correlation was found between presepsin and troponin levels, while moderate positive correlations were observed between presepsin and creatinine, as well as presepsin and aspartate aminotransferase. However, no significant correlation was found between presepsin levels and other comorbid conditions (Hypertension, Diabetes Mellitus, Chronic Kidney Disease) and Chronic Obstructive Pulmonary Disease). In conclusion, positive correlations were identified between presepsin and troponin, creatinine, and aspartate aminotransferase. However, no significant relationships were observed between presepsin and other parameters such as hematocrit, hemoglobin, leukocytes, platelets, urea, low-density lipoprotein cholesterol, alanine aminotransferase, age, hypertension, diabetes mellitus, chronic kidney disease, and chronic obstructive pulmonary disease. These findings suggest that presepsin may be a potential biomarker in the monitoring of heart diseases and could be useful for early diagnosis; however, further research is needed in this area. Keywords: Presepsin, Troponin, Acute Coronary Syndrome, Biomarker