Circulating TGM2 Levels as a Prognostic Biomarker for Coronary Artery Disease Severity and Major Adverse Cardiac Events in Acute Coronary Syndrome

Abstract

Background: Transglutaminase 2 (TGM2) has been implicated in various health conditions, yet its role in acute coronary syndrome (ACS) remains poorly characterized in clinical settings. This study investigated the association between circulating TGM2 levels and the severity of coronary stenosis in ACS. Methods: A total of 242 individuals with ACS were included in this study. Clinical data were collected, and the severity of coronary stenosis was evaluated with the Gensini and Syntax scoring systems. Kaplan-Meier analysis, logistic regression, and receiver operating characteristic (ROC) curve analysis were performed. Results: Circulating TGM2 levels were significantly higher in the STEMI group (176.3 pg/mL) and the non-STEMI group (181 pg/mL) than the UA group (64 pg/mL) and the stable CAD group (50.95 pg/mL) (P < 0.001). Multivariate analysis, after adjustment for confounding factors, identified TGM2 as an independent risk factor for acute myocardial infarction (odds ratio: 44.292 per 100 pg/mL increase in TGM2; 95% CI: 2.491-7.398; P < 0.001). During a median follow-up of 477 days, Kaplan-Meier survival analysis demonstrated that patients with higher TGM2 levels (≥91.9 pg/mL) exhibited a significantly lower MACE-free survival rate (P = 0.0142). ROC curve analysis further revealed that combining TGM2 and Gensini scores yielded superior predictive performance for MACE to that of either parameter alone. Conclusion: Circulating TGM2 is elevated in ACS and is strongly associated with the presence of AMI. Furthermore, it provides prognostic information for MACE, particularly when it is used in combination with established anatomical risk scores.

Keywords

transglutaminase 2 / coronary stenosis / acute coronary syndrome / myocardial infarction / biomarker

^{Data Availability Statement Ethics Statement Funding Acknowledgments Conflicts of Interest Author Contributions Supplementary Material}

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