ijcs International Journal of Cardiovascular Sciences Int. J. Cardiovasc. Sci. 2359-4802 2359-5647 Sociedade Brasileira de Cardiologia BgTJc8KB4GvL3TxzGTZTB7H S2359-56472022000400457 ijcs.20220087 10.36660/ijcs.20220087 Editorial Neuropeptides Y and Other Promising Biomarkers in Acute Coronary Syndrome 0000-0002-2612-8040 Andrade Fernanda A. 1 0000-0001-5923-2912 Carvalho Leonardo 1 3 0000-0001-8509-1463 Silva Pedro Gabriel Melo de Barros 2 5 UNIFESP São Paulo SP Brazil UNIFESP, São Paulo, SP – Brazil Instituto de Pesquisa do HCOR São Paulo SP Brazil Instituto de Pesquisa do HCOR, São Paulo, SP – Brazil Brazilian Clinical Research Institute São Paulo SP Brazil Brazilian Clinical Research Institute, São Paulo, SP – Brazil Hospital Samaritano Paulista São Paulo SP Brazil Hospital Samaritano Paulista, São Paulo, SP – Brazil Centro Universitário São Camilo São Paulo SP Brazil Centro Universitário São Camilo, São Paulo, SP – Brazil Mailing Address: Pedro Gabriel Melo de Barros e Silva Hospital Samaritano Paulista. Av. Brigadeiro Luís Antônio, Postal Code 01333-030 – Bela Vista, São Paulo – SP, E-mail: pedro.barros@bcri.org.br 13 07 2022 2022 35 4 457 458 This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Keywords Acute Coronary Syndrome Neuropeptide Y Receptors Neuropeptide Y Nucleotide Polymorphism Biomarkers Obesity Hypertension Stroke Mortality

Neuropeptide Y (NPY) is a very common neurotransmitter with 36 amino acids that acts as a stimulator of angiogenesis, inflammation and adipogenesis through the NPY2 receptor.1 The description of high plasma concentrations of NPY in acute coronary syndrome (ACS) and left ventricular dysfunction and its close relationship with the sympathetic nervous system reinforces the possibility of a new prognostic biomarker for risk stratification.2,3

In recent years, changes in the NPY signalling pathway have been related to ACS. For example, the NPYc.20T>C mutation is associated with increased serum lipid levels and consequent increase in the risk of ACS, stroke, hypertension, and obesity.2,3 The NPYc.-485T>C variant has been linked to the development of early atherosclerosis and stroke, and possibly to insulin resistance reduction and development of type 2 diabetes mellitus.4-8

Soares et al.,6 gathered genotypic data of four variants (c.20T>C/c.84G>A/c.150G>A/c.-485T>C) in the NPY gene and two variants (c.-1088C>T/c.-1116A>G) in the NPY2R gene of approximately 500 individuals to determine the correlation of these variants with ACS and TIMI risk.6 Possibly, discrimination of individuals at intermediate from those at high risk and the correlation with clinical outcomes (morbidity and mortality) would allow a more robust inference of a causal link between variants in the NPY and NPY2R genes and cardiovascular events. Finally, further research is also necessary considering the high phenotypic heterogeneity among individuals and populations, and the potential variability in the association between gene variants and outcomes.5

The application of large-scale DNA sequencing methods for the analysis of molecular markers has led to an improvement in these techniques, and the development of larger studies have led to the discovery of new cardiovascular disease biomarkers,9 including myocardial ischemia (Table 1). The clinical application of these biomarkers has been tested in different scenarios, and advances in genomic, proteomic and metabolomic analyses, with the integration of artificial intelligence, would provide better diagnostic and prognostic information.10

Basic information on biomarkers of cardiomyocyte injury
BIOMARKER DIAGNOSTIC/PROAGNOSTIC ORGAN/CELL OF ORIGIN HALF LIFE
Troponin I, T Diagnostic and prognostic Cardiac thin filament 120 min
hFABP Prognostic Cardiomyocyte cytoplasmic protein 27 min
NT-proBNP Diagnostic and prognostic Cardiac ventricles 120 min
MR-proANP Diagnostic and prognostic Cardiac atrial tissue 60-120 min
CMyBP-C Diagnostic Cardiac thin filament unknown
sST2 Diagnostic Cardiomyocytes, cardiac fibroblasts, and vascular endothelial cells unknown
GDF-15 Diagnostic Multiple cells unknown
Gal-3 Diagnostic Multiple cells unknown
Ceramides Diagnostic and prognostic Menbrane lipids 24-72 hours

Editorial referring to the article: Influence of Neuropeptide Y and Neuropeptide Y 2 Receptor Variants in Acute Coronary Syndrome

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