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Abstract：
(1) Background: Due to similar clinical presentation and a lack of specific biomarkers, initial differentiation between Takotsubo syndrome (TTS) and non-ST-segment elevation myocardial infarction (NSTEMI) remains challenging in daily practice. Heat Shock Protein 70 (HSP70) is a novel biomarker that is recognized for its potential in the diagnosis and differentiation of cardiovascular conditions. (2) Methods: Data from a total of 156 patients were analyzed (32.1% NSTEMI, 32.7% TTS, and 35.3% controls). Serum concentrations of HSP70 were determined using ELISA and compared between patients and controls. ROC curve analysis, logistic regression analysis and propensity-score-weighted logistic regression were conducted. (3) Results: Concentrations of HSP70 were highest in patients with TTS (median 1727 pg/mL vs. ACS: median 1545 pg/mL vs. controls: median 583 pg/mL, p < 0.0001). HSP70 was predictive for TTS in binary logistic regression analysis (B(SE) = 0.634(0.22), p = 0.004), which even remained significant after correction for possible confounders in propensity-score-weighted analysis. ROC curve analysis also revealed a significant association of HSP70 with TTS (AUC: 0.633, p = 0.008). (4) Conclusions: Based on our findings, HSP70 constitutes a promising biomarker for discrimination between TTS and NSTEMI, especially in combination with established cardiovascular biomarkers like pBNP or high-sensitivity cardiac troponin.
摘要：
（1）背景：由于临床表现相似，缺乏特异性生物标志物，在日常实践中,Takotsubo综合征(TTS)与非ST段抬高型心肌梗死(NSTEMI)之间的初步鉴别仍具有挑战性.热休克蛋白70（HSP70）是一种新型生物标志物，因其在心血管疾病的诊断和鉴别中的潜力而被认可。（2）方法：对总共156例患者的数据进行了分析（32.1%的NSTEMI，32.7%TTS,和35.3%的控制）。使用ELISA测定HSP70的血清浓度，并在患者和对照组之间进行比较。ROC曲线分析,采用logistic回归分析和倾向评分加权logistic回归分析.（3）结果：TTS患者的HSP70浓度最高（中位数为1727pg/mL与ACS：中位数1545pg/mL与对照：中位数583pg/mL，p<0.0001)。在二元逻辑回归分析中，HSP70对TTS具有预测作用(B(SE)=0.634(0.22)，p=0.004),在倾向得分加权分析中对可能的混杂因素进行校正后，这一点甚至仍然很重要。ROC曲线分析还显示HSP70与TTS显著相关(AUC:0.633,p=0.008)。(4)结论：根据我们的发现，HSP70构成了区分TTS和NSTEMI的有希望的生物标志物，特别是与已确定的心血管生物标志物如pBNP或高敏心肌肌钙蛋白联合使用。
