Potential of mid-infrared spectroscopy to aid the triage of patients with acute chest pain

Abstract

A total of 1,429 serum samples from 389 consecutive patients with acute chest pain were analyzed with the goal to aid the rapid diagnosis of acute myocardial infarction. To the best of our knowledge this is the largest and most comprehensive study on mid-infrared spectroscopy in cardiology. We were able to identify those signatures in the mid-infrared spectra of the samples, which were specific to either acute myocardial infarction or chest pain of other origin (angina pectoris, oesophagitis, etc). These characteristic spectral differences were used to distinguish between the cause of the donor's acute chest pain using robust linear discriminant analysis. A sensitivity of 88.5% and a specificity of 85.1% were achieved in a blind validation. The area under the receiver operating characteristics curve amounts to 0.921, which is comparable to the performance of routine cardiac laboratory markers within the same study population. The biochemical interpretation of the spectral signatures points towards an important role of carbohydrates and potentially glycation. Our studies indicate that the "Diagnostic Pattern Recognition (DPR)" method presented here has the potential to aid the diagnostic procedure as early as within the first 6 hours after the onset of chest pain.

Vibrational spectroscopic analysis of body fluids: avoiding molecular contamination using centrifugal filtration

“…Therefore, the use of centrifugal devices can greatly improve the sensitivity of the analysis by separating the different molecules according to their molecular weight 24,39,40 . Figure 2 shows the spectrum of the dried complete serum sample (A), the >100K serum fraction (B), and the <100Kserum fraction (D).…”

“…The spectra of the filtrates were taken from samples which were processed using unwashed centrifugal filter devices. [34][35][36][37][38][39][40] .…”

Vibrational spectroscopy of biofluids for disease screening or diagnosis: translation from the laboratory to a clinical setting

“…In the handling of some biofluids such as blood, there remain challenges to be overcome [98]. Whilst there is a large body of compelling evidence to support the application of vibrational spectroscopy to biofluids such as blood to triage patients for particular conditions such as myocardial infarction [99,100], the integration of these techniques into standard clinical practice remains some way off [101] and definitive clinical trials are needed to define their true diagnostic accuracy [102]. The enormous advantage of a real-time analytical monitoring device is that in the face of emerging disease such as neurodegeneration, one could take simple medications to slow down the progress of the pathology [103].…”

Assessing the challenges of Fourier transform infrared spectroscopic analysis of blood serum

“…The focus of our blood research is prostate cancer (CaP), therefore we demonstrate the use of different methods on a sample of male human blood serum as a model. In current investigations of methodology, sub-fractioning of serum samples is yet another configuration option to consider [5,7]. Inevitably this approach adds to the sample preparation, however, at this early stage of analysis, separating the whole serum into sub-fractions also reduces the spectral complexity ( Figure 1).…”

“…Over the years, there have been frequent reports of both transmission and attenuated total reflectance (ATR) measurements of blood-derived samples for diagnostic applications such as bovine spongiform encephalopathy (BSE) [4], cardiology [5], bladder cancer [6], brain cancer [7] and ovarian cancer [8]. On first inspection, the application of infrared spectroscopy for the analysis of blood serum may seem straight forward to the uninitiated.…”