Serum Tetranectin as a Predictive Biomarker of Premature Coronary Artery Disease and Its Correlation with Coronary Stenosis Severity

Abstract

Objectives: Premature coronary artery disease (PCAD) in individuals younger than 45 years carries significant clinical and socioeconomic implications. This study aimed to evaluate serum tetranectin (TN) as a potential non-invasive biomarker for diagnosing PCAD and predicting its severity. Methodology: A case–control study was conducted including 84 PCAD patients undergoing elective coronary angiography and 84 age- and sex-matched controls with normal coronary findings. Serum TN levels were measured using ELISA, and severity of coronary stenosis was determined by SYNTAX and Gensini scoring systems. Results: Serum TN levels were significantly lower in PCAD patients than in controls (87.7 [32.5–381.3] vs. 153.1 [58.1–608.8], P < 0.001). TN levels demonstrated strong negative correlations with both SYNTAX (r = –0.882, P < 0.001) and Gensini (r = –0.836, P < 0.001) scores. ROC analysis showed excellent discriminatory accuracy for predicting high SYNTAX scores (AUC = 0.970, cutoff ≤54.2 ng/mL). Multivariate regression confirmed TN as an independent predictor of PCAD (OR = 0.995, P = 0.008) and of severity indices. Conclusion: Serum TN is a promising biomarker for the non-invasive diagnosis and risk stratification of PCAD. Its strong inverse correlation with coronary severity scores and echocardiographic dysfunction supports its potential utility in early detection and disease monitoring.