{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T03:00:59Z","timestamp":1775012459157,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T00:00:00Z","timestamp":1739836800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Approximately 10% of patients with myocardial infarction present with non\u2010obstructive coronary arteries (MINOCA), whose characteristics differ from those with obstructive coronary lesions (MICAD). Inflammation plays a key role in myocardial infarction. This study aims to develop a biomarker\u2010based index for accurate differentiation between MINOCA and MICAD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective, observational cohort study including 111 patients admitted for myocardial infarction: 46 with MINOCA and 65 with MICAD. Blood samples were collected within the first 24\u2009h to measure high\u2010sensitivity C\u2010reactive protein, interleukin\u20106, asymmetric dimethylarginine, and peak high\u2010sensitivity troponin T. The association of these biomarkers with MICAD risk was analyzed using logistic regression. Scoring systems were developed using optimization algorithms to predict the diagnosis before coronary angiography, applied to both individual biomarkers and a combined index.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients had a mean age of 67 years (SD 13.3), with a male predominance (68.5%). Higher levels of IL\u20106 and high\u2010sensitivity troponin T were significantly associated with increased MICAD risk (OR: 1.58; 95% CI: 1.01\u20132.46, and OR: 2.27; 95% CI: 1.61\u20133.26, respectively). As score increases, interleukin\u20106 and high\u2010sensitivity troponin T increase the likelihood of MICAD classification, while higher asymmetric dimethylarginine levels reduce it. Each one\u2010point increase in the combined index multiplies MICAD risk by six (OR:6.16, 95%CI: 2.72\u201313.95; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). While individual indexes improved the diagnostic performance of biomarkers, the combined index demonstrated superior accuracy (AUC: 0.918).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A biomarker\u2010based scoring system was developed, achieving superior discriminatory capacity for differentiating MINOCA from MICAD compared to the individual analysis of biomarkers in absolute values or independent indexes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.70090","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T07:53:37Z","timestamp":1739951617000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["\u201cA Biomarker\u2010Based Scoring System to Assess the Presence of Obstructive Coronary Artery Disease in Patients With Myocardial 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