scholarly journals Fast skeletal troponin I, but not the slow isoform, is increased in patients under statin therapy: a pilot study

2018 ◽  
Vol 29 (1) ◽  
pp. 68-76
Author(s):  
Alessandro Trentini ◽  
Maria C Manfrinato ◽  
Tiziana Bellini ◽  
Carlo A Volta ◽  
Stefania Hanau ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Creatine Kinase ◽  
Statin Therapy ◽  
Muscle Damage ◽  
Troponin I ◽  
Academic Hospital ◽  
Creatine Kinase Mb ◽  
The University ◽  
Fast Twitch ◽  
Muscular Damage

Introduction: Statin therapy is often associated with muscle complaints and increased serum creatine kinase (CK). However, although essential in determining muscle damage, this marker is not specific for skeletal muscle. Recent studies on animal models have shown that slow and fast isoforms of skeletal troponin I (ssTnI and fsTnI, respectively) can be useful markers of skeletal muscle injury. The aim of this study was to evaluate the utility of ssTnI and fsTnI as markers to monitor the statin-induced skeletal muscle damage. Materials and methods: A total of 51 patients (14 using and 37 not using statins) admitted to the intensive care unit of the University of Ferrara Academic Hospital were included in this observational study. Serum activities of CK, aldolase, alanine aminotransferase and myoglobin were determined by spectrophotometric assays or routine laboratory analysis. Isoforms ssTnI and fsTnI were determined by commercially available ELISAs. The creatine kinase MB isoform (CK-MB) and cardiac troponin I (cTnI) were evaluated as biomarkers of cardiac muscle damage by automatic analysers. Results: Among the non-specific markers, only CK was significantly higher in statin users (P = 0.027). Isoform fsTnI, but not ssTnI, was specifically increased in those patients using statins (P = 0.009) evidencing the major susceptibility of fast-twitch fibres towards statins. Sub-clinical increase in fsTnI, but not CK, was more frequent in statin users (P = 0.007). Cardiac markers were not significantly altered by statins confirming the selectivity of the effect on skeletal muscle. Conclusions: Serum fsTnI could be a good marker for monitoring statin-associated muscular damage outperforming traditional markers.

Modifications in the Concentrations of Circulating Myoglobin after Treatment with Low Doses of Adriamycin

1985 ◽  
Vol 71 (5) ◽  
pp. 463-468 ◽  
Author(s):  
Giovanni Carulli ◽  
Aldo Clerico ◽  
Alessandra Marini ◽  
Maria Grazia Del Chicca ◽  
Renato Vanacore ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Creatine Kinase ◽  
Cancer Patients ◽  
Muscle Damage ◽  
Low Doses ◽  
Skeletal Muscle Damage ◽  
Creatine Kinase Mb

The modifications in the concentration of circulating myoglobin have been studied by means of a radioimmunoassay in 15 cancer patients undergoing polychemotherapy including adriamycin. In 8 patients significant increases in myoglobin levels were found after injection of low doses of the drug (25-50 mg/m2). Moreover, a disturbance of the normal biorhythm of the protein was evident in 12 patients. Creatine kinase-MB was evaluated by means of a radioimmunoassay, but there was no relation between an increase in the isoenzyme and an increase in myoglobin. No ECG modifications were detected. These data indicate that the measurement of myoglobin may offer an indication of myocardial or skeletal muscle damage caused by adriamycin.

Clinical and Analytical Validation of an Enzymometric Assay for Creatine Kinase-Mb isoenzyme

1986 ◽  
Vol 23 (4) ◽  
pp. 463-469 ◽  
Author(s):  
J E B Youens ◽  
J Calvin ◽  
C P Price
Keyword(s):  
Myocardial Infarction ◽  
Skeletal Muscle ◽  
Creatine Kinase ◽  
Catalytic Activity ◽  
Muscle Damage ◽  
Analytical Validation ◽  
Skeletal Muscle Damage ◽  
Specific Measurement ◽  
Creatine Kinase Mb

The analytical validation of an immunoenzymometric technique for the specific measurement of the creatine kinase-MB isoenzyme is described. Its application is shown in the diagnosis of myocardial infarction. A difference in the correlation of the mass and catalytic activity of the CK-MB isoenzyme is shown between patients suffering myocardial infarction and those with skeletal muscle damage.

scholarly journals Frontal QRS-T angle as a predictive marker for myocardial damage in acute carbon monoxide poisoning

2021 ◽  
pp. 096032712110434
Author(s):  
Yusuf K Tekin ◽  
Gülaçan Tekin ◽  
Naim Nur ◽  
İlhan Korkmaz ◽  
Sefa Yurtbay
Keyword(s):  
Carbon Monoxide ◽  
Creatine Kinase ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Myocardial Damage ◽  
Cardiac Troponin I ◽  
Arterial Oxygen ◽  
Co Poisoning ◽  
Arterial Blood ◽  
Creatine Kinase Mb

Introduction The present study was undertaken to investigate the prognostic value of the frontal QRS-T angle associated with adverse cardiac outcomes in patients with carbon monoxide (CO) poisoning in early stages in the emergency department. Materials and methods The data of 212 patients with CO poisoning who were admitted to the ED between January 2010 and May 2020 were retrospectively analyzed. The frontal QRS-T angle was obtained from the automatic reports of the EKG device. Results Compared to patients without myocardial damage, among patients with myocardial damage, statistically high creatinine, creatine kinase MB, cardiac troponin I, and frontal QRS-T angle values were found ( p < 0.001 for all parameters), while the saturation of arterial blood pH and arterial oxygen values were found to be lower ( p = 0.002 and p < 0.001, respectively). The frontal QRS-T angle values were correlated with creatine kinase, creatine kinase-MB, cardiac troponin I, and oxygen saturation (SpO2) in arterial blood (r = 0. 232, p = 0.001; r = 0. 253, p = < 0.001; r = 0. 389, p = < 0.001; r = −0. 198, p = 0.004, respectively). The optimum cut-off value of the frontal QRS-T angle was found to be 44.5 (area under the curve: 0.901, 95% confidence interval: 0.814–0.988, sensitivity: 87%, specificity: 84%). Conclusions The frontal QRS-T angle, a simple and inexpensive parameter that can be easily obtained from 12-lead surface electrocardiography, can be used as an early indicator in the detection of myocardial damage in patients with CO poisoning.

scholarly journals Camrelizumab-related lethal arrhythmias and myasthenic crisis in a patient with metastatic thymoma: a case report

2021 ◽  
Author(s):  
Bo Zhang ◽  
Laxman Gyawali ◽  
Zengzhang Liu ◽  
Huaan Du ◽  
Yuehui Yin
Keyword(s):  
Creatine Kinase ◽  
Troponin I ◽  
Malignant Tumors ◽  
Checkpoint Inhibitors ◽  
Underlying Disease ◽  
High Dose ◽  
Team Approach ◽  
Myasthenic Crisis ◽  
Conduction Abnormality ◽  
Creatine Kinase Mb

Abstract Immune checkpoint inhibitors (ICIs) have emerged in recent years as a promising treatment option for several malignant tumors. However, ICI therapy has also been associated with various immune-related adverse events (irAEs), especially with pre-existing autoimmune status, which sometimes can be life-threatening. A 68-year-old woman diagnosed with metastatic thymoma was treated with camrelizumab as her initial anti-tumor protocol at a nearby hospital. On 11 days after the first dose of camrelizumab, the patient was admitted to our hospital with symptoms of dyspnea, fatigue, and poor appetite. Workup on admission indicated dramatically elevated transaminase, troponin I, creatine kinase, and creatine kinase MB and a new-onset conduction abnormality on electrocardiography. She had no other underlying disease prior to ICI treatment; therefore, ICI-related myocarditis, myositis and hepatitis were diagnosed, and intravenous methylprednisolone (80mg/day) and other supporting treatments were administered sequentially. Coronary angiography was performed on day 3 of hospitalization, but no abnormality was detected. On the same day, she lapsed into a coma with respiratory muscle failure, which was highly suspected of myasthenic crisis. Therefore, mechanical ventilation and higher dose of methylprednisolone (1 g/day) plus intravenous immunoglobulin (20g/day) were applied immediately. The third artrioventricular block occurred abruptly and an urgent temporary pacemaker was placed. Repeated ventricular tachycardia (VT) occurred, and even multiple antiarrhythmic drugs used in combination failed to alleviate the VT storm. On day 5 of hospitalization, she suffered from ventricular fibrillation and die of cardiac arrest. In conclusion, close follow-up should be conducted after ICI treatment, especially for patients already with or at high risk for autoimmune disorders. Once diagnosed with severe irAEs, prompt high dose of glucocorticoid alone or in combination with other immunomodulators if necessary should be administered. A multidisciplinary team approach is of importance for better management of patients with multiple organs involvement.

scholarly journals Impact of Antibody Specificity and Calibration Material on the Measure of Agreement between Methods for Cardiac Troponin I

1999 ◽  
Vol 45 (6) ◽  
pp. 822-828 ◽  
Author(s):  
David J Newman ◽  
Yemi Olabiran ◽  
William D Bedzyk ◽  
Suzette Chance ◽  
Eileen G Gorman ◽  
...  
Keyword(s):  
Creatine Kinase ◽  
Regression Analysis ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Troponin I ◽  
Antibody Specificity ◽  
Serum Pool ◽  
Creatine Kinase Mb ◽  
Patient Values ◽  
Calibration Material

Abstract Background: Available assays for cardiac troponin I (cTnI) yield numerically different results. The aim of this study was to compare patient values obtained from four cTnI immunoassays. Methods: We studied the Stratus® II assay, the Opus® II assay, the Access® assay, and a research-only cTnI heterogeneous immunoassay that uses the Dade Behring aca® plus immunoassay system equipped with two new noncommercial monoclonal antibodies. Because the aca plus cTnI assay is for research only, we first evaluated and analytically validated it for serum and citrated plasma. Initially, each method was calibrated using the method-specific calibrator supplied by each manufacturer; however, the aca plus cTnI assay was calibrated using patient serum pools containing cTnI and selected on the basis of increased creatine kinase MB isoenzyme and with values assigned by use of the Stratus cTnI assay. For method comparisons, individual patient sample cTnI values were determined and compared with the Stratus II assay. Results: Passing and Bablock regression analysis yielded slopes of 1.44 (r = 0.96; n = 72) for the Opus II vs Stratus II assays; 0.07 (r = 0.91; n = 72) for the Access vs Stratus II assays; and 0.90 (r = 0.91, n = 72) for the aca plus vs Stratus II assays. The recalibration of each method with a Stratus II-assigned serum pool improved, but did not entirely eliminate, the slope differences between the different assays (range, 1.00–1.16). The observed scatter in the correlation curves remained. Conclusion: There is a need to further explore the specificities of these assays with respect to the different circulating forms of cTnI.

Comparable detection of acute myocardial infarction by creatine kinase MB isoenzyme and cardiac troponin I

1994 ◽  
Vol 40 (7) ◽  
pp. 1291-1295 ◽  
Author(s):  
J E Adams ◽  
K B Schechtman ◽  
Y Landt ◽  
J H Ladenson ◽  
A S Jaffe
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Characteristic Curve ◽  
Cardiac Injury ◽  
Cardiac Troponin I ◽  
Creatine Kinase Mb ◽  
Coronary Care

Abstract Although measurement of cardiac troponin I (cTnI) is, in some situations, more specific for detection of cardiac injury than is measurement of the MB isoenzyme of creatine kinase (MBCK), its sensitivity and specificity relative to MBCK for detection of myocardial infarction has not been established. Accordingly, we studied prospectively 199 consecutive patients admitted to the coronary care unit. Values of MBCK and cTnI mass were determined in all samples. Of the 188 patients admitted with a suspicion of acute myocardial ischemia, 89 were diagnosed as having an acute myocardial infarction on the basis of the patterns of MBCK values. Eighty-six of these patients also had increased cTnI (concordance, 96.6%); three did not. Of the patients diagnosed as without infarction, five with unstable angina and symptoms in the day(s) prior to admission had increased cTnI, for a cTnI specificity of 94.9%. Receiver operating characteristic curve analysis indicated that cTnI and MBCK had statistically indistinguishable diagnostic accuracies for the detection of acute myocardial infarction.

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