scholarly journals Biochemical markers of cardiac diseases

2004 ◽  
Vol 23 (3) ◽  
pp. 201-211 ◽  
Author(s):  
Mauro Panteghini
Keyword(s):  
Biochemical Markers ◽  
Coronary Plaque ◽  
Plaque Instability ◽  
Coronary Syndrome ◽  
Early Markers ◽  
Early Injury ◽  
Cardiac Troponins ◽  
Rule Out

This article reviews the current contribution of the determination of biochemical markers to clinical cardiology and discusses some important developments in this field. Biochemical markers play a pivotal role in the diagnosis and management of patients with acute coronary syndrome (ACS), as witnessed by the incorporation of cardiac troponins into new international guidelines for patients with ACS and in the redefinition of myocardial infarction. Despite the success of cardiac troponins, there is still a need for development of early markers that can reliably rule out ACS from the emergency room at presentation and detect myocardial ischemia also in the absence of irreversible myocyte injury. Under investigation are two classes of indicators: markers of early injury/ischemia and markers of coronary plaque instability and disruption. Finally, with the characterization of the cardiac natriuretic peptides, Laboratory Medicine is also assuming part in the assessment of cardiac function.

scholarly journals Biochemical Cardiac Markers in Clinical Cardiology

1970 ◽  
Vol 10 (2) ◽  
pp. 100-108 ◽  
Author(s):  
Palanisamy Pasupathi ◽  
Y Yagneswara Rao ◽  
Jawahar Farook ◽  
Govindaswamy Bakthavathsalam
Keyword(s):  
Myocardial Infarction ◽  
Biochemical Markers ◽  
Biochemical Marker ◽  
Disease Risk ◽  
Coronary Syndrome ◽  
Clinical Cardiology ◽  
Early Markers ◽  
Diagnostic Sensitivity And Specificity ◽  
Cardiac Troponins ◽  
Rule Out

Millions of patients present annually with chest pain, but only 10% to 15% have myocardial infarction. Lack of diagnostic sensitivity and specificity of clinical and conventional markers prevents or delays treatment and leads to unnecessary costly admissions. Comparative data are lacking on the new markers, yet using all of them is inappropriate and expensive. The biochemical marker determination to clinical cardiology and discusses some important developments in this field. Biochemical markers play a pivotal role in the diagnosis and management of patients with acute coronary syndrome (ACS), as witnessed by the incorporation of cardiac troponins into new international guidelines for patients with ACS and in the redefinition of myocardial infarction. Despite the success of cardiac troponins, there is still a need for the development of early markers that can reliably rule out ACS from the emergency room at presentation and also detect myocardial ischaemia in the absence of irreversible myocyte injury. The cardiac natriuretic peptides, Laboratory Medicine are also assuming a role in the assessment of cardiac function. Biochemical markers now play an important role in the detection of disease, risk stratification and the monitoring of therapy. Keywords: Biochemical markers, Myocardial infarction, Troponin, Brain natriuretic peptide   doi: 10.3329/jom.v10i2.2824   J MEDICINE 2009; 10 : 100-108

scholarly journals Renal Allograft-Related Inflammation and Accelerated Coronary-Artery Disease: A Case Report

2021 ◽  
Author(s):  
Rainer Ullrich Pliquett ◽  
Andrea Tannapfel ◽  
Sait Sebastian Daneschnejad
Keyword(s):  
Kidney Transplant ◽  
Systemic Inflammation ◽  
Renal Allograft ◽  
Active Role ◽  
Coronary Plaque ◽  
Plaque Instability ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
Artery Disease

Background: Although persistent systemic inflammation is considered to be predictive for future cardiovascular events, it remains unclear whether or not C-reactive protein (CrP) plays an active role in coronary-plaque instability. Here, we report a case of a patient with failed and super-infected renal allograft as a source for systemic inflammation presenting with repeat acute coronary syndromes. Case presentation: A 52-years-old male type-2 diabetic with a failed kidney transplant who was hospitalized for acute urinary-tract infection. In the presence of other, classic cardiovascular risk factors, peak values of CrP coincided with episodes of unstable angina treated by cardiologic interventions. Besides pyelonephritis, the histological examination of the kidney transplant revealed signs of chronic rejection and the presence of a renal cell carcinoma in situ. Once the renal allograft has been removed, systemic inflammation was attenuated, the patient was not rehospitalized for acute-coronary syndrome within the next 12 months. Conclusion: In this case, systemic inflammation was paralleled by instability of coronary plaques as documented by repeat coronary angiograms.

scholarly journals Cardiac Troponins: Analytical Characteristics and Diagnostic Capabilities of Modern (High-sensitive) Determination Methods

2021 ◽  
Author(s):  
Aleksey Michailovich Chaulin ◽  
Duplyakov V Dmitry
Keyword(s):  
Myocardial Infarction ◽  
Physiological State ◽  
Economic Damage ◽  
Routine Practice ◽  
Coronary Syndrome ◽  
Highly Sensitive ◽  
Sensitive Determination ◽  
Determination Methods ◽  
Cardiac Troponins

Cardiovascular diseases have a leading role in terms of morbidity, mortality, and disability of the population, causing significant socio-economic damage to all countries of the world. This circumstance requires researchers to constantly seek for new biomarkers and improve methods for determining existing biomarkers, and search for new therapeutic targets to improve diagnostic and treatment strategies. Recently, there have been some important changes in laboratory diagnostics of patients with acute coronary syndrome, due to the introduction into the routine practice of new high and ultrasensitive methods for the determination of biomarkers of injury, specific to cardiac muscle tissue, namely cardiac troponins. A key advantage of highly sensitive immunochemical assays is the ability to detect cardiac troponins in the early stages of myocardial infarction. This allows making the optimal decision on the early choice and conduct of reperfusion therapy, which significantly improves the further prognosis of patients. Among the most significant generally recognised disadvantages of highly sensitive determination methods are low specificity and a huge variety of troponin immunoassays. The decrease in specificity is reflected in the fact that cardiac troponins are no longer considered the “gold standard” of diagnosis related to Acute Myocardial Infarction (AMI) (irreversible ischaemic damage to cardiomyocytes). As a result, any damage to the myocardium, even insignificant and reversible under physiological state (physical activity, stress) and several pathological conditions, can lead to an increase in serum levels of cardiac troponins and affect the accuracy of the diagnosis. Each method for the determination of cardiac troponins, among the existing wide variety of troponin immunoassays, possesses different analytical characteristics, and detects different concentrations of troponins in the same patient. This article provides a view of current data on the biology of cardiac troponins, and defines the analytical characteristics of new high-sensitive methods for the determination of cardiac troponins.

scholarly journals Correlation of Serum Uric Acid Levels with Nonculprit Plaque Instability in Patients with Acute Coronary Syndromes: A 3-Vessel Optical Coherence Tomography Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Donghui Zhang ◽  
Ruoxi Zhang ◽  
Ning Wang ◽  
Lin Lin ◽  
Bo Yu
Keyword(s):  
Optical Coherence Tomography ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Elevated Serum ◽  
Coronary Plaque ◽  
Optical Coherence ◽  
Plaque Instability ◽  
Coronary Syndrome ◽  
Fibrous Cap ◽  
Coronary Syndromes

Elevated serum uric acid (SUA) level is known to be a prognostic factor in patients with acute coronary syndrome (ACS). However, the correlation between SUA level and coronary plaque instability has not been fully evaluated. The aim of this study was to investigate the association between SUA level and plaque instability of nonculprit lesions in patients with ACS using optical coherence tomography. A total of 150 patients with ACS who underwent 3-vessel optical coherence tomography were selected. Patients were classified into 3 groups according to tertiles of SUA level. There was a trend towards a thinner fibrous cap (0.15 ± 0.06 versus 0.07 ± 0.01 versus 0.04 ± 0.01 mm2, p<0.001) and a wider mean lipid arc (169.41 ± 33.16 versus 177.22 ± 37.76 versus 222.43 ± 47.65°, p<0.001) with increasing SUA tertile. The plaques of the high and intermediate tertile groups had a smaller minimum lumen area than the low tertile group (6.02 ± 1.11 versus 5.38 ± 1.28 mm2, p<0.001). In addition, thin-cap fibroatheromas, microvessels, macrophages, and cholesterol crystals were more frequent in the high tertile group than the low and intermediate groups. Multivariate analysis showed SUA level to be a predictor of plaque instability.

scholarly journals Coronary CT Angiography in the Quantitative Assessment of Coronary Plaques

2014 ◽  
Vol 2014 ◽  
pp. 1-14 ◽  
Author(s):  
Zhonghua Sun ◽  
Lei Xu
Keyword(s):  
Quantitative Assessment ◽  
Coronary Plaque ◽  
Plaque Composition ◽  
Coronary Syndrome ◽  
Coronary Ct ◽  
Vulnerable Plaques ◽  
Clinical Presentations ◽  
Recent Developments ◽  
The Relationship

Coronary computed tomography angiography (CCTA) has been recently evaluated for its ability to assess coronary plaque characteristics, including plaque composition. Identification of the relationship between plaque composition by CCTA and patient clinical presentations may provide insight into the pathophysiology of coronary artery plaque, thus assisting identification of vulnerable plaques which are associated with the development of acute coronary syndrome. CCTA-generated 3D visualizations allow evaluation of both coronary lesions and lumen changes, which are considered to enhance the diagnostic performance of CCTA. The purpose of this review is to discuss the recent developments that have occurred in the field of CCTA with regard to its diagnostic accuracy in the quantitative assessment of coronary plaques, with a focus on the characterization of plaque components and identification of vulnerable plaques.

Association between abdominal fat distribution and coronary plaque instability in patients with acute coronary syndrome

2020 ◽  
Vol 30 (7) ◽  
pp. 1169-1178
Author(s):  
Kozo Okada ◽  
Kiyoshi Hibi ◽  
Yasuhiro Honda ◽  
Peter J. Fitzgerald ◽  
Kouichi Tamura ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Fat Distribution ◽  
Coronary Plaque ◽  
Abdominal Fat ◽  
Plaque Instability ◽  
Coronary Syndrome

P5366Eicosapentaenoic acid therapy is associated with decreased coronary plaque instability assessed using optical frequency domain imaging

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Konishi
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Frequency Domain ◽  
Density Lipoprotein ◽  
Coronary Plaque ◽  
Cholesterol Concentration ◽  
Optical Frequency ◽  
Plaque Instability ◽  
Coronary Syndrome ◽  
Lipid Index

Abstract Background The relationship between eicosapentaenoic acid (EPA) therapy and coronary plaque stability assessed by optical frequency domain imaging (OFDI) has not been thoroughly described. Hypothesis EPA therapy is associated with decreased plaque instability in patients undergoing percutaneous coronary intervention (PCI) using OFDI. Methods Data on coronary artery plaques from 121 patients presenting with acute coronary syndrome or stable angina who consecutively underwent PCI between October 2015 and July 2018 were retrospectively analyzed. Of these patients, 109 were untreated (no-EPA group), whereas 12 were treated with EPA (EPA group). Each plaque's morphological characteristics were analyzed using OFDI. Results We used 1:4 propensity score matching for patients who received or did not receive EPA therapy before PCI. Baseline characteristics were balanced between both groups (age, sex, body mass index, diabetes mellitus, hypertension, dyslipidemia, chronic kidney disease, smoking, previous PCI or coronary artery bypass grafting, previous myocardial infarction, prior statin use, acute coronary syndrome, hemoglobin A1c level, low-density lipoprotein cholesterol concentration, triglyceride concentration, and high-density lipoprotein cholesterol concentration). The EPA group had significantly lower mean lipid index (818±806 vs. 1,574±891) and macrophage grade (13.5±5.9 vs. 19.3±7.4) but higher mean minimum fibrous cap thickness (109.2±55.7 vs. 81.6±36.4 μm) than the no-EPA group (P=0.010, 0.019, and 0.040, respectively). Multiple logistic regression analyses showed that prior EPA use was independently associated with lower lipid index and macrophage grade (P=0.043 and 0.024, respectively). Conclusion This OFDI analysis suggests that EPA therapy is associated with decreased plaque instability in patients undergoing PCI. Acknowledgement/Funding None

scholarly journals Analysis of Predictive Model of Coronary Vulnerable Plaque under Hemodynamic Numerical Simulation

2022 ◽  
Vol 2022 ◽  
pp. 1-10
Author(s):  
Qiang Song ◽  
Mingwei Chen ◽  
Jin Shang ◽  
Zhi Hu ◽  
Hui Cai
Keyword(s):  
Biochemical Markers ◽  
Vulnerable Plaque ◽  
Diagnostic Value ◽  
Plaque Instability ◽  
Coronary Syndrome ◽  
Plaque Area ◽  
Hemodynamic Characteristics ◽  
History Of ◽  
Serum Biochemical ◽  
Auc Value

Objective. Vulnerable plaque is considered to be the cause of most clinical coronary arteries, and linear cytokines are an important factor causing plaque instability. Early prediction of vulnerable plaque is of great significance in the treatment of cardiovascular diseases. Methods. Computational fluid dynamics (CFD) was used to simulate the hemodynamics around plaques, and the serum biochemical markers in 224 patients with low-risk acute coronary syndrome (ACS) were analyzed. Vulnerable plaques were predicted according to the distribution of biochemical markers in serum. Results. CFD can accurately capture the hemodynamic characteristics around the plaque. The patient’s age, history of hyperlipidemia, apolipoprotein B (apoB), adiponectin (ADP), and sE-Selection were risk factors for vulnerable plaque. Area under curve (AUC) values corresponding to the five biochemical markers were 0.601, 0.523, 0.562, 0.519, 0.539, and the AUC value after the combination of the five indicators was 0.826. Conclusion. The combination of multiple biochemical markers to predict vulnerable plaque was of high diagnostic value, and this method was convenient and noninvasive, which was worthy of clinical promotion.

Characterization of Impressed Current Technique to Model Corrosion of Reinforcement in Concrete

2020 ◽  
Vol 11 (1) ◽  
pp. 93-99
Author(s):  
Abu Zakir Morshed ◽  
Sheikh Shakib ◽  
Tanzim Jahin
Keyword(s):  
Immersion Time ◽  
Chloride Content ◽  
Engineering Science ◽  
Coastal Regions ◽  
Faraday’S Law ◽  
Current Technique ◽  
Corrosion Cell ◽  
Impressed Current

Corrosion of reinforcement is an important durability concern for the structures exposed to coastal regions. Since corrosion of reinforcement involves long periods of time, impressed current technique is usually used to accelerate the corrosion of reinforcement in laboratories. Characterization of impressed current technique was the main focus of this research,which involved determination of optimum chloride content and minimum immersion time of specimens for which the application of Faraday’s law could be efficient. To obtain optimum chloride content, the electrolytes in the corrosion cell were prepared similar to that of concrete pore solutions. Concrete prisms of 200 mm by 200 mm by 300 mm were used to determine the minimum immersion time for saturation. It was found that the optimum chloride content was 35 gm/L and the minimum immersion time for saturation was 140 hours. Accounting the results, a modified expression based on Faraday’s law was proposed to calculate weight loss due to corrosion. Journal of Engineering Science 11(1), 2020, 93-99

The Determination of Sense via Deleuze and Blanchot: Paradoxes of the Habitual, the Immemorial, and the Eternal Return

2008 ◽  
Vol 2 (2) ◽  
pp. 155-177 ◽  
Author(s):  
Eugene Brently Young
Keyword(s):  
Eternal Return

Eternal return is the paradox that accounts for the interplay between difference and repetition, a dynamic at the heart of Deleuze's philosophy, and Blanchot's approach to this paradox, even and especially through what it elides, further illuminates it. Deleuze draws on Blanchot's characterisations of difference, forgetting, and the unlivable to depict the ‘sense’ produced via eternal return, which, for Blanchot, is where repetition implicates or ‘carries’ pure difference. However, for Deleuze, difference and the unlivable are also developed by the living repetition or ‘contraction’ of habit, which results in his distinctive characterization of ‘force’, ‘levity’, and sense in eternal return.

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