scholarly journals ANALYSIS OF SOLUBLE FIBRIN MONOMER AS DIAGNOSTIC MARKER FOR ACUTE MYOCARDIAL INFARCTION AND ITS CORRELATION WITH CARDIAC TROPONIN I

2019 ◽  
Vol 25 (3) ◽  
pp. 279 ◽  
Author(s):  
Maimun Zulhaidah Arthamin ◽  
Lydiana Parmadi ◽  
Dwi Priyadi Djatmiko ◽  
Elvin Richela Lawanto
Keyword(s):  
Myocardial Infarction ◽  
Troponin I ◽  
Diagnostic Marker ◽  
Roc Curve Analysis ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
St Segment Elevation ◽  
St Segment ◽  
Spearman’S Correlation ◽  
Rule Out

Background. The diagnosis of non-ST-segment elevation myocardial infarction (NSTEMI) is required early and accurate to avoid missing diagnosis and improve the rule out of AMI patients. There is a relationship between AMI and the state of hypercoagulation and/or thrombosis process. sFM is a protrombotic marker that is found to be associated with early AMI incidence compared to cTnI that increases after mionecrosis. The aim of this study is to determine that sFM can be used as biomarker for AMI and the correlation between sFM and cTnI.Methods. A cross-sectional analytic observational study was conducted among 23 AMI patients and 27 healthy controls. AMI were established using clinical, ECG and laboratory findings. sFM levels were measured with Stago Compact Max analyzer. Statistical analysis was performed using the Spearman’s correlation coefficient, ROC curve analysis, and 2x2 contingency table.Results. A significant correlation were found between the sFM and the cTnI (r=0.422, p<0.05). With a sFM cutoff level of 2.56 µg/mL, AMI could be diagnosed with sensitivity and specificity of 82.6% and 40.7%, respectively (AUC=0,638).Discussion. sFM is a new biomarker for systemic thrombus events, both cardiac and non-cardiac.Conclusions and Suggestions. sFM can be considered as an parameter of AMI. Similar studies with cohort method involving large number may be needed in the future study. 

scholarly journals Copeptin to rule out myocardial infarction in Blacks versus Caucasians

2018 ◽  
Vol 8 (5) ◽  
pp. 395-403 ◽  
Author(s):  
Neil Beri ◽  
Lori B Daniels ◽  
Allan Jaffe ◽  
Christian Mueller ◽  
Inder Anand ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Troponin I ◽  
Black Population ◽  
P Value ◽  
St Segment Elevation ◽  
Incremental Value ◽  
St Segment ◽  
Rule Out

Background: Copeptin in combination with troponin has been shown to have incremental value for the early rule-out of myocardial infarction, but its performance in Black patients specifically has never been examined. In light of a potential for wider use, data on copeptin in different relevant cohorts are needed. This is the first study to determine whether copeptin is equally effective at ruling out myocardial infarction in Black and Caucasian races. Methods: This analysis of the CHOPIN trial included 792 Black and 1075 Caucasian patients who presented to the emergency department with chest pain and had troponin-I and copeptin levels drawn. Results: One hundred and forty-nine patients were diagnosed with myocardial infarction (54 Black and 95 Caucasian). The negative predictive value of copeptin at a cut-off of 14 pmol/l (as in the CHOPIN study) for myocardial infarction was higher in Blacks (98.0%, 95% confidence interval (CI) 96.2–99.1%) than Caucasians (94.1%, 95% CI 92.1–95.7%). The sensitivity at 14 pmol/l was higher in Blacks (83.3%, 95% CI 70.7–92.1%) than Caucasians (53.7%, 95% CI 43.2–64.0%). After controlling for age, hypertension, heart failure, chronic kidney disease and body mass index in a logistic regression model, the interaction term had a P value of 0.03. A cut-off of 6 pmol/l showed similar sensitivity in Caucasians as 14 pmol/l in Blacks. Conclusions: This is the first study to identify a difference in the performance of copeptin to rule out myocardial infarction between Blacks and Caucasians, with increased negative predictive value and sensitivity in the Black population at a cut-off of 14 pmol/l. This also holds true for non-ST-segment elevation myocardial infarction and, although numbers were small, similar trends exist in the normal troponin population. This may have significant implications for early rule-out strategies using copeptin.

scholarly journals Significant association between serum resistin and hypersensitive troponin I levels in patients with a first ST-segment elevation myocardial infarction

2019 ◽  
Author(s):  
Yong Zhu ◽  
Chengping Hu ◽  
Yu Du ◽  
Yan Liu ◽  
Jinxing Liu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Troponin I ◽  
Linear Regression Analysis ◽  
Coronary Intervention ◽  
Multiple Linear Regression Analysis ◽  
Primary Pci ◽  
Cross Sectional ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Abstract Background Resistin, a proinflammatory adipocytokine secreted predominately by macrophages in humans, plays an important role in the pathogenesis and development of atherosclerosis. The present research mainly investigated the association between serum resistin level and peak hypersensitive cardiac troponin I (hs-cTnI) in patients with ST-segment elevation myocardial infarction (STEMI).Methods We consecutively enrolled 92 patients with a first STEMI in this cross-sectional and observational study. Resistin concentrations upon admission and 24 h and 72 h after primary percutaneous coronary intervention (PCI) were all measured. The change in resistin (δ Resistin) was defined as (serum resistin concentration at admission)-(serum resistin concentration 24 h after intervention).Results Serum resistin concentration decreased rapidly after primary PCI. Resistin at admission correlated positively with tumour necrosis factor-α (r = 0.522, p<0.001) and macrophage migration inhibitory factor (r = 0.471, p<0.001). Additionally, resistin at admission correlated negatively with the reactive oxygen species scavengers superoxide dismutase (r = -0.261, p = 0.012) and glutathione peroxidase (r = -0.235, p = 0.024). Most importantly, serum resistin concentrations upon admission (r = 0.381, p<0.001) and 24 h (r = 0.372, p<0.001) and 72 h (r = 0.347, p = 0.001) after primary PCI all correlated with peak hs-cTnI, while δ Resistin was not associated with peak hs-cTnI. After multiple linear regression analysis, serum resistin (beta = 13.593, 95% CI 5.951 to 21.235, p < 0.001) at admission and 24 h (beta = 13.972, 95% CI 5.662 to 22.282, p = 0.001) and 72 h (beta = 14.455, 95% CI 5.178 to 23.733, p = 0.003) after intervention remained associated with peak hs-cTnI.Conclusions In our present research, serum resistin concentrations at different time points all correlated positively with peak hs-cTnI, which may suggest that serum resistin concentrations during the acute phase of STEMI are useful for forecasting myocardial infarction size and prognosis in patients after primary PCI. Additionally, our research also indicated that resistin may regulate myocardial IRI partly by promoting the inflammatory process and oxidative stress.

scholarly journals Loeffler’s endocarditis and possible coronary spasm secondary to eosinophilic coronary periarteritis with ECG change mimicking acute non-ST-segment elevation myocardial infarction: A case report

2020 ◽  
Author(s):  
Fan-xin Kong ◽  
Meng Li ◽  
Chun-Yan Ma ◽  
Ping-ping Meng ◽  
Yong-huai Wang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Differential Diagnosis ◽  
Coronary Artery ◽  
Troponin I ◽  
Hypereosinophilic Syndrome ◽  
Coronary Spasm ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Abstract Background Loeffler’s endocarditis is an inflammatory cardiac condition of hypereosinophilic syndrome which rarely involves coronary artery. When coronary artery is involved, known as eosinophilic coronary periarteritis, the clinical presentation, electrocardiographic changes and troponin level are extremely nonspecific and may mimic acute coronary syndrome. It is very important to make differential diagnosis for ECPA in order to avoid the unnecessary further invasive coronary angiography. Case presentation We report a case with chest pain, ST-segment depression in electrocardiogram and increased troponin-I mimicking acute non-ST-segment elevation myocardial infarction. However, quick echocardiography showed endomyocardial thickening with normal regional wall motion, which corresponded to the characteristics of Loeffler’s endocarditis. Emergent blood analysis showed marked increase in eosinophils and computed tomography angiography found no significant stenosis of coronary artery. Manifestations of magnetic resonance imaging consisted with findings of echocardiography. Finally, the patient was diagnosed as Loeffler’s endocarditis and possible coronary spasm secondary to eosinophilic coronary periarteritis. Conclusion This case exhibits the crucial use of quick transthoracic echocardiography and the emergent hematological examination for differential diagnosis in such scenarios as often if electrocardiogram change mimicking myocardial infarction.

scholarly journals Level of the growth differentiation factor-15 in patients with acute myocardial infarction

Kardiologiia ◽  
2020 ◽  
Vol 60 (11) ◽  
pp. 42-48
Author(s):  
A. A. Sabirzyanova ◽  
A. S. Galyavich ◽  
L. V. Baleeva ◽  
Z. M. Galeeva
Keyword(s):  
Myocardial Infarction ◽  
Correlation Coefficient ◽  
Troponin I ◽  
Statistical Significance ◽  
White Blood Cells ◽  
Rank Correlation ◽  
Growth Differentiation Factor 15 ◽  
St Segment Elevation ◽  
Differentiation Factor ◽  
St Segment

Aim To reveal relationships between growth differentiation factor-15 (GDF-15) and laboratory and instrumental indexes in patients with myocardial infarction in acute phase.Material and methods The study included 118 patients younger than 70 years with ST-segment elevation or non-ST segment elevation myocardial infarction (MI). For these patients, GDF-15 was measured by enzyme immunoassay within 48 h of MI clinical onset along with a routine examination. Statistical significance of differences in qualitative variables was assessed by the Student’s t-test for normal distribution and by the nonparametric Mann-Whitney U-test; significance of differences in quantitative variables was assessed by the Pearson’s chi-squared test. The presence of a relationship between quantitative variables was assessed with the Pearson’s correlation coefficient and the Spearman’s rank correlation coefficient.Results For patients with MI, mean GDF-15 concentration was 2.25±1.0 ng/ml. Moderate correlations were found for GDF-15 and levels of natriuretic peptide (r=0.36, p<0.01), white blood cells (r=0.32, p<0.01), and ejection fraction (Simpson rule) (r=-0.32, p<0.01); weak correlations were found with levels of troponin I (r=0.21, p=0.02) and urea (r=0.20, p=0.04), and interventricular septal thickness by echocardiography (r= -0.26, p<0.01). GDF-15 was higher in patients with ST-segment elevation MI (2.36±1.02 vs 1.99±0.96, p<0.05) and in the presence of hypo- or akinetic areas (2.35±1.05 vs 1.85±0.70, p<0.05). No dependence of GDF-15 on the presence of traditional cardiovascular risk factors was observed.Conclusion GDF-15 correlates with major markers of myocardial injury; its level is higher in patients with ST-segment elevation MI regardless of the infarct location.

scholarly journals Risk Assessment of Patients After ST-Segment Elevation Myocardial Infarction by Killip Classification: An Institutional Experience

2020 ◽  
Author(s):  
Kashif Ali Hashmi ◽  
Fahar Adnan ◽  
Atif Ali Hashmi ◽  
Javaria Parwez Ali ◽  
Muhammad Irfan ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Hospital Mortality ◽  
Local Population ◽  
Cross Sectional Study ◽  
Class I ◽  
Cross Sectional ◽  
Killip Class ◽  
St Segment Elevation ◽  
St Segment ◽  
Hospital Patients

Abstract Objectives: Revalidation of Killip class in our local population is mandatory. We planned this study to increase cardiologist readiness to tackle the risks associated with increased mortality in each class post ST elevation myocardial infarction (STEMI). Objectives were to determine frequency of Killip class I, II, III, IV and in-hospital mortality in each Killip class in patients with left ventricle failure secondary to STEMI.Results: This cross-sectional Study was conducted in Department of Cardiology, Jinnah Hospital. Patients with STEMI were stratified using Killip Class and validation was performed by determining the within 15 days in-hospital mortality in each Killip class. Patients with chronic disease were excluded. The frequency (percentage) of patients with STEMI in each killip class from I to IV was 395 (81.4%), 46 (9.5%), 27(5.6%) and 17(3.5%) respectively while in-hospital mortality came out to be, 39 (9.8%), 4 (8.6%), 25 (92.5%), and 17(100%), in Killip class I, II, III and IV respectively. Presence of diabetes, history of smoking and BMI more than 30kg/m2 were significant contributor to mortality along with higher Killip class and age of presentation. It is concluded that Killip class is a valid tool for risk stratification for patients after STEMI.

scholarly journals Use of high-sensitivity cardiac troponins in the emergency department for the early rule-in and rule-out of acute myocardial infarction without persistent ST-segment elevation (NSTEMI) in Italy

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Aldo Clerico ◽  
Martina Zaninotto ◽  
Alberto Aimo ◽  
Ruggero Dittadi ◽  
Domenico Cosseddu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Emergency Department ◽  
High Sensitivity ◽  
Cardiac Biomarkers ◽  
Controversial Issues ◽  
Medicina Di Laboratorio ◽  
International Guidelines ◽  
St Segment Elevation ◽  
St Segment ◽  
Rule Out

Abstract Serial measurements of cardiac troponin are recommended by international guidelines to diagnose myocardial infarction (MI) since 2000. However, some relevant differences exist between the three different international guidelines published between 2020 and 2021 for the management of patients with chest pain and no ST-segment elevation. In particular, there is no agreement on the cut-offs or absolute change values to diagnose non-ST-segment elevation MI (NSTEMI). Other controversial issues concern the diagnostic accuracy and cost-effectiveness of cut-off values for the most rapid algorithms (0 h/1 h or 0 h/2 h) to rule-in and rule-out NSTEMI. Finally, another important point is the possible differences between demographic and clinical characteristics of patients enrolled in multicenter trials compared to those routinely admitted to the Emergency Department in Italy. The Study Group of Cardiac Biomarkers, supported by the Italian Scientific Societies Società Italiana di Biochimica Clinica, Italian Society of the European Ligand Assay Society, and Società Italiana di Patolgia Clinica e Medicina di Laboratorio decided to revise the document previously published in 2013 about the management of patients with suspected NSTEMI, and to provide some suggestions for the use of these biomarkers in clinical practice, with a particular focus on the Italian setting.

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