Use of Troponin I as a Biochemical Marker for Diagnostics of Asphictic State in Mechanical Asphyxia

The purpose of the study was to determine the quantitative content of the biochemical marker of myocardial damage (subunits of the troponin complex: Troponin I) in the blood as a diagnostic criterion for asphyxia in mechanical asphyxia. Materials and methods. To determine the presence of asphyxia, the quantitative content of Troponin I in the blood of 12 dead people was studied and analyzed, among which violent death was observed in 7 cases and non-violent – in 5 cases. The study for biochemical detection of Troponin I used a method based on enzyme-linked immunosorbent assay followed by statistical processing of the results using the MedStat package. Results and discussion. Among the biochemical markers for the diagnosis of asphyxia in hanging and aspiration asphyxia, the most indicative is the determination of the quantitative content of Troponin I in the blood, which is also used in clinical practice to substantiate the diagnosis of cardiac pathology. Therefore, it is important to conduct a differential diagnosis of changes in quantitative indicators of biochemical markers depending on the cause and genesis of death. During the study of the quantitative content of Troponin I in the blood of those who died of mechanical asphyxia (hanging, aspiration asphyxia), it was found that the content of troponin I is from 140 ng/ml to 170 ng/ml. The quantitative content of Troponin I in the blood of those who died of acute and chronic coronary heart disease (control group) is from 10.1 ng/ml to 120 ng/ml. The average value of the quantitative content of Troponin I in two samples was found: in the blood of those who died of mechanical asphyxia – 156 ng/ml±4.4 ng/ml; in the blood of those who died of acute and chronic coronary heart disease – 45.62 ng/ml±22.4 ng/ml. The study revealed a difference in quantitative indicators of biochemical markers depending on the cause and genesis of death, found that the quantitative content of Troponin I in the blood of the dead from mechanical asphyxia (hanging, aspiration asphyxia) compared with the quantitative content of Troponin I in the blood of the dead with chronic coronary heart disease is higher, at the level of significance p=0.008. Conclusion. Thus, in the course of research, the feasibility of using changes in quantitative indicators of the biochemical marker Troponin I to determine the asphyxiation in violent death (mechanical asphyxia) and differential diagnosis in cases of non-violent death (acute and chronic coronary heart disease) was proved, which significantly increases efficiency and reliability of forensic medical examinations

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Results of study of biochemical markers of bone metabolism in men with coronary heart disease

Medical alphabet ◽

10.33667/2078-5631-2020-15-39-43 ◽

2020 ◽

pp. 39-43

Author(s):

A. V. Voronkina ◽

T. A. Raskina ◽

M. V. Letaeva ◽

Yu. V. Averkieva ◽

O. S. Malyshenko ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Bone Formation ◽

Bone Metabolism ◽

Biochemical Markers ◽

Coronary Atherosclerosis ◽

Cathepsin K ◽

Arterial Calcification ◽

Mineral Density ◽

Bone Remodeling Markers

The development of atherosclerosis is closely related to the calcification of the vessel intima and fibrous plaques, being a complex and multifactorial process, in which the markers of bone formation and resorption play an important role. Objective. To study the biochemical markers of bone metabolism in men with stable coronary heart disease (CHD). Material and methods. The study included 102 men with verified CHD. Data were evaluated by densitometry, coronary angiography, multispiral computed tomography, color duplex scanning of brachiocephalic arteries, serum lipids (total cholesterol, triglycerides [TG], high-density [LHD] and low-density lipoprotein cholesterol), concentrationsin the blood of osteocalcin (OC), bone alkaline phosphatase (BAP), cathepsin K and C-telopeptides (CTx). Results. Concentrations of BAP, cathepsin K and CTx in patients with CHD were significantly higher than in men without CHD. The concentration of OC in men with normal bone mineral density was significantly lower than in patients with osteopenic syndrome. There was a direct correlation between OC and antiatherogenic HDL cholesterol and the inverse correlation between OC and TG, CTx and TG. There was no correlation between the level of bone remodeling markers and coronary artery (CA) lesion variant and the severity of coronary atherosclerosis on SYNTAX scale. The correlation analysis did not reveal the connection of biochemical markers of bone metabolism with the severity of coronary atherosclerosis and calcification and thickness of intima-media complex of carotid arteries. Absolute values of bone formation indices (BAP, OC) were significantly higher in patients with severe СA calcification than in patients without signs of calcification. Summary. Increased rates of osteogenesis and osteoresorption characterize the accelerated process of bone metabolism and indicate in favor of high rates of bone loss in men with CHD, which confirms the likelihood of common pathophysiological mechanisms of bone resorption and arterial calcification.

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Estimation of the Safety of Intraoperative Fluid Therapy during Great Abdominal Surgery in Patients with Coronary Heart Disease

Ukraïnsʹkij žurnal medicini bìologìï ta sportu ◽

10.26693/jmbs05.05.158 ◽

2020 ◽

Vol 5 (5) ◽

pp. 158-163

Author(s):

V. I. Lysenko ◽

◽

E. A. Karpenko ◽

Ya. V. Morozova

Keyword(s):

Heart Failure ◽

Coronary Heart Disease ◽

Heart Disease ◽

Fluid Therapy ◽

Troponin I ◽

Significant Proportion ◽

Myocardial Damage ◽

Enzyme Linked Immunosorbent Assay ◽

Cardiac Complications ◽

Fluid Regimen

The study of intraoperative fluid therapy tactics has been of great interest over the past few years, especially in people with concomitant coronary heart disease, as they make up a significant proportion of all surgical patients. The purpose of our study was to assess the risk of intraoperative myocardial damage in patients with concomitant coronary heart disease depending on the fluid regimen used based on monitoring of hemodynamic parameters, electrocardiogram and biomarkers of myocardial damage. Material and methods. The study involved 89 patients, who were divided into two groups depending on the tactics of intraoperative fluid therapy – restrictive and liberal. In order to detect cardiac complications at different stages, we assessed biomarkers of myocardial damage Troponin I, NT-proBNP by solid-phase enzyme-linked immunosorbent assay (ELISA). Results and discussion. Analysis of the obtained data showed that MINS (myocardial injury in noncardiac surgery) incidents were diagnosed in 5 patients (11.1%) in the first group and in 6 patients (13.6%) in the second. In patients of both groups there was an increase in NT-proBNP in the dynamics at all stages, and in the 2nd group, with a liberal regimen of intraoperative fluid therapy, it was more pronounced. It should be noted that the obtained values of NT-proBNP in all patients did not differ significantly from those allowed for this age group; such dynamics of NT-proBNP may indicate a relative risk of complications of liberal fluid therapy in patients with baseline heart failure. One of the important points when choosing the mode of fluid therapy in patients with high cardiac risk is the assessment of the initial volemic status and careful monitoring of water balance in the perioperative period with the desire for "zero" balance. The obtained dynamics of laboratory markers of myocardial damage indicates that in patients with a significant reduction in cardiac reserves compensated for heart failure, a restrictive fluid regimen is preferable, which is also confirmed by slight changes in the concentration of biomarkers. Conclusion. Thus, the study demonstrated the relative safety of selected fluid regimens in patients with concomitant coronary heart disease without signs of congestive heart failure

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Possibilities for treating aspirin-i lesions of the stomach and duodenum in patients with chronic coronary heart disease

Clinical Medicine (Russian Journal) ◽

10.30629/0023-2149-2020-98-3-231-235 ◽

2020 ◽

Vol 98 (3) ◽

pp. 231-235

Author(s):

N. Yu. Borovkova ◽

M. V. Buyanova ◽

T. E. Bakka ◽

M. P. Nistratova ◽

T. V. Vlasova ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Proton Pump Inhibitor ◽

Blood Serum ◽

Proton Pump ◽

The Body ◽

Control Group ◽

Pge2 Level ◽

Endogenous Prostaglandins ◽

Chronic Coronary Heart Disease

To evaluate possibilities of aspirin-induced gastroduodenopathy treatment in the patients with chronic ischemic heart disease by means of applying the internal endogenous prostaglandins stimulant. Material and methods. 340 patients suffering from chronic coronary heart disease and receiving a long-term acetylsalicylic acid (ASA) therapy were examined on the base of the cardiovascular care unit of The Nizhny Novgorod Regional Clinical Hospital named after N.A. Semaschko. There were evaluated frequency, nature and severity of the aspirin-induced gastroduodenopathy. The patients with coronary heart disease and aspirin-induced gastroduodenopathy were divided in two groups. In the first group of patients there was applied rebamipide therapy (in a single daily dose 300 mg) in combination with the proton pump inhibitor (PPI) — pantoprazole. In the second group there was applied only pantoprazole therapy. For the purpose of specification of AIG pathogenetic mechanisms development, all the examined chronic coronary heart disease cases were tested on the prostaglandin E2 (PGE2) level in blood serum before the therapy beginning and after the treatment. The control group was formed of chronic coronary heart disease patients showing no AIG evidence. Statistical processing of the received data was fulfilled with the program «Statistika 10.0». Results. AIG was registered in 15% out of 340 chronic coronary heart disease patients. According to the endoscopic examination erosive disease of the body and antrum prevailed among the patients. The PGE2 level in the blood serum was significantly lower (р = 0,00087) in these patients in comparison with the control group. In association with PPI and rebamipide mixed therapy, esophagogastroduodenoscopy results showed no pathological findings in gastrointestinal mucosa and statistically significant (р = 0,00067) blood serum PGE2 level growing in all the treated patients. As a result of exclusive PPI therapy there was marked positive dynamics in endoscopic view in 19 out of 25 patients and a tendency to normalization of PGE2 level in the blood serum. However, PGE2 level growing was insignificant. Conclusion. The presented research demonstrates the possibility of AIG treatment with the use of internal endogenous prostaglandins stimulant — rebamipide in complex with proton pump inhibitor PPI therapy.

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