RESEARCH ON CONCENTRATION CHANGE OF H-FABP IN EARLY DIAGNOSIS OF ACUTE MYOCARDIAL INFARCTION

2016 ◽  
pp. 86-92
Author(s):  
Thị Thoa Giao ◽  
La Hieu Nguyen ◽  
Van Minh Huynh
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Troponin T ◽  
Average Concentration ◽  
Cutoff Point ◽  
Control Group ◽  
Fatty Acid Binding ◽  
Predictive Values ◽  
Significant Difference ◽  
Sensitivity Specificity

Objective: To evaluate the change of H-FABP in patients with Acute Myocardial Infarction at the time of 6 hours previously and 24 hours afterwards. To identify the sensitivity, specificity, positive predictive and negative predictive values, H-FABP cutoff point in comparison with hs troponin T. Methods: prospective study on 84 patients with Acute Myocardial Infarction and 28 healthy volunteers at Da Nang Hospital. The study period lasts from March 2014 to June 2015. Results: The average age of the diseased group is 62.57 ± 12.91 and the control group is 55.43 ± 12.33; a higher percentage of men than women 3 times in the disease group, 2 times compared with women in the control group. Regarding change of H-FABP concentrations in Acute Myocardial Infarction: H-FABP increased within 30 minutes after the onset, increased rapidly in the duration from 0-6 hours, peaked after 6-12 hours with the average concentration of 245.13 ± 452.63 ng/ml and returned to normal state after 36 hours. Meanwhile, hs troponin T appeared slower in blood after 3-6 hours, peaked after 12-24 hours at a concentration of 4.52 ± 3.38 average ng/ml. H-FABP and hs troponin T concentrations had significant difference statistically between the intervals with p <0,05. According to the results of our study: cutoff point of H-FABP was 6.6 ng/ml, sensitivity 88.1%, specificity 82.1%; compared with hs troponin T, the cutoff point was 0.014 ng/ml, sensitivity 82.1%, specificity 96.4%. If combining H-FABP with hs troponin T, the sensitivity will increase to 92.6% and specificity of 82.1%. The sensitivity, specificity, positive predictive and negative predictive values of H-FABP and hs of troponin T in the duration of 0-3 hours, were 89.3%, 82.1%, 93.7%, 69.7% and 53.3 %, 89.3%, 84.3%, 64.1% respectively; in the duration of 3-6 hours were 91.7%, 83.3%, 83.3%, 88.5% and 83.3%, 91.7%, 90.6%, 84.6% respectively; so in the duration of 0-6 hours, the H-FABP sensitivity was higher than that of hs troponin T; If combining H-FABP and hs troponin T, the sensitivity would increase at all time, Specifically, within 0-3 hours, 3-6 hours, 3-12 hours, 12-24 hours, and > 36 hours the sensitive was 92.9%, 95.8%, 94.7%, 96.2%, 90.6%, 85.7% respectively. The area under the ROC curve point of H-FABP 0-3 hours is 0.921 and the hs troponin T was 0.918. Conclusion: The study asserted that H-FABP is a superior biomarker in terms of sensitivity, more superior to hs troponin T in diagnosing myocardial necrosis in the early phase of 0-6 hours, the golden hours of acute MI; which helps make important decisions on treatment methods, risk stratification and prognosis. Keywords: marker, H-FABP (Heart type Fatty Acid Binding Protein), hs troponin T (high sensitive troponin T), acute myocardial infarction.

Systemic Thrombin Generation and Activity Resistant to Low Molecular Weight Heparin Administered Prior to Streptokinase in Patients with Acute Myocardial Infarction

1997 ◽  
Vol 77 (01) ◽  
pp. 057-061 ◽  
Author(s):  
Dennis W T Nilsen ◽  
Lasse Gøransson ◽  
Alf-Inge Larsen ◽  
Øyvind Hetland ◽  
Peter Kierulf
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Molecular Weight ◽  
Body Weight ◽  
Low Molecular Weight Heparin ◽  
Troponin T ◽  
Bleeding Complications ◽  
Control Group ◽  
Low Molecular Weight ◽  
Creatine Kinase Mb

SummaryOne hundred patients were included in a randomized open trial to assess the systemic factor Xa (FXa) and thrombin inhibitory effect as well as the safety profile of low molecular weight heparin (LMWH) given subcutaneously in conjunction with streptokinase (SK) in patients with acute myocardial infarction (MI). The treatment was initiated prior to SK, followed by repeated injections every 12 h for 7 days, using a dose of 150 anti-Xa units per kg body weight. The control group received unfractionated heparin (UFH) 12,500 IU subcutaneously every 12 h for 7 days, initiated 4 h after start of SK infusion. All patients received acetylsalicylic acid (ASA) initiated prior to SK.Serial blood samples were collected prior to and during the first 24 h after initiation of SK infusion for determination of prothrombin fragment 1+2 (Fl+2), thrombin-antithrombin III (TAT) complexes, fibrinopeptide A (FPA) and cardiac enzymes. Bleeding complications and adverse events were carefully accounted for.Infarct characteristics, as judged by creatine kinase MB isoenzyme (CK-MB) and cardiac troponin T (cTnT), were similar in both groups of patients.A comparable transient increase in Fl+2, TAT and FPA was noted irrespective of heparin regimen. Increased anti-Xa activity in patients given LMWH prior to thrombolytic treatment had no impact on indices of systemic thrombin activation.The incidence of major bleedings was significantly higher in patients receiving LMWH as compared to patients receiving UFH. However, the occurrence of bleedings was modified after reduction of the initial LMWH dose to 100 anti-Xa units per kg body weight.In conclusion, systemic FXa- and thrombin activity following SK-infusion in patients with acute MI was uninfluenced by conjunctive LMWH treatment.

scholarly journals Troponin T and Histological Characteristics of Rat Myocardial Infarction Induced by Isoproterenol

2007 ◽  
Vol 7 (3) ◽  
pp. 212-217 ◽  
Author(s):  
Sabaheta Hasić ◽  
Radivoj Jadrić ◽  
Emina Kiseljaković ◽  
Zakira Mornjaković ◽  
Mira Winterhalter-Jadrić
Keyword(s):  
Myocardial Infarction ◽  
Troponin T ◽  
Myocardial Necrosis ◽  
Control Group ◽  
High Dose ◽  
Male Adult ◽  
Histological Changes ◽  
Significant Difference ◽  
Intraperitoneal Dose ◽  
Histological Characteristics

In our investigation, we used short-time model of myocardial infarction of rats induced by high dose of isoproterenol (ISP). We investigated cardiac troponin T blood level (cTnT) and histological characteristics of rat myocardium. ISP, single, intraperitoneal dose 250 mg/kg was given to male, adult, Wistar rats (n=12). Rats were distributed depending on their body weight in subgroups: ISP I (BW 260-280g) and ISP II (BW 250-400g). Control group (n=9) was treated with intraperitoneal dose of 0,95% NaCl. Cardiac TnT was measured by electrochemiluminiscence (ECLA) sandwich immunoassay in rat serum 4 hours after ISP application. Rats’ hearts were dissected and examined by qualitative histological method (HE). Statistical significance was set at 0,05. There was significant difference in cTnT of ISP II (p=0,0001) vs. control and ISP I (p<0,05) vs. control. Significant difference was beetween ISP I and ISP II subgroups (p<0.001). The accent of histological changes of myocardium was on nuclei of cell. Cells showed acydophilic changes and nuclei disappearance as signs of coagulative necrosis development. Extensivity of histological changes were different beetween ISP I and ISP II subgroup. Used dose of ISP induced development of myocardial necrosis in rats. Suben-docardial portion of myocardium was more vulnerability than subepicardial portion. Rats of ISP II had more extensive histological changes than these in ISP I. Administered doses of ISP enabled cTnT utilization as a marker of myocardial necrosis.

Kinetics of high-sensitivity cardiac troponin T or troponin I compared to creatine kinase in patients with revascularized acute myocardial infarction

2015 ◽  
Vol 53 (5) ◽  
Author(s):  
Kamila Solecki ◽  
Anne Marie Dupuy ◽  
Nils Kuster ◽  
Florence Leclercq ◽  
Richard Gervasoni ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
Significant Difference ◽  
Kinetics Of

AbstractCardiac biomarkers are the cornerstone of the biological definition of acute myocardial infarction (AMI). The key role of troponins in diagnosis of AMI is well established. Moreover, kinetics of troponin I (cTnI) and creatine kinase (CK) after AMI are correlated to the prognosis. New technical assessment like high-sensitivity cardiac troponin T (hs-cTnT) raises concerns because of its unclear kinetic following the peak. This study aims to compare kinetics of cTnI and hs-cTnT to CK in patients with large AMI successfully treated by percutaneous coronary intervention (PCI).We prospectively studied 62 patients with anterior AMI successfully reperfused with primary angioplasty. We evaluated two consecutive groups: the first one regularly assessed by both CK and cTnI methods and the second group by CK and hs-cTnT. Modeling of kinetics was realized using mixed effects with cubic splines.Kinetics of markers showed a peak at 7.9 h for CK, at 10.9 h (6.9–12.75) for cTnI and at 12 h for hs-cTnT. This peak was followed by a nearly log linear decrease for cTnI and CK by contrast to hs-cTnT which appeared with a biphasic shape curve marked by a second peak at 82 h. There was no significant difference between the decrease of cTnI and CK (p=0.63). CK fell by 79.5% (76.1–99.9) vs. cTnI by 86.8% (76.6–92.7). In the hs-cTnT group there was a significant difference in the decrease by 26.5% (9–42.9) when compared with CK that fell by 79.5% (64.3–90.7).Kinetic of hs-cTnT and not cTnI differs from CK. The role of hs-cTnT in prognosis has to be investigated.

scholarly journals Study of Cardiac markers in Acute Myocardial Infarction Patients

2016 ◽  
Vol 4 (04) ◽  
pp. 19-22
Author(s):  
Prashant Kumar Shah
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Biochemical Parameters ◽  
Creatine Phosphokinase ◽  
Troponin T ◽  
P Value ◽  
Cardiac Markers ◽  
Glutamate Oxaloacetate Transaminase ◽  
Significant Difference ◽  
Serum Glutamate

Introduction: Acute Myocardial infarction (AMI) or Myocardial infarction (MI) (ie, heart attack) is the irreversible death (necrosis) of heart muscle due to prolonged lack of oxygen supply (ischemia). Biochemically the study of Cardiac markers like myoglobin, troponin, Creatine –phosphokinase (CPK), Serum glutamate oxaloacetate transaminase (SGOT), Lactate dehydrogenase ( LDH) can used in the assessment of Myocardial infarction. Materials and methods: Total 70 patients (50 MI patient and 20 control (not diagnosed as MI) were enrolled for the study and the biochemical investigations like Total CPK,CPK-MB, Troponin-T and I, LDH and SGOT were conducted for the study. Result and discussion: Each of the following biochemical parameters examined were significantly increases in case of AMI/MI patients (case) when compared with control. Troponin -T shows significant difference than other cardiac markers (p value for Troponin-T is less tahn.001). Conclusion: Appropriate study of cardiac markers like CPK, LDH, SGOT, Troponin is significant for the study and evaluation of myocardial infarction. Troponin –T is most appropriate and significant than other cardiac markers mention in the study.

scholarly journals The Preference, Effect, and Prognosis of Intra-Aortic Balloon Counterpulsation in Acute Myocardial Infarction Complicated by Cardiogenic Shock Patients: A Retrospective Cohort Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Wenjun Wang ◽  
Feifei Yang ◽  
Xixiang Lin ◽  
Qin Zhong ◽  
Zongren Li ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Propensity Score ◽  
Cardiogenic Shock ◽  
Cumulative Incidence ◽  
Control Group ◽  
Study Cohort ◽  
Significant Difference ◽  
Intra Aortic Balloon Counterpulsation ◽  
Balloon Counterpulsation

Backgrounds. Intra-aortic balloon counterpulsation is increasingly used in acute myocardial infarction complicated by cardiogenic shock. The aim of this study was to explore the preference, effect, and prognosis of intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock patients. Methods. Data of acute myocardial infarction complicated by cardiogenic shock patients at the Fourth Medical Center of PLA General Hospital were collected retrospectively. A propensity score was calculated with a logistic regression which contained clinically meaningful variables and variables selected by Lasso and then used to match the control group. The cumulative incidence curve and Gray’s test were employed to analyse the effect and prognosis of intra-aortic balloon counterpulsation on mortality. Results. A total of 1962 acute myocardial infarction cases admitted between May 2015 and November 2018 were identified, and 223 cases with acute myocardial infarction complicated by cardiogenic shock were included as the study cohort, which contained 34 cases that received IABP and 189 cases that did not receive IABP. Patients with higher alanine aminotransferase ( OR = 1.93 , 95% CI 1.29-2.98), higher triglyceride ( OR = 3.71 , 95% CI 1.87-7.95), and higher blood glucose ( OR = 1.08 , 95% CI 0.99-1.18) had a higher probability of receiving intra-aortic balloon counterpulsation. In the propensity score matching analysis, 34 cases received intra-aortic balloon counterpulsation and 102 matched controls were included in the comparison. By comparing the cumulative incidence of in-hospital mortality, there was no statistically significant difference between the intra-aortic balloon counterpulsation group and matched control group ( P = 0.454 ). Conclusion. The use of intra-aortic balloon counterpulsation may not improve the prognosis of the acute myocardial infarction complicated by cardiogenic shock patients.

Detecting plaque rupture? Soluble CD40 ligand for early diagnosis of acute myocardial infarction in the emergency department

2010 ◽  
Vol 27 (Suppl 1) ◽  
pp. A6.2-A6
Author(s):  
Richard Body
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Emergency Department ◽  
Early Diagnosis ◽  
Adverse Events ◽  
Troponin T ◽  
Cd40 Ligand ◽  
Soluble Cd40 Ligand ◽  
Calcium Blockers ◽  
Significant Difference

BackgroundIn recent years there has been growing interest in the identification of novel biomarkers that may enable early exclusion of acute coronary syndromes (ACS) in the Emergency Department (ED). Soluble CD40 ligand (sCD40L) has been identified as a potential marker of coronary plaque destabilisation and platelet activation. We aimed to investigate the value of sCD40L measured at the time of ED presentation for enabling early diagnosis and exclusion of ACS.MethodsWe recruited patients presenting to the ED with suspected cardiac chest pain within the previous 24 h. We measured sCD40L in plasma samples taken at the point of ED presentation. All patients had troponin T measured at least 12 h after symptom onset and were followed up for 6 months for adverse events (death, acute myocardial infarction (AMI) or the need for urgent revascularisation).Results706 patients were recruited to the study. sCD40L levels were significantly lower in smokers, in patients with hyperlipidaemia or prior coronary revascularisation and in patients taking statins, r angiotensin-converting enzyme or calcium blockers. There was no significant difference in sCD40L levels between patients with (median 33.8ng/ml, IQR 18.0–80.5) and without (36.3 ng/ml, IQR 14.2–94.3) AMI (p=0.92) or between patients who did (34.0 ng/ml, 14.2–94.3) and who did not (34.9, 18.2–80.4) develop adverse events (p=0.82). The area under the Receiver Operating Characteristic curve was 0.50 (95% CI 0.45 to 0.56) for AMI and 0.49 (0.44–0.55) for adverse events. There was no trend towards increasing incidence of either outcome with ascending quintiles of sCD40L.ConclusionssCD40L is unhelpful in the ED diagnosis of ACS. Future work in this area should focus on other biomarkers.

Early increase in serum fatty acid binding protein 4 levels in patients with acute myocardial infarction

2016 ◽  
Vol 7 (6) ◽  
pp. 561-569 ◽  
Author(s):  
Masaru Obokata ◽  
Tatsuya Iso ◽  
Yoshiaki Ohyama ◽  
Hiroaki Sunaga ◽  
Tomoka Kawaguchi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Fatty Acid ◽  
Fatty Acid Binding Protein ◽  
Troponin T ◽  
Binding Protein ◽  
Serum Fatty Acid ◽  
Metabolic Complications ◽  
Fatty Acid Binding ◽  
Acid Binding Protein

Background: Acute myocardial infarction (AMI) induces marked activation of the sympathetic nervous system. Fatty acid binding protein 4 (FABP4) is not only an intracellular protein, but also a secreted adipokine that contributes to obesity-related metabolic complications. Here, we examined the role of serum FABP4 as a pathophysiological marker in patients with AMI. Methods and results: We studied 106 patients presenting to the emergency unit with a final diagnosis of AMI, including 12 patients resuscitated from out-of-hospital cardiac arrest (OHCA) caused by ventricular fibrillation. FABP4 levels peaked on admission or just after percutaneous coronary intervention and declined thereafter. Regression analysis revealed no significant correlation between peak FABP4 and peak cardiac troponin T determined by Roche high-sensitive assays (hs-TnT). Notably, FABP4 levels were particularly elevated in AMI patients who were resuscitated from OHCA (median 130.2 ng/mL, interquartile range (IQR) 51.8–243.9 ng/mL) compared with those without OHCA (median 26.1 ng/ml, IQR 17.1–43.4 ng/mL), while hs-TnT levels on admission were not associated with OHCA. Immunohistochemistry of the human heart revealed that FABP4 is abundantly present in adipocytes within myocardial tissue and epicardial adipose tissue. An in vitro study using cultured adipocytes showed that FABP4 is released through a β3-adrenergic receptor (AR)-mediated mechanism. Conclusions: FABP4 levels were significantly elevated during the early hours after the onset of AMI and were robustly increased in OHCA survivors. Together with the finding that FABP4 is released from adipocytes via β3-AR-mediated lipolysis, our data provide a novel hypothesis that serum FABP4 may represent the adrenergic overdrive that accompanies acute cardiovascular disease, including AMI.

scholarly journals Comparison of Mean Platelet Volume in Acute Myocardial Infarction vs. Normal Coronary Angiography

2016 ◽  
Vol 8 (11) ◽  
pp. 320 ◽  
Author(s):  
Alireza Rai ◽  
Mohammadreza Saidi ◽  
Nahid Salehi ◽  
Farzad Sahebjamei ◽  
Masoud Jalilian ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Platelet Count ◽  
Coronary Angiography ◽  
University Hospital ◽  
Control Group ◽  
Platelet Volume ◽  
St Segment Elevation ◽  
Significant Difference ◽  
Normal Coronary Angiography

<p>Considering the importance of cardiovascular disease and the role that platelets have in thrombosis formation in the coronary arteries, this study was done in order to assess platelet-related indices in patients who suffered acute myocardial infarction (MI) and compare them with those who had normal coronary angiography results.In this descriptive-analytical study, 200 patients who were admitted to our university hospital due to chest pain were included. The patients were divided into five groups including ST-segment elevation MI (STEMI), non-STEMI, unstable angina (UA), stable angina (SA), and healthy subjects (as control group). Platelet-related indices including platelet count as well asmean platelet volume (MPV) was determined. For this purpose, blood samples were taken from the patients upon admission and platelet count and volume were measured within three hours of admission.There was no statistically significant difference regarding MPV between the study groups (P&gt; 0.05).</p><p>MPV did not have any role in diagnosing various types of coronary artery disease (CAD).</p>

scholarly journals Automatizáltan mérhető biomarkerek az akut myocardialis infarctus diagnosztikájában

2015 ◽  
Vol 156 (24) ◽  
pp. 964-971
Author(s):  
Ferenc Kovács ◽  
Ibolya Kocsis ◽  
Marina Varga ◽  
Enikő Sárváry ◽  
György Bicsák
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Troponin I ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Biomarkers ◽  
Fatty Acid Binding ◽  
High Sensitivity Troponin ◽  
Creatine Kinase Mb

Introduction: Cardiac biomarkers have a prominent role in the diagnosis of acute myocardial infarction. Aim: The aim of the authors was to study the diagnostic effectiveness of automated measurement of cardiac biomarkers. Method: Myeloperoxidase, high-sensitivity C-reactive protein, myoglobin, heart-type fatty acid binding protein, creatine kinase, creatine kinase MB, high-sensitivity troponin I and T were measured. Results: The high-sensitivity troponin I was the most effective (area under curve: 0.86; 95% confidence interval: 0.77–0.95; p<0.001) for the diagnosis of acute myocardial infarction. Considering a critical value of 0.35 ng/mL, its sensitivity and specificity were 81%, and 74%, respectively. Combined evaluation of the high-sensitivity troponin T and I, chest pain, and the electrocardiogram gave the best results for separation of acute myocardial infarction from other diseases (correct classification in 62.5% and 98.9% of patients, respectively). Conclusions: Until a more sensitive and specific cardiac biomarker becomes available, the best method for the diagnosis of acute myocardial infarction is to evaluate electrocardiogram and biomarker concentration and to repeat them after 3–6 hours. Orv. Hetil., 2015, 156(24), 964–971.

Sign in / Sign up

Export Citation Format

Share Document