ROLE OF SERUM ISCHEMIC MODIFIED ALBUMIN COMBINED WITH HS-TROPONIN T (HS-TNT) IN DIAGNOSIS NON-ST SEGMENT ELEVATION ACUTE CORONARY SYNDROMES

2017 ◽  
pp. 64-69
Author(s):  
Quang Tuan Pham ◽  
Ta Dong Nguyen ◽  
Van Minh Huynh

Background: Early diagnosis in ACS is significant to treatment and prognosis. It helps to reduce death and complications. What is the value from a combination of IMA and hs-TnT for diagnosing non-ST segment elevation acute coronary syndromes. Objective: To determine the serum concentration of IMA and hs-TnT in patients with non-ST segment elevation acute coronary syndromes. To define sensitivity and specificity when combining IMA and hs-TnT in diagnosis non-ST segment elevation acute coronary syndromes. Subject and Method: 75 patients hospitalized in Hue Central Hospital with breast pain. Diagnosis of non-ST segment elevation acute coronary syndromes is done on 37 of those as in a patients group (ESC in 2015); 38 others are chosen as a controls group. Cross-sectional study with comparison is applied. Result: In 2 tests at different time points, the concentration of hs-TnT and IMA in patients group with non-ST segment elevation acute coronary syndromesis higher compared with that in the controls group (median: 0,065ng/mL > 0,006ng/mL and 0,162ng/mL > 0,0055ng/mL). Average IMA concentration in patients group is 93,49± 89,56 IU/mL (median: 58,57IU/mL) and higher compared with the controls group which reaches15,01 ± 9,87 IU/mL (median:11,735IU/mL). It results in a statistical significance p<0,001. The cut off point of hs-TnT > 0,014ng/mL and IMA>28,68 IU/ML, reaching a sensitivity at 88,9% and a specificity at 100%, AUC = 0,97, p < 0,001, 95% CI= 0,915 – 1,00. Conclusion: Combination of IMA and hs-TnT results in a high value for diagnosis of non-ST segment elevation acute coronary syndromes. Key words: hs-Troponin T, IMA, NSTE-ACS

2017 ◽  
pp. 197-202
Author(s):  
Quang Tuan Pham ◽  
Ta Dong Nguyen ◽  
Nguyen Tuong Van Ha ◽  
Van Minh Huynh

Background: Early diagnosis in ACS is significant to treatment and prognosis. It helps to reduce death and complications. What is the value of IMA concentration for diagnosing non-ST segment elevation acute coronary syndromes. Objective: Studying the IMA concentration in blood serum in patients with non-ST segment elevation acute coronary syndromes; determining sensitivity, specificity and cut off point of IMA in diagnosis of non-ST segment elevation acute coronary syndromes. Subject and Method: 75 patients hospitalized in Hue Central Hospital with breast pang, presenting non-ST segment elevation acute coronary syndromes. Based-on the ESC Guidelines 2015, diagnosis of non-ST segment elevation acute coronary syndromes is made on 37 of those as in a patients group; 38 others are chosen as a controls group. Cross-sectional study with comparison is applied. Result: (i) Concentration of enzymes CK-MB and of hs-TnT in the patients group is higher compared with that in the controls group. Average IMA concentration in patients group is 93.49± 89.56 IU/mL (median: 58.57IU/mL) and higher compared with the controls group which reaches 15.01 ± 9.87 IU/mL (median: 11.735IU/mL). It results in a statistical significance p<0,001. (ii) The cut off point for diagnosing non-ST segment elevation acute coronary syndromes > 28.68IU/mL, reaching a sensitivity at 91.9% and a specificity at 86.8%, AUC = 0.98, 95% CI=0.95-1.00, p<0.001, OR= 74.8, 95% CI =16.54 - 338.38, p<0.001. Conclusion: IMA has high sensitivity and specificity in diagnosis of non-ST segment elevation acute coronary syndromes. Key words: iMA, NSTEMi, Acute coronary syndrome without ST elevation


2011 ◽  
Vol 412 (15-16) ◽  
pp. 1350-1356 ◽  
Author(s):  
Gjin Ndrepepa ◽  
Siegmund Braun ◽  
Stefanie Schulz ◽  
Robert A. Byrne ◽  
Jürgen Pache ◽  
...  

Author(s):  
David Erlinge ◽  
Göran Olivecrona

Acute coronary syndromes are classified as ST segment elevation myocardial infarction (STEMI), non-STEMI (NSTEMI) or unstable angina. Most patients with NSTEMI present with a history of chest pain that has subsided spontaneously before or soon after arrival at the emergency room, but with positive cardiac markers (usually troponin T or I) indicative of myocardial infarction. NSTEMI has a risk of recurrent myocardial infarction of 15–20% and a 15% chance of 1-year mortality. Patients with non-STE-acute coronary syndromes are at similar risk as a STEMI patient at 1 year. The strongest objective signs of NSTEMI are a positive troponin and ST segment depression. NSTEMI should be acutely treated with aspirin, an adenosine diphosphate-receptor antagonist, and an anticoagulant (fondaparinux or low molecular weight heparins). NSTEMI should be investigated with coronary angiography within 72 hours. Curative treatment is percutaneous coronary intervention or coronary artery bypass grafting.


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