Study of Ischemia Modified Albumin as New Potential Diagnostic Biomarker In Acute Myocardial Infarction.

2020 ◽  
Vol 7 (2) ◽  
pp. 41-46
Author(s):  
Dr. Dhananjay V. Andure ◽  
Dr. Sangita. M. Patil ◽  
Dr. M. P. Bankar ◽  
Dr. R. K. Padalkar ◽  
Dr. A. P. Pathak
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Chest Pain ◽  
Predictive Value ◽  
Troponin I ◽  
Control Group ◽  
Diagnostic Biomarker ◽  
Ischemia Modified Albumin ◽  
Creatine Kinase Mb

Background: Because of the varied presentation and associated high mortality the identification of patients with acute myocardial infarction is very critical for the patient management and has a bearing on the prognosis. Only about 22% patients admitted to cardiac care centers with chest pain having truly myocardial infarction. Aim: The goal of present study was to assess diagnostic value of serum ischemia modified albumin and compare it with sensitive cardiac troponin I and Creatine Kinase-MB in acute myocardial infarction. Methods: A diagnostic case control study was conducted on 102 patients presenting to the Emergency Department within 6 hrs of acute chest pain and 115 healthy age and sex matched volunteers formed the control group. Serum ischemia modified albumin level was estimated by albumin cobalt binding test using digital spectrophotometer, while troponin I was measured by immunofluroscence assay and creatine Kinase-MB was determined by immunoinhibition method.  The sensitivity and specificity of ischemia modified albumin, troponin I and creatine kinase-MB for detection of acute myocardial infarction were analyzed. The results of ischemia modified albumin, troponin I and creatine kinase-MB alone and in combination were correlated. Results: Ischemia modified albumin (p<0.05) and troponin I (p<0.001) concentrations were significantly higher in acute myocardial infarction than healthy controls. Sensitivity, specificity, positive predictive value and negative predictive value of ischemia modified albumin for detection of acute myocardial infarction was 88.24%, 93.91%, 92.78% and 90.00% compared to 86.27%, 93.04%, 91.67% and 88.43% respectively for the troponin I and 78.43%, 100%, 100%, and 83.94% for creatine kinase-MB. Combined use of ischemia modified albumin, troponin I, creatine kinase-MB significantly enhanced the sensitivity to 96%. The area under the receiver operating characteristic curve of ischemia modified albumin in acute myocardial infarction was 0.90. Conclusion: Ischemia modified albumin is a new potential diagnostic biomarker used together with other gold standard cardiac biomarkers can improve early diagnosis of acute myocardial infarction.

Equivalent early sensitivities of myoglobin, creatine kinase MB mass, creatine kinase isoform ratios, and cardiac troponins I and T for acute myocardial infarction

1995 ◽  
Vol 41 (9) ◽  
pp. 1266-1272 ◽  
Author(s):  
J Mair ◽  
D Morandell ◽  
N Genser ◽  
P Lechleitner ◽  
F Dienstl ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Chest Pain ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Troponin T ◽  
Turnaround Time ◽  
Serum Marker ◽  
Creatine Kinase Mb

Abstract Early sensitivities of creatine kinase (CK), CKMB (activity and mass), CKMM and CKMB isoform ratios, myoglobin, cardiac troponin I (cTnI), and cardiac troponin T (cTnT) were compared to find the most sensitive serum marker for acute myocardial infarction (AMI) during the first hours after onset of chest pain. In a prospective study we investigated 37 consecutive patients with AMI who were admitted to the coronary care unit within 4 h after onset of chest pain. Blood samples were drawn every hour for the first 10 h after admission. CKMB mass concentrations, CKMM and CKMB isoform ratios, myoglobin, cTnI, and cTnT increased significantly (P &lt; or = 0.0067) earlier than CK and CKMB activity and were also significantly (P &lt; or = 0.046) and markedly more sensitive on admission. Differences in early sensitivities of myoglobin, CKMB mass, CK isoform ratios, cTnI, and cTnT were small and not significant. Therefore, turnaround time and practicality for emergency determination of methods, specificities of markers, the required specificity in the individual patient, and costs mainly determine the choice among myoglobin, CKMB mass, CK isoforms, cTnI, and cTnT.

Comparable detection of acute myocardial infarction by creatine kinase MB isoenzyme and cardiac troponin I

1994 ◽  
Vol 40 (7) ◽  
pp. 1291-1295 ◽  
Author(s):  
J E Adams ◽  
K B Schechtman ◽  
Y Landt ◽  
J H Ladenson ◽  
A S Jaffe
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Characteristic Curve ◽  
Cardiac Injury ◽  
Cardiac Troponin I ◽  
Creatine Kinase Mb ◽  
Coronary Care

Abstract Although measurement of cardiac troponin I (cTnI) is, in some situations, more specific for detection of cardiac injury than is measurement of the MB isoenzyme of creatine kinase (MBCK), its sensitivity and specificity relative to MBCK for detection of myocardial infarction has not been established. Accordingly, we studied prospectively 199 consecutive patients admitted to the coronary care unit. Values of MBCK and cTnI mass were determined in all samples. Of the 188 patients admitted with a suspicion of acute myocardial ischemia, 89 were diagnosed as having an acute myocardial infarction on the basis of the patterns of MBCK values. Eighty-six of these patients also had increased cTnI (concordance, 96.6%); three did not. Of the patients diagnosed as without infarction, five with unstable angina and symptoms in the day(s) prior to admission had increased cTnI, for a cTnI specificity of 94.9%. Receiver operating characteristic curve analysis indicated that cTnI and MBCK had statistically indistinguishable diagnostic accuracies for the detection of acute myocardial infarction.

Creatine kinase radioimmunoassay and isoenzyme electrophoresis compared in the diagnosis of acute myocardial infarction.

1980 ◽  
Vol 26 (7) ◽  
pp. 861-866 ◽  
Author(s):  
H A Homburger ◽  
G L Jacob
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Chest Pain ◽  
Predictive Value ◽  
Positive Test ◽  
Test Results ◽  
Diagnostic Specificity ◽  
B Subunit ◽  
Creatine Kinase B

Abstract We compared, in 116 patients, the relative usefulness of results of tests for creatine kinase B isoenzymes, as measured by radioimmunoassay, and the MB isoenzyme, as measured by electrophoresis, in diagnosis of acute myocardial infarction. The radioimmunoassay was specific for isoenzymes of creatine kinase containing the B subunit. All patients with acute transmural infarcts had positive test results by both techniques, but concentrations of B-isoenzymes were more frequently above normal than were MB bands in the case of patients with acute subendocardial infarcts and in the case of all patients with acute myocardial infarcts from whom sera were collected more than 24 h after onset of chest pain. Concentrations of B-isoenzymes also were increased, even when MB bands were not electrophoretically detectable, in specimens from several patients without documented actue myocardial infarcts. These abnormal results presumably were caused by increased concentrations of the BB isoenzyme in serum. Accordingly, an increased concentration of B-isoenzymes had less diagnostic specificity and predictive value for acute myocardial infarction than did a detectable MB band. Results of isoenzyme electrophoresis were more reliable for establishing this diagnosis, but the results of radioimmunoassay were more reliable for excluding it in patients with chest pain as the primary symptom.

Myoglobin, creatine kinase MB, and cardiac troponin-I to assess reperfusion after thrombolysis for acute myocardial infarction: Results from TIMI 10A

1997 ◽  
Vol 134 (4) ◽  
pp. 622-630 ◽  
Author(s):  
Milenko J. Tanasijevic ◽  
Christopher P. Cannon ◽  
Donald R. Wybenga ◽  
George A. Fischer ◽  
Christine Grudzien ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Troponin I ◽  
Creatine Kinase Mb

scholarly journals Evaluation of a New Assay for Cardiac Troponin I vs Creatine Kinase-MB for the Diagnosis of Acute Myocardial Infarction

1997 ◽  
Vol 4 (1) ◽  
pp. 6-12 ◽  
Author(s):  
Gerard X. Brogan ◽  
Judd E. Hollander ◽  
Charles F. McCuskey ◽  
Henry C. Thode ◽  
Jeffrey Snow ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Troponin I ◽  
Creatine Kinase Mb

scholarly journals Use of Saliva-Based Nano-Biochip Tests for Acute Myocardial Infarction at the Point of Care: A Feasibility Study

2009 ◽  
Vol 55 (8) ◽  
pp. 1530-1538 ◽  
Author(s):  
Pierre N Floriano ◽  
Nicolaos Christodoulides ◽  
Craig S Miller ◽  
Jeffrey L Ebersole ◽  
John Spertus ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Troponin I ◽  
Screening Method ◽  
Lab On A Chip ◽  
Rapid Screening ◽  
Whole Saliva ◽  
Creatine Kinase Mb ◽  
Unstimulated Whole Saliva

Abstract Background: For adults with chest pain, the electrocardiogram (ECG) and measures of serum biomarkers are used to screen and diagnose myocardial necrosis. These measurements require time that can delay therapy and affect prognosis. Our objective was to investigate the feasibility and utility of saliva as an alternative diagnostic fluid for identifying biomarkers of acute myocardial infarction (AMI). Methods: We used Luminex and lab-on-a-chip methods to assay 21 proteins in serum and unstimulated whole saliva procured from 41 AMI patients within 48 h of chest pain onset and from 43 apparently healthy controls. Data were analyzed by use of logistic regression and area under curve (AUC) for ROC analysis to evaluate the diagnostic utility of each biomarker, or combinations of biomarkers, in screening for AMI. Results: Both established and novel cardiac biomarkers demonstrated significant differences in concentrations between patients with AMI and controls without AMI. The saliva-based biomarker panel of C-reactive protein, myoglobin, and myeloperoxidase exhibited significant diagnostic capability (AUC = 0.85, P &lt; 0.0001) and in conjunction with ECG yielded strong screening capacity for AMI (AUC = 0.96) comparable to that of the panel (brain natriuretic peptide, troponin-I, creatine kinase-MB, myoglobin; AUC = 0.98) and far exceeded the screening capacity of ECG alone (AUC approximately 0.6). En route to translating these findings to clinical practice, we adapted these unstimulated whole saliva tests to a novel lab-on-a-chip platform for proof-of-principle screens for AMI. Conclusions: Complementary to ECG, saliva-based tests within lab-on-a-chip systems may provide a convenient and rapid screening method for cardiac events in prehospital stages for AMI patients.

scholarly journals Evaluation of the Efficiency of N-terminal Pro-B-type Natriuretic Peptide for Diagnosis of Acute Myocardial Infarction

2020 ◽  
Author(s):  
Abuagla M. Dafalla ◽  
Leena A. Dafalla ◽  
ShamsEldein M. Ahmed ◽  
Yousif A. Mohammed ◽  
Adam D. Abakar ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Natriuretic Peptide ◽  
Predictive Value ◽  
Troponin I ◽  
Venous Blood ◽  
Cardiac Biomarkers ◽  
Control Group ◽  
Heart Cell ◽  
Cardiac Biomarker

Background: Cardiac diseases are one of the major causes of death worldwide with increasing incidence rate per year, particularly in developing countries such as Sudan owing to urbanization and changing lifestyle. Myocardial infarction is a consequence of the imbalance between the heart blood supply and the required heart cell; this disorder leads to necrosis of myocardium and may cause death. It could be diagnosed by at least two of the following criteria: chest pain, electrocardiography (ECG) elevation, and levels on cardiac biomarkers. This study aimed to evaluate the efficiency of N-terminal pro-B-type natriuretic peptide (NTproBNP) for the diagnosis of acute myocardial infarction (AMI).  Methods: This analytical case–control hospital-based study was conducted on a total of 70 individuals, of which 40 participants were suspected of or diagnosed with AMI, while 30 healthy subjects  were included as a control group. Three ml of venous blood were collected in lithium heparin containers. Troponin I (TnI) as a cardiac biomarker was measured by TOSOH AIA-360, while the NTproBNP level was detected using I-Chroma II. Personal and clinical data were collected directly from each participant using a predesigned questionnaire. Results: A significant increase in the TnI level (mean: 13.13 ± 18.9 ng/ml) and NTproBNP (mean: 5756.5 ± 8378.2 pg/mL) in AMI patients were detected when compared with control mean (0.02 ± 0.00 ng/ml and 57.8 ± 42.32 pg/mL, respectively). Conclusions: NTproBNP gave a high sensitivity (87.5%), specificity (100%), positive predictive value (100%), and negative predictive value (85.7%) in the diagnosis of AMI when compared with another cardiac biomarker such as TnI. Keywords: acute myocardial infarction, NTproBNP, troponin I, Medani Heart Center, Sudan

scholarly journals Antioxidant and Anti-Inflammatory Effects of Curcumin Nanoparticles on Drug-Induced Acute Myocardial Infarction in Diabetic Rats

Antioxidants ◽  
2019 ◽  
Vol 8 (10) ◽  
pp. 504 ◽  
Author(s):  
Boarescu ◽  
Boarescu ◽  
Bocșan ◽  
Gheban ◽  
Bulboacă ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Serum Levels ◽  
Control Group ◽  
Protective Effects ◽  
Curcumin Nanoparticles ◽  
Creatine Kinase Mb ◽  
Anti Inflammatory

We have investigated the cardio-protective effects of pretreatment with curcumin nanoparticles (CUN) compared to conventional curcumin (CUS) on the changes in oxidative stress parameters and inflammatory cytokine levels during induced acute myocardial infarction (AMI) in rats with diabetes mellitus (DM). DM was induced with streptozotocin, and AMI with isoproterenol. Eight groups of seven Wister Bratislava rats were included in the study. The N-C was the normal control group, AMI-C was the group with AMI, DM-C was the group with DM, and DM-AMI-C was the group with DM and AMI. All four groups received saline solution orally during the whole experiment. S-DM-CUS-AMI and S-DM-CUN-AMI groups received saline for seven days prior to DM induction and continued with CUS (200 mg/kg bw, bw = body weight) for S-DM-CUS-AMI and CUN for S-DM-CUN-AMI (200 mg/kg bw) for 15 days before AMI induction. The CUS-DM-CUS-AMI group received CUS (200 mg/kg bw), while the CUN-DM-CUN-AMI received CUN (200 mg/kg bw) for seven days prior to DM induction, and both groups continued with administration in the same doses for 15 days before AMI induction. CUS and CUN prevented elevation of creatine kinase, creatine kinase-MB, lactate dehydrogenase in all groups, with better results in the CUN (S-DM-CUN-AMI and CUN-DM-CUN-AMI groups). CUS and CUN significantly reduced serum levels of oxidative stress markers (malondialdehyde, the indirect assessment of nitric oxide synthesis, and total oxidative status) and enhanced antioxidative markers (total antioxidative capacity and thiols, up to 2.5 times). All groups that received CUS or CUN showed significantly lower serum levels of tumor necrosis factor-alpha, interleukin-6, and interleukin-1β. The best antioxidative and anti-inflammatory effects were obtained for the group that received CUN before DM induction (CUN-DM-CUN-AMI group). Pretreatment with CUN proved higher cardio-protective effects exerting an important antioxidative and anti-inflammatory impact in the case of AMI in DM.

Interpretation of high sensitive troponin assays: acute or chronic myocardial damage?

2011 ◽  
Vol 152 (38) ◽  
pp. 1528-1534 ◽  
Author(s):  
Eszter Szánthó ◽  
Zoltán Szabó ◽  
József Varga ◽  
György Paragh ◽  
Anna V. Oláh
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Troponin I ◽  
Troponin T ◽  
Troponin Level ◽  
Cardiac Damage ◽  
Creatine Kinase Mb ◽  
Two Samples ◽  
High Sensitive Troponin

Troponin is the first choice in the diagnosis of acute myocardial infarction. Correct interpretation is challenging, because high sensitive troponin tests used today detect even the smallest cardiac damage. Methods: High sensitive troponin T (Roche) and troponin I (Mitsubishi Pathfast) and creatine-kinase activity were measured in 20 patients, each having two samples with the time lapse 3–9 hours. Results: In the group without acute myocardial infarction (n = 10) no significant increase in creatine-kinase and creatine-kinase-MB levels were seen, and the mild raise of troponins was due to other cardiovascular problems (atrial fibrillation, paroxysmal supraventricular tachycardia). With acute myocardial infarction (n = 10) a dramatic increase of troponin levels was found in the second samples, and also an increase of creatine-kinase and creatine-kinase-MB activity. According to Fischer-probe a twofold or higher increase of troponin implies 19-times higher risk of acute myocardial infarction in the case of troponin T and 8-times odds ratio at troponin I. Conclusions: The patient’s accompanying diseases should always be considered. If the troponin level is elevated, the measurement should be repeated within 3–6 hours. When troponin shows at least a twofold increase and the patient has chest pain or positive ECG, AMI is likely, and the patient needs special medical care. Although the first troponin level might be elevated if accompanying diseases cause chronic cardiac damage, it can be differentiated by a second troponin measurement. Orv. Hetil., 2011, 152, 1528–1534.

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