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1.
M. I. Akpanabiatu I. B. Umoh E. E. Edet T. Ekanem S. Ukaffia J. I. Ndem 《Indian journal of clinical biochemistry : IJCB》2009,24(3):241-244
Serum creatine kinase (CK), creatine kinase isoenzyme (CK-MB) and aspartate aminotransferase (AST) are key players in the
diagnostic study of cardiac complications. These enzymes are specific diagnostic markers of myocardial infarction and hypertension
is a disease condition characterized with a wide range of complications, including myocardial infarction. In this study, we
determined the effects of interaction of vitamin A and Rauwolfia vomitoria (RV) root bark extract on marker enzymes of cardiac
diseases. CK and CK-MB activities had significant decrease in the group of animals with concomitant administration of vitamin
A (40 IU/kg body wt.) and 150 mg/kg body wt. of RV root bark extract. At the interaction of vitamin A with 300 mg/kg body
wt. RV root bark extract, CK-MB only showed significant (p ≥ 0.05) decrease while CK decreased insignificantly. Also at the
interaction of vitamin A with 300 mg/kg body wt. RV root bark extract, AST increased significantly but decreased significantly
at the interaction of vitamin A (40 IU/kg body wt.) and 150 mg/kg body wt. of RV root bark extract. Our findings showed that
vitamin A dose did not lower the activities of cardiac marker enzymes. However, concomitant administration of RV root bark
extract at 150 mg/kg body wt. with vitamin A shows significant reduction in the activities of CK, CK-MB and AST. These findings
suggest that interaction of vitamin A with RV root bark extract would be a meaningful ethno-pharmaceutical approach in the
management of myocardial infarction and treatment of hypertension. 相似文献
2.
Anand K. Pyati Basavaraj B. Devaranavadagi Sanjeev L. Sajjannar Shashikant V. Nikam Mohd. Shannawaz Satish Patil 《Indian journal of clinical biochemistry : IJCB》2016,31(4):439-445
The study aimed to investigate whether heart-type fatty acid binding protein (H-FABP) measurement provides additional diagnostic value to that of conventional cardiac markers in acute myocardial infarction (AMI) within first 6 h after the onset of symptoms. The study included 120 subjects: 60 AMI cases and 60 age and sex matched controls. The cases and controls were further divided into 2 subgroups depending on the time since onset of chest pain as (1) subjects within 3 h and (2) between 3 and 6 h of onset of chest pain. In all the cases and controls, serum H-FABP concentration was measured by Immunoturbidimetric method, serum Troponin I and myoglobin concentrations by Chemiluminescence immunoassay and serum CK-MB concentration by Immuno-inhibition method. The sensitivity, specificity, positive and negative predictive values of H-FABP were significantly greater than CK-MB and myoglobin but were lesser than Troponin I in patients with suspected AMI in both within 3 h and 3–6 h groups. Receiver operating characteristic curves demonstrated greatest diagnostic ability for Troponin I (AUC = 0.99, p < 0.001) followed by H-FABP (AUC = 0.906, p < 0.001) within 3 h and 3–6 h after the onset of chest pain. In conclusion, the diagnostic value of H-FABP is greater than CK-MB and myoglobin but slightly lesser than troponin I for the early diagnosis of AMI within first 6 h of chest pain. H-FABP can be used as an additional diagnostic tool for the early diagnosis of AMI along with troponin I. 相似文献
3.
A serial follow up study of cardiac marker enzymes during the week after acute myocardial infarction
Laboratory infarction diagnostics are based on the detection of elevated serum activities of creatine kinase (CK) Creatine
kinase Isoenzyme MB (CKMB) and Transaminases. Determination of these cardiac marker enzymes permits the diagnosis of transmural
myocardial infarction. However in such patients the diagnosis of acute myocardial infarction can be confirmed by the clinical
symptoms and changes in the ECG, in addition to the enzyme assays. The 50 AMI patients selected in the present study were
those admitted to the ICCU of Shri Krishna Hospital, Karamsad. The blood samples were taken at Zero hours (i.e. at the time
of admission of the patient). Within 6 hrs of the starting of chest pain, 1.5 million units of streptokinase were mixed with
100 to 150ml of normal saline and administered by infusion over a period of one hour. The blood samples were further collected
at intervals of 6 hrs, 14hrs, 32hrs, 48hrs, 5th day and 7th day. The blood samples were analyzed for CK, CKMB, SGOT, α HBDH and Cardiac specific Troponin T. By 6hrs the CK and CKMB
values had started rising, the rise continuing at 14hrs with peak values at 32hrs. The CK showed a slight decrease by 48 hrs.
The cardiac Troponin T showed wide time window from 4 hrs to 7th day for detecting myocardial damage. The maximum cardiac Troponin T values were during the first 24hrs. Cardiac Troponin
T in serum appears to be a more sensitive and early indicator of myocardial cell injury in comparison to CKMB. 相似文献
4.
Laboratory infarction diagnostics are based on the detection of elevated serum activities of total Creatine Kinase (CK), Creatine
Kinase isoensyme MB, (CKMB), Lactate dehydrogenase (LDH), isoenzyme forms of LDH and transaminases. Determination of these
cardiac marker enzymes permits a highly sensitive diagnosis of transmural myocardial infarction. In such patients the diagnosis
of acute myocardial infarction can be confirmed by the clinical, symptoms, and changes in the ECG in addition to the enzyme
assays. The 50 AMI patients selected in the present study were those admitted to the ICCU of Shri Krishna Hospital, Karamsad.
The blood samples were taken at the time of admission (ie. within four hours of the start of chest pain). The samples were
analyzed for CK, CKMB, SGOT, (Serum glutamate oxaloactate transaminase) αHBDH α-hydroxybutyrate dehydrogenase and troponin
T. The serum CKMB activity in AMI showed an increase only 5–6 hours after the commencement of chest pain. The elevation in
SGOT and αHBDH was still delayed. At the same time we could observe that the cardiac Troponin T (cTnT) was elevated at the
time of admission of the patient itself. This increase of cTnT in AMI patients was 20 times higher than the normal blood donors.
The controls included 25 normal blood donors and 25 patients with polytraumatic injuries with no chest contusion. The study
shows that cTnT estimation could serve in the early diagnosis of AMI. The increase of cardiac troponin T in AMI patients was
20 times higher than the normal blood donors in AMI patients at the time of admission. Cardiac troponin T in serum appears
to be a more sensitive indicator of myocardial cell injury than CKMB activity and its detection in the circulation may be
a useful prognostic indicator in patients with unstable angina as well. When the blood of normal blood donors or that of patients
with polytraumatic injury was analysed the troponin T values were well within the normal range in both the above categories
showing that cardiac troponin T is highly specific for heart tissue. Although CKMB and cardiac troponin T are released soon
after the myocardial injury, the release of cardiac troponin T is much earlier than CKMB thereby invalidating the important
role of cardiac troponin T in diagnosing AMI. Cardiac troponin T has been shown to be highly sensitive for cardiac injury
and not elevated in any other trauma, heavy exercise or skeletal muscle injury. Cardiac troponin T is ordinarily undetectable
in healthy individuals, and so its measurement can serve as a powerful tool in the diagnosis of AMI. 相似文献
5.
Sanjiv Gupta K. N. Singh V. Bapat V. Mishra D. K. Agarwal P. Gupta 《Indian journal of clinical biochemistry : IJCB》2008,23(1):89-91
The comparative diagnostic efficacy of two cardiac markers: CK-MB and cTn-T, has scarcely been investigated in Indian patients
of acute myocardial infarction. The present study was conducted for the same objective. The present study comprised of 59
patients. Males were 44 (75%) and females were 15 (25 %). The age of patients ranged from 32–84 years with mean age of 62.8
yrs. The mean age of males and females were 60 and 63 yrs respectively. All patients presented with history of chest pain
with a 12 leads ECG proven MI (ST Elevation, discordant T-waves). CK-MB was estimated in peripheral blood samples at 0,24,48
and 72 hours by an autoanalyzer. Following 12 hours of admission bed side Troponin-T test was done employing cTn-T marker
kit. Initially (0 hr), in 50% patients CK-MB was elevated. By end of 24 hours all the patients were CKMB positive and peak
level was attained at 24 hrs. Then it tended to decline over next 48 hrs. There were no false positive or negative results.
The cTn-T test was positive only in 22 % of ECG positive infarctions. However, the cTn-T positive cases were always accompanied
by a higher CK-MB levels. A significantly lower cTn-T positive cases in Indian patients can only be attributed to some difference
in amino acid sequence of Indian cTn-T and occidental cTn-T. A larger study from other Indian cardiac centers can either substantiate
or contradict our results. 相似文献
6.
Lippi G Cervellin G Banfi G Plebani M 《Biochemia medica : ?asopis Hrvatskoga dru?tva medicinskih biokemi?ara / HDMB》2011,21(1):55-62
The timely diagnosis of acute coronary syndrome (ACS), in particular myocardial infarction (MI), is still one of the most challenging issues in medicine. The introduction into routine laboratory practice of assays for measuring the cardiospecific troponins has dramatically revolutionized the diagnostic approach and the recent development of methods with improved analytical sensibility (i.e., highly sensitivity [HS] assays), has further contributed to improve the negative predictive value of troponin testing but, contextually, has substantially lowered the clinical specificity of these markers. In particular, clinical studies have demonstrated the existence of an exercise-related increase of HS-troponins, with measurable values detectable in up to 94% of athletes undergoing endurance sports. This measurable amount oftroponin in blood would mirror an increased membrane permeability and early troponin release rather than reflecting a clinically threatening myocardial injury. As such, the measurable amount of cardiac troponins as assessed with the novel HS assays requires major clinical focus (i.e., serial measurement of cardiac biomarkers, detailed clinical history-taking, integration with ECG and imaging findings) to prevent misdiagnosis of ACS and/or MI in otherwise healthy persons. 相似文献
7.
Uday Kumar Anand Sharan Shaheena Kamal 《Indian journal of clinical biochemistry : IJCB》2003,18(2):6-7
Usually CPK, CK-MB and lactate dehydrogenase (LDH) enzymes are measured in blood during the period of myocardial infarction.
The changes in LDH assay indicates duration of the infarction.
The level of lactate dehydrogenase is 500 times greater in tissue than those found in serum. A small mass of damaged tissue
causes leakage of enzyme and increases its level in serum.
Any cause of tissue break down/hemolysis which is sufficiently severe can produce LDH pattern similar to that in myocardial
infarction.
We report this case of small bowel volvulus showing significant increase in LDH.
It may be due to tissue necrosis which increases the level of LDH in serum. 相似文献
8.
Neelima Singh Vedika Rathore Roshan Kumar Mahat Puneet Rastogi 《Indian journal of clinical biochemistry : IJCB》2018,33(3):356-360
Cardiac markers are used to evaluate functions of heart. However, there are no satisfactory cardiac biomarkers for the diagnosis of acute myocardial infarction (AMI) within 4 h of onset of chest pain. Among novel cardiac markers, glycogen phosphorylase BB (GPBB) is of particular interest as it is increased in the early hours after AMI. The present study was conducted with the objective to find out the sensitivity and specificity of GPBB over other cardiac markers i.e. myoglobin and CKMB in patients of AMI within 4 h after the onset of chest pain. The study includes 100 AMI patients and 100 normal healthy individuals as controls. In all the cases and controls, serum GPBB and myoglobin concentrations were measured by ELISA where as CK-MB was measured by diagnostic kit supplied by ERBA. The sensitivity and specificity of glycogen phosphorylase BB (GPBB) were greater than CK-MB and myoglobin in patients of AMI within 4 h after the onset of chest pain. Hence, glycogen phosphorylase BB (GPBB) can be used as additional biomarker for the early diagnosis of AMI. 相似文献
9.
T. Angeline RitaMary Aruna K. Ramadevi G. Mohan Nirmala Jeyaraj 《Indian journal of clinical biochemistry : IJCB》2003,18(1):103-106
Coronary artery disease is now a major health problem in India. In past few decades the battle to reduce the incidence of
coronary artery disease has led the researchers to look for various clinical markers, which would help early diagnosis of
the diseases. The present study was undertaken to assess the level of lipoprotein (a) [Lp(a)] and few other lipids in selected
myocardial infarction (MI) patients below 45 years without having any traditional risk factors but with positive family history.
Fasting blood samples were taken from 65 patients and their total cholesterol, LDL cholesterol, VLDL cholesterol, HDL cholesterol,
triglycerides and serum Lp(a) were determined. The control group consisted of 50 age matched healthy individuals. The mean
Lp(a) level was 58.6±3.20 mg/dl in patients and 19.70±0.18 mg/dl in controls. Thus Lp(a) levels were found significantly higher
in patients with MI (p<0.05 for patients versus control) as compared to the controls. There was no significant difference
in the levels of total cholesterol (TC), LDL, VLDL HDL, TGL as compared to controls but there was an increase in TC/HDL cholesterol
ratio. The results of this study suggest that high level of Lp(a) and TC/HDL ratio has a distinctive association with MI,
independent of other common coronary risk factors. Hence, Lp(a) level in serum emerges to be a promising marker for diagnosis
of coronary artery diseases. 相似文献
10.
Nazia Parveen K. N. Subhakumari Sajitha Krishnan 《Indian journal of clinical biochemistry : IJCB》2015,30(2):150-154
In recent years, an important objective of cardiovascular research has been to find new markers that would improve the risk stratification and diagnosis of patients presenting with symptoms of acute coronary syndrome (ACS). Established biomarkers for diagnosis of ACS includes troponins and creatine kinase MB (CK-MB). Pregnancy associated plasma protein A (PAPP-A) is an emerging marker which has been described as a marker of plaque instability. PAPP-A is a large metalloproteinase involved in insulin-like growth factor signaling and has been shown to be involved in pathological processes like atherosclerosis. Many studies have been published regarding release of PAPP-A in circulation during ACS. The objective of this study was to evaluate the role of PAPP-A as an early marker of ACS by comparing levels of PAPP-A in patients with acute myocardial infarction (AMI) and unstable angina (UA) with asymptomatic controls. The association of PAPP-A with markers of myocardial necrosis and the association of PAPP-A levels to the presence of risk factors for coronary artery disease was also studied. We measured PAPP-A levels in patients with AMI (30), UA (23) and asymptomatic controls (45). PAPP-A was estimated using PAPP-A US (ultra sensitive) ELISA manufactured by DRG (Germany). PAPP-A levels were significantly elevated in patients with AMI and in patients with UA (mean levels 64.26 ± 1.05 and 36.23 ± 1.05 ng/ml respectively; p < 0.001). Mean PAPP-A levels in controls were 10.68 ± 1.04 ng/ml. In UA cases PAPP-A levels were elevated when the troponin I and CK-MB levels were within the normal range. No correlation was observed between PAPP-A with markers of myocardial necrosis. PAPP-A can serve as a useful biomarker in the diagnosis of ACS, especially UA, where cardiac troponin levels and CK-MB levels are not elevated and ECG changes are inconclusive. 相似文献
11.
Serum creatine kinase MB isoenzyme (CKMB) and myoglobin have been studied in 35 cases with myocardial infarction. Increased values for both serum CKMB and myoglobin have been found in all the patients in the second sample collected 4 hr. after admission while in 22 patients in the first sample collected immediately after admission. Thus, the present study shows a good correlation between serum CKMB and myoglobin and therefore, suggests the possibility of using the serum myoglobin estimation in early detection of myocardial infarction either alone or in combination with the serum CKMB. 相似文献
12.
Santosh K. Shukla Suman B. Sharma Usha R. singh 《Indian journal of clinical biochemistry : IJCB》2015,30(1):27-34
Sustained high levels of circulating catecholamines are reported to induce cardiotoxicity. Isoproterenol (ISP), a synthetic catecholamine has been widely employed to induce myocardial injury, though the role of inflammation and apoptosis is not well established. This study was designed to investigate the underlying mechanism of oxidative damage, inflammatory signaling, cell death in ISP induced myocardial infarction in rats. Wistar albino rats were divided in two groups: group I (sham control) and group II (ischemic control). ISP (85 mg/kg, s.c.) was administered at an interval of 24 h to group II for two consecutive days. On day third, after 48 h of the first injection of ISP, blood was collected from retro orbital plexus of rat eyes to estimate the biochemical parameters. Glutathione (GSH) and superoxide dismutase (SOD) were measured for antioxidant status. Similarly, malondialdehyde (MDA) was measured as an index of lipid peroxidation. Cardiac markers (SGOT, CK-MB, TropI and LDH) and pro-inflammatory cytokines (IL-6, CRP and TNF-α) were also estimated in ISP-induced rats. At the end of experiments animals were sacrificed for histopathological studies. GSH and SOD showed significant decrease after ISP challenge as compared to sham (control) group (p < 0.01) while MDA level, increased significantly (p < 0.01). ISP, also increased the level of cardiac markers and markers of inflammation significantly (p < 0.01), which was further verified by histopathological studies of the heart tissues. The study confirmed that ISP causes detrimental changes in the myocardium by altering cardiac and inflammatory markers, which leads to severe necrosis. The deleterious effects produced by ISP substantiate its suitability as a novel animal model for evaluation of cardioprotective agents/drugs. 相似文献
13.
Enzymology is a diagnostic indicator for myocardial infarction and diabetes in hypertension patients. Therefore the selection
of methods for measurement of cardiac enzyme, Aspartate transaminase (AST), Creatine kinase(CK), and isoenzyme of creatine
kinase (MB form), determine the effectiveness of antihypertension drug would provide the physician with diagnostic and prognostic
clinical evidence. 相似文献
14.
Shalia KK Mashru MR Soneji SL Shah VK Payannavar S Walvalkar A Mokal RA Mithbawkar SM Kudalkar KV Abraham A Thakur PK 《Indian journal of clinical biochemistry : IJCB》2010,25(3):273-279
Platelet-endothelial cell adhesion molecule-1 (PECAM-1) has role in atherosclerotic plaque development as well as in thrombosis leading to myocardial infarction (MI). Present study was aimed to analyse the association of PECAM-1 Leu125Val gene polymorphism with MI in Indian population. Subjects included healthy individuals as control (N = 116) and MI patients (N = 100) divided into two groups; MI patients at presentation of the acute event (MI-Group-1, N = 46) and patients with recent event of MI stabilized with treatment 4.5 days from their symptoms (MI-Group-2, N = 54). The difference in the distribution of Leu125Val genotype frequencies of controls and patients did not reach statistical significance. However Leu allele frequency (0.57) was more associated with MI patients as compared to control (0.504). sPECAM-1 levels were significantly elevated in patients at acute event of MI (MI-Group-1) by 44.1% (P = 0.009) as compared to controls and by 95.2% (P = 0.001) as compared to stabilized MI patients (MI-Group-2). 相似文献
15.
Mukesh Nandave Ipseeta Mohanty T. C. Nag Shreesh Kumar Ojha Rajan Mittal Santosh Kumari Dharamvir Singh Arya 《Indian journal of clinical biochemistry : IJCB》2007,22(1):22-28
The present study evaluated the cardioprotective potential of vitamin-E by studying its effect on hemodynamic parameters,
lipid peroxidation, myocyte injury marker and ultrastructural changes in model of isoproterenol-induced myocardial necrosis
in rats. Wistar albino male rats (150–200 g) were randomly divided into saline, ISP control, and vit E groups. Vitamin E group
was administered vitamin E at a dose of 100mg/kg/day while saline and ISP control groups received saline orally for one month.
On 29th and 30th day, ISP (85 mg/kg, sc) was administered at an interval of 24 h to vit E and ISP control rats. On 31st day, rats of all groups were anesthetized and hemodynamic parameters were recorded. At the end of experimentation, animals
were sacrificed; hearts were excised and processed for biochemical and ultrastructural studies. ISP administration produced
marked cardiac necrosis as evidenced by significant decrease in my ocardial creatine kinase-MB as well as increase in malonaldialdehyde
levels. ISP-induced myocardial necrosis resulted in myocardial dysfunction as evidenced by significant depression in heart
rate and mean arterial pressure in the ISP control group as compared to saline control. Salient ultrastructural changes including
extensive loss of myofibrils, muscle necrosis, loss of mitochondria, and formation of several intracytoplasmic vacuoles and
lipid droplets further confirmed the ISP-induced myocardial damage. However, subsequent to ISP challenge, vit E treatment
significantly preserved the myocardium by restoring myocardial CK-MB activity, inhibiting the ISP-induced lipid peroxidation
and ultrastructural changes. Additionally, pre-and co-treatment of vit E prevented the deleterious ultrastructural changes
caused by ISP. These beneficial effects of chronic vit E treatment also translated into significant restoration of the altered
hemodynamic parameters. The present study clearly demonstrated the cardioprotective potential of vit E at dose of 100 mg/kg
in ISP-induced model of myocardial necrosis in rats. The significant restoration of altered hemodynamic parameters, myocardial
CK-MB activity, prevention of ISP-induced rise in lipid peroxidation and ultrastructural changes may confirm its cardioprotective
effect. 相似文献
16.
Fleming JJ Janardhan HP Jose A Selvakumar R 《Indian journal of clinical biochemistry : IJCB》2011,26(1):32-40
In the present study, the cause of suspected false-positive (anomalous) values for CK-MB activity, in Indian patients investigated
for ACS. Total serum CK and CK-MB activity, serum Troponin I were measured and CK-MB as a percentage of the total CK activity
(%CK-MB) calculated. CK-MB was also estimated using densitometry and CK-MB mass assay. Anomalous specimens were tested for
the presence of CK isoenzymes. In 22 healthy subjects, 11 male and female, the %CK-MB ranged from 3.6 to 30.2. In 11 male
patients, with proven ACS, the %CK-MB was from 4.0 to 17.5. The cut off for anomalous CK-MB activity values was set as >33.0%.
In 35 patients with anomalies, total CK values ranged from 39 to 231 U/L, CK-MB from 30 to 161 U/L. Investigation of CK isoenzymes,
showed 10 patients had a CK-BB band, 14 an intermediate band between CK-MM and CK-MB (macro-CK type 1), 7 had a cathodal band
(macro-CK type 2), and 3 had a band intermediate between CK-MB and CK-BB. This later band does not seem to have been previously
reported. Against the CK-MB mass assay, the activity assay showed no correlation, in 43 patients (19 M, 24 F), Pearson coefficient
(R2) was 0.006. The CK-MB immunoinhibition assay is better described as measuring “non-CK-MM activity.” A %CK-MB activity >6%
as a marker of ACS is not valid in our patient population. Laboratories should not use only CK-MB activity as a biochemical
marker of ACS. 相似文献
17.
Kavita K. Shalia V. K. Shah M. R. Mashru S. L. Soneji J. B. Vasvani S. S. Payannavar A. P. Walvalkar R. A. Mokal S. M. Mithbawkar K. V. Kudalkar A. Abraham P. K. Thakur 《Indian journal of clinical biochemistry : IJCB》2010,25(1):20-28
The study aimed to analyze the circulating levels of thrombotic and haemostatic components; tissue factor, tissue factor pathway inhibitor, tissue plasminogen activator and plasminogen activator inhibitor-1 in patients with acute myocardial infarction at presentation (Group 1, n=49), unstable angina and Non-ST elevated MI after treatment (Group 2, n=22), stable angina (Group 3, n=18) and healthy individuals (Group 4, n=31). Significant finding was increase in tissue factor not only in Group 1 (2.0 fold, P=0.001), Group 2 (2.2 fold, P=0.015) but also in Group 3 (1.8 fold, P=0.018) as compared to controls. In Group 1 Plasminogen activator inhibitor-1 increased significantly (35.8%, P=0.02). Tissue factor pathway inhibitor and tissue plasminogen activator demonstrated increase in Group 1 of age<40 years while insignificant changes in elder patients. Increased thrombotic and decreased fibrinolytic conditions in acute myocardial infarction patients were observed. Increase TF in stable angina demonstrates procoagulant status in these patients as well. 相似文献
18.
R. Chawla Navendu Goyal Rajneesh Calton Shweta Goyal 《Indian journal of clinical biochemistry : IJCB》2006,21(1):77-82
Early identification of patients with acute myocardial infarction is of prime importance due to the associated very high mortality.
Only 22% of the patients presenting at emergency cardiology care with chest pain have coronary disease. A number of biochemical
tests like CKMB and Troponin-T/I have been introduced for early detection of the coronary syndrome (ACS). Ischemia modified
albumin (IMA) has been recently introduced as a marker of myocardial ischemia. We estimated serum IMA in four sequential samples
from 25 patients admitted to ICCU. Twenty five healthy volunteers formed the control group from which the normal range was
derived. IMA was significantly raised in ischemia patients than in controls as well as compared to the patients who did not
have cardiac ischemia. IMA demonstrated good discrimination between the ischemic and the non-ischemic patients with an Odds
Ratio of 16.9 (6.29–46.87) than CKMB which showed an Odds Ratio of 2.07 (1.18–6.08). Sensitivity and specificity of IMA for
the detection of ACS was 78.0% and 82.7% compared to 58.0% and 60.0%, respectively for the CK-MB assay. The area under the
ROC curve of IMA for ischemic v/s non-ischemic patients was 0.834. IMA appears to be developing into a new and very potent
marker, of cardiac ischemia. 相似文献
19.
J. H. Keffer M.D. 《Indian journal of clinical biochemistry : IJCB》1999,14(1):34-39
In this paper, I have attempted to place the evolving insights of the pathophysiology of coronary atherosclerosis in the context
of the conventional perspective of clinical medicine. We strive to prevent death and to relieve suffering. Our clinical tools
are critical but limited. Troponin, a biomarker of unprecedented organ specificity, in the context of the appropriate setting
of new chest pain (or its equivalent syndrome), is an extraordinary aid to clinical diagnosis. Highly effective therapy is
evolving which reduces loss of myocardium, undoubtedly reducing not only acute death but progression to congestive heart failure.
Even if the newer therapies of the GpIIb/IIIa platelet antagonists and antithrombins are not yet widely employed, or may not
be available to some physicians, the convincing demonstration of myocardial injury by troponin presents objective evidence
to both the patient and the attending physician that serious compliance with a program of risk reduction must be urgently
considered. Hoeg has described the mosaic of risk factors beyond the conventional and often ignored basic ones (JAMA, 1997,
277, 1387–1390). He provides thoughtful hope and encouragement for both patient and physician to do more in prevention of
the subsequent predictable progression. We should look on a troponin positive vague unstable angina event as similar to a
tremor which preceeds a subsequent earthquake. Although the mass of myocardium lost in such an episode may be small, it is
a warning of the major acute myocardial infarction which can be predicted to follow at a later time if the course of the individual
patient is not altered. Troponin is the objective evidence. 相似文献
20.
Neela Patil Vishwas Chavan N. D. Karnik 《Indian journal of clinical biochemistry : IJCB》2007,22(1):45-51
Free radicals play an important role in the pathogenesis of tissue damage in many clinical disorders, including atherosclerosis.
Antioxidants protect the body from damage caused by free radicals. In this study we investigated oxidative stress, antioxidants
and inflammatory molecules in patients with acute myocardial infarction. This study has been carried out on 106 patients with
acute myocardial infarction, (89 men and 17 females). The control group consisted of 50 healthy, age-matched subjects (40
men and 10 females). Levels of Glucose, lipid profile, glutathione reduced, glutathione peroxidase, Superoxide dismutase,
Glycosylated hemoglobin, fibrinogen, vitamin C, vitamin E, malondialdehyde, ceruloplasmin, adenosine deaminase, lysozyme and
sialic acid were measured. Malondialdehyde and ceruloplasmin levels were significantly high and antioxidants such as vitamin
C, vitamin E, glutathione reduced, glutathione peroxidase and superoxide dismutase were significantly decreased in diabetic
and non-diabetic AMI patients as compared with control (p<0.001). Inflammatory markers showed significant rise in diabetic
patients as compared with controls. Our results clearly show increased inflammation and oxidative stress in patients with
acute myocardial infarction. Depression of antioxidant system in these patients confirms this conclusion. 相似文献