Background. The diagnosis of non-ST-segment elevation myocardial infarction (NSTEMI) is required early and accurate to avoid missing diagnosis and improve the rule out of AMI patients. There is a relationship between AMI and the state of hypercoagulation and/or thrombosis process. sFM is a protrombotic marker that is found to be associated with early AMI incidence compared to cTnI that increases after mionecrosis. The aim of this study is to determine that sFM can be used as biomarker for AMI and the correlation between sFM and cTnI.Methods. A cross-sectional analytic observational study was conducted among 23 AMI patients and 27 healthy controls. AMI were established using clinical, ECG and laboratory findings. sFM levels were measured with Stago Compact Max analyzer. Statistical analysis was performed using the Spearman’s correlation coefficient, ROC curve analysis, and 2x2 contingency table.Results. A significant correlation were found between the sFM and the cTnI (r=0.422, p<0.05). With a sFM cutoff level of 2.56 µg/mL, AMI could be diagnosed with sensitivity and specificity of 82.6% and 40.7%, respectively (AUC=0,638).Discussion. sFM is a new biomarker for systemic thrombus events, both cardiac and non-cardiac.Conclusions and Suggestions. sFM can be considered as an parameter of AMI. Similar studies with cohort method involving large number may be needed in the future study.
Introduction. Alpha-Fetoprotein (AFP) is a tumor marker that has been widely used for HCC, but there has been no increased AFP in 35-45% patients with HCC. Protein induced by vitamin K absence or antagonist II (PIVKA-II) is an abnormal prothrombin secreted in HCC and is expected can be used for HCC diagnostic marker. The objective of this study was to compare serum PIVKA-II levels in the patients with HCC, cirrhosis and healthy control and determine the diagnostic value of PIVKA-II for hepatocellular carcinoma. Methods. This was a cross-section analytic observational study to identify the diagnostic value of PIVKA-II for HCC diagnosis. The diagnosis of 20 cirrhotic patients and 15 patients with HCC was established by history taking, physical examination, and additional examination according to the diagnosis criteria. A group of 12 individuals with normal liver function were used as healthy control subjects. Serum PIVKA-II levels were analyzed with immunoassay method. Comparison study used the Independent-Samples Kruskal Wallis Test. ROC curve analysis and 2x2 contingency table was used to calculate sensitivity, specificity, positive and negative predictive value (PPV and NPV).Results. The serum PIVKA-II level in the patients with HCC was significantly higher than in cirrhotic (p = 0,000) and healthy control patients (p = 0,000). Sensitivity, specificity, PPV, and NPV of PIVKA-II for diagnosis of HCC in cirrhotic patients at a cut-off value of 140.85 mAU/mL were 93.33%, 75%, 73.68%, and 93.75%, respectively (AUC = 0.87).Conclusions and Suggestions. PIVKA-II has high diagnostic value for HCC diagnosis. Diagnostic test that compare serum PIVKA-II level in any size of HCC nodules may be needed in the future.
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