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.
INTRODUCTIONAcute myocardial infarction (AMI), commonly known as a heart attack, results from the interruption of blood supply to a part of the heart, causing heart cells to die. This is most commonly due to occlusion of a coronary artery following the rupture of a vulnerable atherosclerotic plaque which is an unstable collection of lipids (cholesterol and fatty acids) and white blood cells (especially macrophages) in the wall of an artery. The resulting ischemia (restriction in blood supply) and ensuing oxygen shortage, if left untreated for a sufficient period of time, can cause damage or death (infarction) of heart muscle tissue (i.e. myocardium). 1,2Acute myocardial infarction (AMI) continues to be a major cause of morbidity and mortality worldwide.3,4 It remains a leading cause of death in India and represents an enormous cost to health care system. 5 The mortality rate of MI is approximately 30% and for every 1 in 25 patients who survive the initial hospitalization, dies in the first year after AMI. Indians are four time more prone to AMI as compared to the people of other countries due to a combination of the genetic and lifestyle factors that promote metabolic dysfunction. The risk of ABSTRACT Background: Acute myocardial infarction (AMI) is a significant cause of morbidity and mortality worldwide, which results from occlusion of coronary artery. Dyslipidemia is a major risk factor of AMI. C-reactive protein (CRP) is an acute phase protein, synthesized by hepatocytes in response to cytokines released into circulation by activated leukocytes and has been found to increase after AMI. The objective of the present study is to investigate lipid profile in AMI patients and correlate it with inflammatory marker i.e. CRP. Methods: The present study includes 150 AMI patients and 100 normal healthy individuals as controls. In all the cases and controls, serum lipid profile and inflammatory marker were measured by diagnostic kits supplied by ERBA. Results: The levels of lipid profile and inflammatory marker were significantly altered in the AMI cases compared to controls. We found significantly higher levels of total cholesterol, TG, LDL, VLDL, CRP and lower level of HDL in AMI compared to that of control subjects. We also found strong positive correlation of CRP with total cholesterol, triglyceride, LDL-C and VLDL-C and significant negative correlation with HDL-C in AMI patients. Conclusions: We found alterations in the lipid profile and inflammatory marker in AMI cases; hence, all the people should undergo regular check up including lipid profile evaluation and inflammatory marker such as CRP to decrease the incidence, morbidity and mortality from the disease.
Background: Hypertension (HTN) is the most common cardiovascular disease. The objectives of present study are to investigate the comparison between cilnidipine and losartan with respect to changes in blood pressure (BP) and heart rate (HR) in hypertensive patients with or without type 2 diabetes mellitus (DM).Methods: We conducted a longitudinal, prospective, open labelled, comparative clinical study of hypertensive patients with or without type 2 DM. Of 161 enrolled hypertensives, 130 completed the study with follow up over a period of one year. Group I (n=34); and Group III (n = 32) patients with type 2 DM received cilnidipine 10-20mg orally OD. Group II (n =33); and Group IV (n = 31) patients with type 2 DM received losartan 50-100mg orally OD. The dosages were adjusted if the magnitude of reduction was insufficient. The parameters were monitored during follow – up at 4, 8 and 12 weeks.Results: Levels of systolic and diastolic BP and HR significantly decreased with both drugs. However, magnitude of HR reduction was greater with cilnidipine groups as compared to losartan groups with statistically significant difference (group I 70.79±9.21 versus group II 79.42±8.25, p = 0.000 and group III 76.25±7.08 versus group IV 81±7.15, p = 0.010). Of 161 patients, only 1 patient experienced hot flushes from group I.Conclusions: The present study demonstrated that therapy with cilnidipine can be used safely and effectively in hypertensive patients with or without diabetes. Cilnidipine was equally efficacious in lowering BP, while it more effectively reduced HR as compared to losartan. Cilnidipine can, therefore, be recommended as an alternative especially when there is associated tachycardia.
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