Novel biochemical markers in suspected acute coronary syndrome: systematic review and critical appraisal

Dekker, Marieke S.; Mosterd, Arend; Hof, Arnoud W J van ‘t; Hoes, Arno W.

doi:10.1136/hrt.2009.189886

Cited by 86 publications

(53 citation statements)

References 108 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Wilcoxon-próbát alkalmaztunk a felvételkori és a később (6 órán belül) elvégzett hsTn-mérés eredményeinek összehasonlítására. Beszédzavar (1) Apoplexia cerebri (1) Eszméletvesztés (35) AMI (3), delirium tremens (1), epilepszia (3), exsiccosis (1), hyperglikaemiás ketoacidosis (3), hypoglikaemia (2), ictus caloris (1), sokk (2), collapsus (2), pancreatitis acuta (2), fi brillatio auricularis (4), rhabdomyolysis (3), apoplexia cerebri (3), arrhythmia cardiaca (2), embolia pulmonum (2), infarctus cerebri (1) Fejfájás (2) Cephalalgia (1), hypertonia (1) Fulladás (30) Bronchitis acuta (5), COPD (1), hydrothorax (2), bronchitis chronica (1), decompensatio cardiaca (9), fi brillatio auricularis (3), pneumonia (4), neoplasma pulmonum malignum (2), oedema pulmonum (3) Gyengeség (20) Infarctus cerebri (1), cholecystitis (1), exsiccosis (2), anxietas (1), TIA (15) Hányás (3) Gastritis acuta (1), subileus (2) Hasfájás (5) Exsiccosis (1), hyperaciditas (1), pancreatitis acuta (1), szeptikus sokk (2) Lábduzzadás (5) MVT (2) [5]. Az AMI bekövetkezte utáni praenecrosis-és necrosis-biomarkerek koncentrációjának változását mutatja a 3. ábra.…”

Section: Statisztikai Elemzésunclassified

See 1 more Smart Citation

Automatizáltan mérhető biomarkerek az akut myocardialis infarctus diagnosztikájában

et al. 2015

View full text Add to dashboard Cite

Kanizsai Dorottya Kórház, Sürgősségi Osztály, NagykanizsaBevezetés: A szív biomarkerei kiemelkedő szerepet kaptak az akut myocardialis infarctus diagnosztikájában. Célkitűzés: A szerzők automatizáltan mérhető szívbiomarkerek diagnosztikai hatékonyságát vizsgálták. Módszer: Mieloperoxidázt, nagy érzékenységű C-reaktív fehérjét, mioglobint, szívtípusú zsírsavkötő fehérjét, kreatinkinázt, kreatinkináz-MB-t, nagy érzékenységű troponin-I-t és -T-t mértek. Eredmények: Akut myocardialis infarctusban a leghatéko-nyabbnak (görbe alatti terület: 0,86; 95%-os megbízhatósági tartomány: 0,77-0,95; p<0,001) a nagy érzékenységű troponin-I bizonyult. A kritikus értéknél (0,35 ng/mL) az érzékenység 81%, a fajlagosság 74% volt. A nagy érzékeny-ségű troponin-T, -I, a mellkasi fájdalom és az elektrokardiogram együttes értékelése különítette el legjobban az akut myocardialis infarctust az egyéb kórképektől (korrekt besorolás: 62,5% és 98,9%). Következtetések: Amíg nem áll rendelkezésre megfelelő érzékenységű és fajlagosságú szívbiomarker, addig nincs jobb módszer az akut myocardialis infarctus gyanúja esetén, mint 3-6 óra múlva újra elvégezni az elektrokardiogram-és biomarker-vizsgálatot. Orv. Hetil., 2015, 156(24), 964-971. Kulcsszavak: akut myocardialis infarctus, szívbiomarkerek Automated measurement of biomarkers for the diagnosis of acute myocardial infarctionIntroduction: Cardiac biomarkers have a prominent role in the diagnosis of acute myocardial infarction. Aim: The aim of the authors was to study the diagnostic effectiveness of automated measurement of cardiac biomarkers. Method: Myeloperoxidase, high-sensitivity C-reactive protein, myoglobin, heart-type fatty acid binding protein, creatine kinase, creatine kinase MB, high-sensitivity troponin I and T were measured. Results: The high-sensitivity troponin I was the most effective (area under curve: 0.86; 95% confi dence interval: 0.77-0.95; p<0.001) for the diagnosis of acute myocardial infarction. Considering a critical value of 0.35 ng/mL, its sensitivity and specifi city were 81%, and 74%, respectively. Combined evaluation of the high-sensitivity troponin T and I, chest pain, and the electrocardiogram gave the best results for separation of acute myocardial infarction from other diseases (correct classifi cation in 62.5% and 98.9% of patients, respectively). Conclusions: Until a more sensitive and specifi c cardiac biomarker becomes available, the best method for the diagnosis of acute myocardial infarction is to evaluate electrocardiogram and biomarker concentration and to repeat them after 3-6 hours.

show abstract

Section: Statisztikai Elemzésunclassified

“…Ebből adódik magasabb diagnosztikus hatékonysága. Ezért másokkal egyetértve: a MYO helyett kellene mérni, mint korai markert [15]. A hsTnI sokkal érzékenyebbnek, de kevésbé fajlagosnak bizonyult, mint a hsTnT AMI-ban.…”

Section: Statisztikai Elemzésunclassified

Automatizáltan mérhető biomarkerek az akut myocardialis infarctus diagnosztikájában

et al. 2015

View full text Add to dashboard Cite

show abstract

“…The use of alternative markers has been reviewed in detail previously [17] . However, most of the studies evaluated in this review neither compared the alternative markers with cTn nor assessed the potential added value.…”

Section: Myoglobinmentioning

confidence: 99%

“…Due to its small size, H-FABP is rapidly cleared from the blood by the kidney. H-FABP has been widely analyzed for its potential in the diagnosis of MI [17] . Most studies suggest that the diagnostic performance of H-FABP is comparable to the conventional cTn assays.…”

Section: Heart Type Fatty Acid Binding Protein (H-fabp)mentioning

confidence: 99%

“…It should be noted that the modification of albumin and therefore the determination of IMA is not specific for myocardial ischemia. Many studies have been performed to assess the diagnostic value of IMA in the work-up of patients with suspected MI [17,24] . Most of them show that IMA is not specific enough to serve as a single biomarker for MI.…”

Section: Ischemia Modified Albumin (Ima)mentioning

confidence: 99%

See 1 more Smart Citation

Laboratory diagnostics of myocardial infarction – troponins and beyond

Lackner

2012

Clinical Chemistry and Laboratory Medicine (CCLM)

View full text Add to dashboard Cite

In the case of suspected acute coronary syndrome and myocardial infarction positive diagnosis or exclusion strongly depend on the use of biomarkers and in particular cardiac troponins (cTn). Especially in the early phase of myocardial infarction the sensitivity of cTn assays has been unsatisfactory. This has led to the investigation of many other potential markers for the early diagnosis of myocardial infarction. In addition, several traditional markers have been advocated, e.g., myoglobin, as these were considered to be more sensitive than cTn. With the advent of high-sensitive (hs) cTn assays the value and practical use of the alternative or additional markers has to be reassessed. According to the currently available data, no single marker is superior to hs-cTn for the diagnosis of acute myocardial infarction. In particular, the notion of superior sensitivity of myoglobin compared to cTn no longer holds true. There are two protein markers, hearttype fatty acid binding protein and copeptin, and plasma free fatty acids that may increase the diagnostic value and specifically the negative predictive value when determined on admission in combination with hs-cTn. However, the incremental gain, if any, is small. Further data are needed to determine, whether these markers can in fact improve diagnosis and if they are superior to the recommended use of the relative or absolute change of hs-cTn after 3 h.

show abstract

Early assessment of acute coronary syndromes in the emergency department: the potential diagnostic value of circulating microRNAs

et al. 2012

View full text Add to dashboard Cite

Previous studies investigating the role of circulating microRNAs in acute coronary syndrome (ACS) were based on small patient numbers, performed no comparison with established markers of cardiac injury and did not have appropriate controls. We determined the potential diagnostic value of circulating microRNAs as novel early biomarkers in 332 suspected ACS patients on presentation to the emergency department (ED) in a prospective single-centre study including cardiac miRNAs (miR-1, -208a and -499), miR-21 and miR-146a. Levels of all miRs studied were significantly increased in 106 patients diagnosed with ACS, even in patients with initially negative high-sensitive (hs) troponin or symptom onset <3 h. MiR-1, miR-499 and miR-21 significantly increased the diagnostic value in all suspected ACS patients when added to hs-troponin T (AUC 0.90). These three miRs were strong predictors of ACS independent of clinical co-variates including patient history and cardiovascular risk factors. Interestingly, the combination of these three miRs resulted in a significantly higher AUC of 0.94 than hs-troponin T (0.89). Circulating microRNAs hold great potential as novel early biomarkers for the management of suspected ACS patients.

show abstract

Novel biochemical markers in suspected acute coronary syndrome: systematic review and critical appraisal

Abstract: IMA and H-FABP seem to be promising biomarkers in the early assessment of ACS. There is an urgent need for adequately designed diagnostic studies of (novel) ACS markers against contemporary troponin assays.

Cited by 86 publications

References 108 publications

Automatizáltan mérhető biomarkerek az akut myocardialis infarctus diagnosztikájában

Automatizáltan mérhető biomarkerek az akut myocardialis infarctus diagnosztikájában

Laboratory diagnostics of myocardial infarction – troponins and beyond

Early assessment of acute coronary syndromes in the emergency department: the potential diagnostic value of circulating microRNAs

Contact Info

Product

Resources

About