Strategies for the Early Diagnosis of Acute Myocardial Infarction Using Biochemical Markers

Abstract

We evaluated different diagnostic strategies for the early diagnosis of acute myocardial infarction, combining sensitivity and specificity of different markers evaluated singly and using combination testing in parallel and serial modes. Myoglobin, cardiac troponin I (TnI), creatine kinase (CK), and CK-MB mass were tested in blood samples from 26 patients with acute myocardial infarction collected at admission (T0; mean = 3.3 hours from the onset of chest pain) and 3 and 6 hours later. The comparison group was made up of 70 patients with renal failure, skeletal muscle diseases, stable angina, unstable angina, and chest pain of nonischemic origin. Single tests showed different sensitivities in relation to the different release kinetics; myoglobin was the most sensitive (69% at T0) although less specific (46%), and TnI showed the highest specificity (90%) and a sensitivity of 54%. Combination testing in a parallel mode using myoglobin and TnI or CK-MB had the same sensitivity and specificity as myoglobin tested singly. The best combination in a serial mode is myoglobin and TnI (at T0 sensitivity, 54%; specificity, 98%), as confirmed by the analysis of the positive predictive value, the negative predictive value, and the accuracy evaluated as a function of different disease prevalences.

Monitoring of Impending Myocardial Damage After Pleuropneumonectomy and Intraoperative Photodynamic Therapy for Malignant Pleural Mesothelioma Using Biochemical Markers

“…The serum concentra-tion of cTnI or cTnT seems to be the best biochemical marker for the detection of minor myocardial damage (10). Recently, for reasons of an insufficient sensitivity in the first hours following acute coronary syndromes, it was recommended to use another, more early, myocardial marker, such as myoglobin, in the cardiac panel for routine laboratory testing (11,12).…”

Sensor systems for medical application based on hemoproteins and nanocomposite materials

“…При остром инфаркте миокарда (ОИМ) концентрация миоглобина резко повышается от нормы (женщины 12-76 нг/мл, мужчины 19-92 нг/мл) до 1500 нг/мл (86 нМ) [134][135][136]. При инфаркте миокарда выраженность гипермиоглобинемии находится в прямой зависимости от размеров очага некроза [137][138][139][140]. По уровню миоглобина можно судить об обширности ОИМ.…”

SERS-Active Substrates Nanoengineering Based on e-Beam Evaporated Self-Assembled Silver Films

“…Detection of ultra-low proteins concentration in solution using novel physical effects like plasmonics, surface-enhanced Raman spectroscopy, and photonic waveguide-based sensors are promising techniques for novel medical diagnostics [1][2][3][4][5][6][7]. In particular, a low myoglobin concentration is a relevant marker of myocardial infarction in human blood plasma [8][9][10]. It is well known that the amplified SERS response of organic molecules could be obtained by depositing those on specially designed silver, gold or copper thin film substrates [11][12][13][14][15], as well as using silver or gold colloidal nanoparticles in solution [16][17][18][19].…”