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1.
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   

2.
Myocardial ischemia produces free radicals that catalyze a series of oxidative reactions that damage healthy tissues. The N-terminal sequence of albumin is one of the proteins modified by these highly reactive oxygen species and forms the ischemia modified albumin (IMA). This study involves investigations undertaken in different study groups to assess the levels of IMA. Mean serum IMA levels (U/mL) in patients with ST-segment elevated myocardial infarction (92.1 ± 10.6), non-ST-segment elevated myocardial infarction (87.3 ± 5.95) and unstable angina (UA) (88.9 ± 6.16) were significantly higher than non-cardiac chest pain (77.9 ± 6.69) and also healthy subjects (54.7 ± 17.2) (p < 0.001). IMA is a highly sensitive marker and has a high predictive value, which might prove the usefulness of this biomarker for early detection of myocardial ischemia. These data indicate a possible role of the IMA test in the early triage of patients with chest pain.  相似文献   

3.
Infants with respiratory distress syndrome (RDS) may suffer from severe hypoxia, asphyxia. In this study, we aimed to evaluate serum ischemia-modified albumin (IMA) level as a diagnostic marker for hypoxia in preterm infants with RDS. Thirty-seven premature newborns with RDS were allocated as the study group and 42 healthy preterm neonates were selected as the control group. IMA was measured as absorbance unit (ABSU) in human serum with colorimetric assay method which is based on reduction in albumin cobalt binding. IMA levels were significantly higher in neonates with RDS as compared to the control group (P < 0.001). Cut-off value of IMA (ABSU) was 0.72, the sensitivity level was 91.9 %, the specificity was 78.6 %, positive predictive value was 79.1 % and negative predictive value was 91.7 % at RDS. Area under curve values was 0.93 (P < 0.001; 95 % CI, 0.88–0.98) in the receiver operating characteristic curve. We concluded that elevated blood IMA levels might be accepted as a useful marker for hypoxia in newborn with RDS.  相似文献   

4.
Myocardial infarction is a major consequence of coronary artery disease. Apart from the traditional risk factors of myocardial infarction, recently many reports have suggested that hyperhomocysteinemia plays important role in myocardial infarction. Plasma homocysteine level was determined in 60 myocardial infarction patients and in 35 age matched healthy individuals. Statistically significant differences (p<0.01) were observed in the mean of plasma homocysteine concentrations between the acute myocardial infarction patients (24.59±6.14 mM/L) and in normal healthy individuals (13.73 ±3.54 mM/L). The level of homocysteine in myocardial infarction patients is significantly high (p <0.01) among myocardial infarction patients when compared to that of the controls. The the present study indicates a strong association between plasma homocysteine and acute myocardial infarction among Tamilians, thus implying plasma homocysteine as a possible risk factor for myocardial infarction.  相似文献   

5.
Blood samples from 39 patients with acute myocardial infarction and 15 healthy controls were analysed for serum and platelet sialic acid. Serum sialic acid levels in patients with acute myocardial infarction were significantly higher than controls (mean 2.7±0.46 μmol/ml Vs. 1.91±0.17 μmol/ml respectively). Levels of serum orosomucoid, an acute phase reactant, containing sialic acid, were also higher in these patients, suggesting a possible non-specific mechanism of increase in serum sialic acid concentration. In contrast, platelets contained significantly less sialic acid in patients with acute myocardial infarction than control (26.73±1.57 nmol/mg protein and 31.97±2.68 nmol/mg protein respectively).  相似文献   

6.
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   

7.
Acute myocardial Infarction is one of the major causes of morbidity & mortality in world and atherosclerosis is the major cause of ischemic heart disease. In order to determine the better clinical marker of atherosclerosis, we estimated serum low-density lipoprotein (LDL-C) and high sensitivity C-reactive protein (hsCRP). Hundred patients of myocardial infarction and 100 controls irrespective of age and sex were studied for these parameters over a period of 2 years. The statistical analysis showed that the serum hsCRP was significantly raised in myocardial infarction cases than controls (P < 0.01) but LDL-C was not (P > 0.05). We conclude that the serum hsCRP has better predictive value for risk of atherosclerosis.  相似文献   

8.
Biochemical markers of myocardial injury   总被引：1，自引：0，他引：1  
The serum markers of myocardial injury are used to help in establishing the diagnosis of myocardial infarction. The older markers like aspartate amino-transferase, creatine kinase, lactate dehydrogenase etc. lost their utility due to lack of specificity and limited sensitivities. Among the currently available markers cardiac troponins are the most widely used due to their improved sensitivity specificity, efficiency and low turn around time. Studies have shown that cardiac troponins should replace CKMB as the diagnostic ‘gold standard’ for the diagnosis of myocardial injury. The combination of myoglobin with cardiac troponins has further improved the accuracy in the diagnosis of acute coronary syndromes and thereby reducing the hospital stay and patients' money. Among the other new markers of early detection of myocardial damage, heart fatty acid binding protein, glycogen phosphorylase BB and myoglobin/carbonic anhydrase III ratio seem to be the most promising. But the search for the most ideal marker of myocardial injury is still on.  相似文献   

9.
Cholesterol synthesis and its suppression by LDL was measured in freshly isolated leucocytes from patients with acute myocardial infarction and healthy controls. Cells incubated for different time intervals in lipoprotein-deficient serum exhibited increased cholesterol synthesis. The magnitude of this increase was far greater in leucocytes of hyperlipemic patients than in normolipemic patients. Addition of LDL to the incubation medium produced suppression of cholesterol synthesis. This reduction was less in hyperlipemic patients as compared to normolipemic patients. These observations may imply reduced suppression of HMG-CoA reductase activity with high endogenous cholesterol synthesis in patients suffering with acute myocardial infarction.  相似文献   

10.
Changes in the levels of glycoprotein (GP) and glycosminoglycans (GAG) were studied in diabetes associated with myocardial infarction in rats. Diabetes was induced by alloxan while myocardial infarction was induced using isoproterenol. Most of the GAG fraction increased in the heart and aorta in diabetes superimposed with myocardial infarction. The carbohydrate of GP also increased in heart while in serum only sialic acid showed an increase. The activity of lysosomal enzymes showed an increase in the case of β-glucuronidase and β-hexosaminidase while in the case of β-galactosidase and β-fucosidase it showed a decrease in the heart.  相似文献   

11.
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   

12.
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   

13.
Effect of administration of 600 mg. vitamin E each day, for six days, was observed on activity of some of the anti-oxidant enzymes and levels of malondialdehyde (as an index of free radical mediated damage) in the platelets of patients reperfused after myocardial infarction. It has been found that vitamin E administration significantly lowers the level of malondialdehyde in the patients. Vitamin E administration increases the activities of anti oxidant enzymes (viz. superoxide dismutase, glutathione reductase and catalase) tested both in the patients and healthy controls. Vitamin E administration causes general stimulation of anti-oxidant enzyme activities both in healthy persons and the patients, however, lowering of lipid per-oxidation upon administration of vitamin E is specific for patients. These findings exhibit beneficial role of vitamin E administration in the management of the patients reperfused after myocardial infarction.  相似文献   

14.
The study was conducted on 38 patients admitted into the intensive care unit with a provisional diagnosis of sepsis and 25 apparently healthy volunteers as controls. Serum procalcitonin (PCT) was assayed by an electrochemiluminescence method. Serum ischemia modified albumin (IMA), expressed as absorbance units was assayed by the albumin cobalt binding test. Patients with sepsis had significantly higher IMA levels (1.087 ± 0.786) as compared with those without sepsis (0.085 ± 0.234) with a p value <0.0001. The receiver operator characteristic (ROC) plot showed a sensitivity of 100 % and a specificity of 86.2 %. The area under the curve of the ROC plot was 0.917 with a p value of <0.0001. The higher levels of IMA serve to highlight the occurrence of ischemic damage which could be a prelude to poorer prognosis. The performance characteristics of IMA warrants its inclusion along with PCT as a parameter in the diagnosis of sepsis.  相似文献   

15.
Serum lipids and lipoproteins were estimated in 29 patients with acute myocardial infarction during acute phase (day 1,2,3), predischarge and after three months. Serum total lipids, total cholesterol (TC) and LDL-cholesterol (LDLc) showed no significant change during the hospital stay and three months followup. HDL-cholesterol (HDLc), however, started falling from day 2 onwards with statistically significant reduction at pre-discharge and remained so at 3 months. The ratios of TC/HDLc and LDLc/HDLc showed significant increase on predischarge day as compared to day 1. Serum triglycerides also showed an increasing trend after myocardial infarction with a significant increase on day 3 and predischarge as compared to day 1. it is concluded that the optimum time for assessment of serum lipid profile in patients with myocardial infarction seems to be within 24 hours of the acute episode.  相似文献   

16.
The present study conducted on twenty-five uncomplicated cases of acute myocardial infarction diagnosed by clinical and electrocardiographic findings indicated significantly increased level of cardiac Troponin-T and increased activities of the enzymes total creatine kinase, creatine kinase-MB, aspartate transaminase and lactate dehydrogenase as compared to the twenty-five healthy control subjects. The level of cardiac Troponin-T and the activities of the enzymes total creatine kinase, creatine kinase-MB, aspartate transaminase and lactate dehydrogenase was found to be higher in “Q” wave myocardial infarction patients as compared to the non-“Q” wave and the controls. Since cardiac Troponin-T has been shown to increase in unstable angina and renal failure without cardiac disease and creatine kinase-MB activity has been found to be normal in patients with unstable angina and increase very slightly in patients with renal failure, it was concluded that a combination of cardiac Troponin-T and creatine kinase-MB activity was sufficient for the early diagnosis of acute myocardial infarction.  相似文献   

17.
Oxidative stress conditions associated with atherosclerosis leads to oxidative modification of low-density lipoprotein (LDL). The body’s capabilities to inhibit LDL oxidation and to remove or neutralize the atherogenic oxidized LDL (ox-LDL) are limited. When the LDL cholesterol level increases in the blood, it leads to dangerous consequences like atherosclerosis, leading to myocardial infarction. The major effect of an antioxidant in the LDL environment is to prevent the formation of ox-LDL (during atherogenesis. Strategies to reduce LDL oxidation and prevent atherogenesis can involve the enrichment of arterial cells with potent antioxidants that can prevent oxidative damage to the arterial wall. The objective of this study is to evaluate the effect of l-arginine on serum lipid and cholesterol levels in the patients of acute myocardial infarction (AMI). The study consisted of 70 AMI patients and 60 healthy individuals (serving as control) age 55–65 years. Serum levels of total cholesterol, high density lipoprotein (HDL), LDL and Triglycerides were determined on day 1 and day 15 of l-arginine administration (oral dose 3 g/day). The total cholesterol/HDL and the LDL/HDL ratio were calculated and compared. As per the observations, l-arginine administration was found to improve the lipid profile of the subjects. Hence it could be used as an adjuvant therapy for AMI and as a preventive measure for the onset of the disease in the healthy elderly also.  相似文献   

18.
Prostate Specific Antigen (PSA) has emerged as the most applicable and important tumor marker for carcinoma prostate. In the present study PSA was determined in serum of healthy subjects, patients of benign prostate hypertrophy (BPH) and Carcinoma Prostate (Ca−P) to evaluate its diagnostic efficiency in day to day management of prostate cancer patients and in differentiating patients of early prostate cancer from those with BPH. Receiver operating characteristic curve (ROC) revealed 2 ng/ml and 10 ng/ml cut off serum PSA level for BPH and untreated carcinoma prostate patients (Ca−P). An extremely significant increase (P<0.0001) was observed in mean PSA concentration in BPH patients and adenocarcinoma prostate patients when compared to healthy males. Clinical relevance of PSA was highlighted by a case study of cancer patient prior to any therapy till death.  相似文献   

19.
Sepsis is associated with various metabolic derangements as a consequence of inflammatory response, ischemia and oxidative stress. Four parameters of relevance are procalcitonin (PCT), ischemia modified albumin (IMA) pH and lactate. The study was carried out to highlight the concomitant occurrence of sepsis, ischemia and lactic acidosis, all of which could have deleterious effects on organ function. 26 critically ill patients with a provisional diagnosis of sepsis were the test subjects. The control group had 25 apparently healthy volunteers. PCT, lactate and IMA were assayed. PCT was estimated on an automated analyser using electro-chemiluminescence. Lactate and pH were estimated on a blood gas analyzer. Serum IMA was estimated spectrophotometrically by Albumin Cobalt Binding Test. Statistical tools like students ‘t’ test and Venn diagram were employed to depict the outcome of the study. All critically ill patients had significantly higher IMA levels (0.96746 ± 0.73407) as compared to the control group (0.00728 ± 0.00895) with a p value of <0.0001. The Venn diagram was used to depict the finding that all 26 test subjects had elevated levels of IMA, of which PCT was elevated in 22 and lactate in 20. Both PCT and lactate were abnormal in 17 patients. The most significant observation was that all critically ill patients, irrespective of the presence of sepsis or lactic acidosis had elevated levels of IMA which is clearly indicative of the ubiquitous presence of oxidative stress. The Venn diagram is an elegant representation of the concurrent multiple pathophysiological processes which occur in critically ill patients.  相似文献   

20.
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   

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