Cardiac Biomarkers and their Importance in the Diagnosis of Myocardial Ischemia and Acute Myocardial Infarction
Anil K Munta, Vijay Raghavan, Rama M Gorle, Shaik J Basha
Diagnosis, Infarction, Ischemia, Multi markers, Sensitivity, Specificity
Citation Information :
Munta AK, Raghavan V, Gorle RM, Basha SJ. Cardiac Biomarkers and their Importance in the Diagnosis of Myocardial Ischemia and Acute Myocardial Infarction. Indian J Med Biochem 2018; 22 (1):78-84.
Introduction: Myocardial ischemia and acute myocardial infarction are important episodes of cardiac ailments. Cardiac biomarkers are a growing area of interest, constantly evolving and presenting potential promises diagnostically to supplement the instrumental techniques. They play a vital role in every stage of sequel of cardiac ailment by contributing to the diagnosis and differentiating the conditions.
Aim: To evaluate the diagnostic significance of emerging cardiac biomarkers during myocardial ischemia and infarction (AMI) and to construct a definitive pattern shift of markers in ischemia versus infarction in uncomplicated cases, hence the predictive element.
Materials and methods: In this comparative cross-sectional study, three groups i.e. control (n = 33), ischemia (n = 38), and infarction (42) of either sex with an age group of 70 were included. The cardiac parameters, ischemia-modified albumin (IMA), creatine kinase-MB (CK-MB), creatine kinase (CK), high sensitive cardiac troponin I (hscTnI), N-terminal pro brain natriuretic peptide (NTpro-BNP), myoglobin, and heart type fatty acid binding protein (H-FABP) analyses were carried out for their sensitivity and specificity.
Results: All the parameters in infarction were significantly raised when compared with the control group. In ischemia, the markers NTproBNP, hscTnI, and IMA and in infarction, the NTproBNP, hscTnI, and H-FABP showed more area under the curve.
Conclusion: The markers exhibited different pattern shift in ischemia and infarction. The combination of hscTnI, NTproBNP, and IMA would increase the sensitivity in the detection of ischemia. In case of AMI, the H-FABP in the early stages, and NTproBNP, hscTnI, IMA, and CKMB in the later stages of ACS contribute immensely for the diagnosis.
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