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Objective: The elevation of troponin-T (Trop-T) or creatinine kinase myocardial isoform (CKMB) is very common during the percutaneous coronary intervention (PCI). A study was attempted to determine the correlation between elevated Trop-T or CKMB and the parameters of PCI by using multivariate analysis, especially principal component analysis (PCA). Materials and Methods: A prospective observational study was carried out among 100 patients who underwent PCI for stable coronary artery disease in which 31 and 37 patients were found to have elevated Trop-T and CKMB (>3 times) following PCI. The correlation was studied between Trop-T or CKMB (dependent variable) and different parameters, viz., total stent length (mm), fluoroscopy time (min), lesion strength, left ventricular (LV) function, procedural complications, type of lesions, vessels treated with drug eluting stent (DES), and major adverse cardiac events (MACE) as independent variables. Results: For Trop-T, the principal component (PC)-1 and PC-2 obtained 63.49% and 30.88% of the original variation. For PC-1 and PC-2, maximum positive loading was recorded for stent length followed by fluoroscopy time and for LV but negative loading for the type of lesion and type of stent (DES vs bare metal stent [BMS]). For CKMB, the PC-1 and PC-2 obtained 61.22% and 32.08% of the original variation. For PC-1 and PC-2, maximum positive loading was recorded for stent length and fluoroscopy time followed by vessel treated but negative loading for the type of stent and MACE, and maximum positive loading recorded for LV function but negative loading for the type of lesion. Conclusion: This study indicates which factors are most important in preventing periprocedural myocardial injury during PCI and may be a suitable tool to prevent myocardial injury and for subsequent less MACE and better patient outcomes.
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BACKGROUND: Studies have shown that miRNA-148a can promote human bone marrow mesenchymal stem cells to differentiate into mature cardiomyocyte-like cells, but the effect of miRNA-148a on the differentiation of human induced pluripotent stem cells into cardiomyocyte-like cells has not been reported. OBJECTIVE: To investigate the effect of miRNA-148a on the differentiation of human induced pluripotent stem cells into cardiomyocyte-like cells. METHODS: Human induced pluripotent stem cells differentiating into cardiomyocyte-like cells were divided into three groups. Cells in the control group were not treated. Cells in the low expression group were treated with miRNA-148a for 28 days, and those in the high expression group were treated with mimics of miRNA-148a for 28 days. In addition, human induced pluripotent stem cells cultured for 28 days were taken as the blank control group. CCK-8 was used to detect cell proliferation activity. qRT-PCR was used to detect the expression of miRNA-148a. Immunofluorescence staining and western blot analysis were performed to detect the expression of MHC and cTnT protein. RESULTS AND CONCLUSION: The expression of intracellular miR-148a mRNA and cell proliferation activity in the low expression group were lower than those in the blank control and control groups, while those in the high expression group were significantly higher than those in the other three groups (P < 0.01). There were no positive expression of MHC and cTnT in the blank control group. There were positive expressions of MHC and cTnT in the control, low expression and high expression groups. The expression of MHC and cTnT protein in the low expression group was significantly lower than that in the control group, and that in the high expression group was significantly higher than that in the other three groups (P < 0.01). These results suggest that miRNA-148a can promote the differentiation of human induced pluripotent stem cells into cardiomyocyte-like cells.
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Objective To explore the clinical application value of muscle enzymes and high sensitivity cardi-ac troponin T(hs-cTnT)in children with hand foot mouth disease complicated with myocardial injury.Meth-ods 100 children with hand foot mouth disease admitted to the hospital from April 2016 to January 2017 were divided into ECG normal group(n= 40)and ECG abnormal group(n= 60)by electrocardiography.At the same time,50 healthy people were selected as the research group to compare the serum concentration and myo-cardial enzyme index of myocardial enzyme(CK-MB),creatine kinase(CK),α-hydroxybutyrate dehydrogenase (α-HBDH),lactate dehydrogenase(LDH)and aspartate aminotransferase(AST),and high sensitivity cardiac troponin T(hs-cTnT)in three groups.The hs-cTnT and the indexes of myocardial enzymes in acute and re-covery stages of abnormal electrocardiogram for children with hand foot mouth disease were compared.Results The indicators of CK-MB,CK,α-HBDH,LDH,AST and hs-cTnT,etc.in the ECG abnormal group of hand foot mouth disease were significantly higher than those of ECG normal group and control group.The differ-ence was statistically significant(P<0.05).The indicators of CK-MB,CK,α-HBDH,LDH,AST and hs-cT-nT,etc.in the ECG normal group of hand foot mouth disease were significantly higher than those of control group.The difference was statistically significant(P<0.05).The abnormal rate for the indicators of CK-MB, CK,α-HBDH,LDH,AST and hs-cTnT,etc.In the ECG abnormal group of hand foot mouth disease were sig-nificantly higher than those of ECG normal group and normal control group.The difference was statistically significant(P<0.05).The indicators of CK-MB,CK,α-HBDH,LDH,AST and hs-cTnT,etc.Of hand foot mouth disease ECG abnormal group in acute stage were significantly higher than those of recovery stage.The difference was statistically significant(P< 0.05).Conclusion One of the serious complications in children with hand foot and mouth disease is myocardial injury.It is of great clinical value to monitor hs-cTnT and my-ocardial enzymes in the diagnosis of the disease.
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Objective To investigate the clinical application of high-sensitivity cardiac troponin T (hs-cTnT) in the diagnosis of patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Methods The clinical data of 126 patients with NSTE-ACS admitted to the Department of Emergency of the Third People's Hospital in Yunnan Province from July 2016 to June 2017 were retrospectively analyzed, including 76 patients in non-ST-segment elevation myocardial infarction (NSTEMI) group and 50 patients in unstable angina (UA) group. Moreover, the clinical data of venous blood hs-cTnT and creatine kinase MB (CK-MB) were collected at immediate admission, 4 hours and 12 hours after admission to the hospital in the two groups. At last, the differences in levels of hs-cTnT and CK-MB were compared between the two groups. Results The hs-cTnT and CK-MB in NSTEMI group were gradually increased with the prolongation of therapeutic time, the elevation ratios of hs-cTnT were 88.2% (67 cases) and 100.0% (76 cases), 100.0% (76 cases) at admission and 4 hours, 12 hours after admission respectively; and the elevation ratios of CK-MB were 60.0% (30 cases), 80% (40 cases) and 96% (48 cases) respectively at the above time points; there were no significant differences in UA group. The levels of hs-cTnT and CK-MB in NSTEMI group were significantly higher compared to those of UA group at admission and 4 hours, 12 hours after admission [hs-cTnT (μg/L): the levels were respectively 0.182±0.052 vs. 0.010±0.001, 2.421±0.084 vs. 0.011±0.012, 5.647±0.012 vs. 0.11±0.012, CK-MB (U/L): the levels were respectively 36.3±12.1 vs. 8.1±0.5, 179.6±26.3 vs. 8.5±0.5, 286.0±23.2 vs. 7.9±0.7, all P ＜ 0.05]. Conclusion The blood level of hs-cTnT in acute myocardial infarction (AMI) patients is obviously increased, which can be used as the basis to distinguish NSTEMI from UA.
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Objective To evaluate the diagnostic value of serum cardiac fatty acid binding protein (H-FABP), high sensitivity C-reactive protein (hs-CRP) and cardiac troponin T (cTnT) in the diagnosis of myocardial infarction. Methods From August 2015 to July 2016, 50 patients with myocardial infarction were treated as group A, and 48 patients with chest pain caused by other factors were treated as group B, and 53 patients were selected in our hospital physical examination of patients without chest pain as C group. The levels of H-FABP, hs-CRP and cTnT were compared between the three groups. The levels of H-FABP, hs-CRP and cTnT in patients with myocardial infarction at 5 h, 10 h, 24 h and 3 d after admission were compared . Results The positive rate of serum H-FABP, hs-CRP and cTnT in group A was significantly higher than that in group B, group C[(82.00％, 41.00), 68.00％ (34/50), 76.00％ (38/50) VS 8.33％(4/48), 14.58％(7/48),10.42％(5/48) VS 0.00％(0/53),0.00％(0/53),0.00％(0/53)], and the difference was statistically significant (P<0.05). The positive rate of H-FABP and hs-CRP was higher than that of admission at 10 h, 24 h and 3 d at 5 h after admission. The positive rate of cTnT was higher than that at 5 h, 24 h and 3 d at admission (P<0.05). The positive rate of H-FABP was significantly higher than that of the control group (P<0.05). Conclusion Combined detection of serum H-FABP, hs-CRP and cTnT can improve the diagnostic value of myocardial infarction and reduce the misdiagnosis rate.
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Objective To investigate the prognostic value of highly sensitive cardiac Troponin T (hs-cTn T) for sepsis in critically ill patients.Methods Patients estimated to stay in the ICU of Fuxing Hospital for more than 24h were enrolled at from March 2014 to December 2014.Serum hs-cTn T was tested within two hours.Univariate and multivariate linear regression analyses were used to determine the association of variables with the hs-cTn T.Multivariable logistic regression analysis was used to evaluate the risk factors of 28-day mortality.Results A total of 125 patients were finally enrolled including 68 patients with sepsis and 57 without.The levels of hs-cTn T in sepsis and non-sepsis groups were significantly different[52.0(32.5,87.5) ng/L vs 14.0(6.5,29.0) ng/L respectively,P ＜0.001].In sepsis group,hs-cTn T among common sepsis,severe sepsis and septic shock were similar.Hs-cTn T was significantly higher in non-survivors than survivors [27 (13,52) ng/L vs 44.5 (28.8,83.5) ng/L,P ＜ 0.001].Age,sepsis,serum creatinine were independent risk factors affecting hs-cTn T by multivariate linear regression analyses.But hs-cTn T was not a risk factor for death.Conclusion Patients with sepsis had higher serum hs-cTn T than those without sepsis.but it was not found to be associated with the severity of sepsis.
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Objective To investigate the prognostic value of highly sensitive cardiac Troponin T (hs-cTn T) for sepsis in critically ill patients.Methods Patients estimated to stay in the ICU of Fuxing Hospital for more than 24h were enrolled at from March 2014 to December 2014.Serum hs-cTn T was tested within two hours.Univariate and multivariate linear regression analyses were used to determine the association of variables with the hs-cTn T.Multivariable logistic regression analysis was used to evaluate the risk factors of 28-day mortality.Results A total of 125 patients were finally enrolled including 68 patients with sepsis and 57 without.The levels of hs-cTn T in sepsis and non-sepsis groups were significantly different[52.0(32.5,87.5) ng/L vs 14.0(6.5,29.0) ng/L respectively,P ＜0.001].In sepsis group,hs-cTn T among common sepsis,severe sepsis and septic shock were similar.Hs-cTn T was significantly higher in non-survivors than survivors [27 (13,52) ng/L vs 44.5 (28.8,83.5) ng/L,P ＜ 0.001].Age,sepsis,serum creatinine were independent risk factors affecting hs-cTn T by multivariate linear regression analyses.But hs-cTn T was not a risk factor for death.Conclusion Patients with sepsis had higher serum hs-cTn T than those without sepsis.but it was not found to be associated with the severity of sepsis.
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Objective To evaluate the short-term prediction of high-sensitivity cardiac troponin T (hs-cTnT) and other cardiovascular risk biomarkers in patients undergoing maintenance hemodialysis (MHD).Methods We conducted a cohort survey in 296 consecutive MHD patients whose clinical data were retrospectively analyzed.Before MHD,hs-cTnT and other relative cardiovascular biomarkers were detected.The end point (all-cause death) and time of occurring were recorded in the next 13 months.The differences between survival and all-cause death were analyzed by t-test,Mann-Whitney test and x2 test.The best two percentile cutoff point was calculated by X-tile and the survival rate was calculated by Kaplan-Meier Logistic regression analysis was applied to analyze the odd ratio between high risk and non-high risk hs-cTnT group.Non-high risk group was divided into intermediate risk and low risk group based on the 99th percentile of hs-cTnT in healthy population,to further evaluate its short-term prediction value for MHD patients.The short-term significance of hs-cTnT was proved to be independently associated with all-cause death by Logistic regression analysis.Results The mean value of serum hs-cTnT in survival group was 0.05 (0.03～0.07) ng/mL,while in the death group it was 0.07 (0.04～0.14) ng/mL,which had statistical significance (P =0.027).The best two percentile cutoff of hs-cTnT in MHD patients was 0.1 ng/mL.The survival rate in high risk group (hs-cTnT＞0.1 ng/mL) is lower than it in non-high risk group (hs-cTnT≤0.1 ng/mL) (76.67％ vs.96.62％,P ＜0.05).The odd ratios for high risk group and non-high risk group was 7.288 (P＜ 0.001).Moreover,further grouping the non-high risk group by hs-cTnT =0.014 ng/mL,intermediate risk group (hs-cTnT＞0.014 ng/mL) group has lower survival rate than low risk group (hs-cTnT≤0.014ng/mL),while there wasn't any death case occurred in the low risk group.Conclusions Hs-cTnT is an independent risk factor to all-cause death.Thus hs-cTnT can be a strong indicator of short-term prediction and prognostic evaluation.
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Objective To investigate the value of high sensitive cardiac troponin T(hs-cTnT),human heart fatty acid binding protein(H-FABP),B-type natriuretic peptide(BNP),ischemia modified albumin(IMA) and creatine kinase(CK-MB) in the diagnosis of myocardial injury in preeclampsia.Methods A total of 50 women of normal pregnancy in preganancy group,and 50 healthy women without pregnacy were collected in control group,167 women in preeclampsia group (42 cases with myocardial injury,125 cases without myocardial injury).The serum IMA were detected by albumin cobalt binding test,H-FABP were detected by ELISA,hs-cTnT and BNP were detected by microparticle chemiluminescence immunoassay and CK-MB were detected by immuno-suppression.Results Five cardiac markers levels in myocardial injury group of preeclampsia group were significantly higher than those in healthy control group and normal pregnancy women and non myocardial injury group[(t=8.521,7.489,7.256;7.561,6.897,6.235;12.314,9.236,10.251;13.657,11.023,12.031;11.301,10.364,15.567),(P=0.008,0.030,0.035;0.027,0.031,0.033;0.002,0.005,0.003;0.002,0.004,0.003;0.003,0.004,0.001)].There was no significant difference in hs-cTnT among control group and normal pregnancy women and non myocardial injury group[(t=1.678,1.401;1.887,1.784),(P=0.339,0.401;0.289,0.398)].IMA、H-FABP、CK-MB and BNP in normal pregnancy women and non myocardial injury group were higher than in control group [(t=4.784,4.021;3.894,3.784;5.801,5.215),(P=0.024,0.032;0.037,0.041;0.021,0.029)].There was no significant difference in IMA,H-FABP,CK-MB and BNP between normal pregnancy women and non myocardial injury group [(t=1.325,1.257,1.241);(P=0.451,0.329,0.378)].The sensitivity of combined detection of five cardiac markers in preeclampsia myocardial injury was significantly higher than that in single marker(χ2=3.021,3.561,4.215,4.496,5.249;P=0.027,0.024,0.019,0.015,0.009).Conclusion When myocardial damage in pregnant women was determined by cardiac markers,pregnancy should be taken into account as a special physiological cycle.The combined detection of five cardiac markers is conducive to early diagnosis of ischemic myocardial injury in preeclampsia.
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Objective@#To investigate the clinical value of two-dimensional speckle tracking echocardiography(2D-STE) combined with high-sensitive cardiac troponin T (hs-cTnT) in early detection of the cardiotoxicity induced by chemotherapy drug.@*Methods@#Seventy-five non-Hodgkin′s lymphoma patients who received the CHOP regimen were recruited in this study. Conventional echocardiography and 2D-STE were performed on these patients before chemotherapy, the second day after the third course of chemotherapy (during chemotherapy) and the second day after the last course of chemotherapy (after chemotherapy). The parameters included left ventricular ejection fraction (LVEF), global longitudinal strain (LS), global circumferential strain (CS) and global radial strain (RS). The serum hs-cTNT levels were tested simultaneously.@*Results@#Three cycles of CHOP were completed in 30 patients and 6-8 cycles of CHOP were completed in 45 patients. The LVEF of 75 patients before, during and after chemotherapy was (63.8±2.6)%, (63.8±2.8)% and (64.0±3.3)%, respectively, without significant difference (P=0.91). However, the LS of 75 patients before, during and after chemotherapy was (-18.5±1.7)%, (-16.5±1.9)% and (-16.0±1.6)%, respectively. The CS was (-20.9±2.9)%, (-19.3±3.5)% and (-19.2±3.2)%, respectively. The RS was (39.2±6.4)%, (35.3±5.2)% and (35.0±6.2)%, respectively. The hs-cTnT was (0.001 0±0.002 0)ng/ml, (0.006 3±0.008 9)ng/ml and (0.007 3±0.003 8)ng/ml, respectively. The LS, CS and RS were significantly decreased while hs-cTnT was significantly increased during chemotherapy when compared to those before chemotherapy (all of P<0.01). Alternatively, the LS, CS, RS and hs-cTnT after chemotherapy were marginally different from those during chemotherapy (all of P>0.05). Moreover, TLS-SD, TCS-SD and TRS-SD showed no significant difference before, during and after chemotherapy (all of P>0.05). The reduction of LS was positively associated with the enhancement of hs-cTnT after chemotherapy (r=0.60, P<0.01).@*Conclusion@#2D-STE combined with hs-cTnT can effectively and precisely detect the occult cardiotoxicity induced by anthracycline.
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BACKGROUND: Elevated cardiac troponin T (cTnT) levels have been reported in patients with acute ischemic stroke, however, the prognostic relevance is not well established. We evaluated the association between cTnT elevation and prognosis in patients with acute ischemic stroke. METHODS: The 182 consecutive patients enrolled had new-onset acute ischemic stroke. Their clinical and laboratory findings were collected retrospectively. Stroke severity and prognosis were determined using the National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS) scores, as well as 30-day all-cause mortality. The patients were divided into two groups according to their cTnT levels: ≤14 and >14 ng/L. Cox proportional hazards regression analysis was performed to determine the associations between clinical or laboratory variables and 30-day all-cause mortality. The Kaplan-Meier method was used to compare the overall survival rate in patients with elevated and normal cTnT levels. RESULTS: The cTnT level was elevated in 14.8% of the patients. Age, NIHSS and mRS scores, creatinine kinase-MB, and 30-day all-cause mortality were significantly higher in patients with elevated cTnT levels than in those with normal cTnT levels. The hazard ratio of the elevated vs. normal cTnT group for 30-day all-cause mortality was 8.06 (95% confidence interval: 1.13-57.25, P=0.037). A Kaplan-Meier survival analysis revealed a significantly higher survival rate in patients with normal cTnT levels compared to those with elevated cTnT levels (P<0.0001). CONCLUSIONS: An elevated cTnT level is significantly associated with poor short-term outcomes in patients with acute ischemic stroke.
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Humans , Creatinine , Methods , Mortality , Prognosis , Retrospective Studies , Stroke , Survival Rate , Troponin T , TroponinABSTRACT
Objective To evaluate whether there is a correlation among plasma levels of procalcitonin (PCT),N-terminal pro-brain natriuretic peptide (NT-pro-BNP)and cardiac troponin T (cTnT)in patients with sepsis,as well as significance to prognosis of patients.Methods 48 patients with sepsis who were admitted to the intensive care unit of a hospital between September 2014 and March 2015 were chosen for study,patients were divided into severe and mild sepsis groups according to the disease condition,plasma levels of PCT,NT-pro-BNP,and cTnT were de-tected,mortality of patients were analyzed statistically,relation between plasma levels of PCT,NT-pro-BNP,cT-nT and patients’death were compared.Results The plasma levels of PCT,NT-pro-BNP and cTnT in severe sepsis group were significantly higher than those in mild sepsis group (all P <0.05);mortality of mild sepsis group was significantly lower than that of severe sepsis group (10.53% vs 41.38%,P <0.05);Levels of PCT,NT-pro-BNP and cTnT levels in died patients were all higher than surviving patients (all P <0.05);levels of PCT and NT-pro-BNP,NT-pro-BNP and cTnT were positively correlated respectively (rs = 0.337,P <0.05;rs =0.456,P =0.001, respectively ),while PCT was not significantly correlated with cTnT.Plasma levels of PCT,NT-pro-BNP,and cTnT were all correlated with the prognosis of patients (P <0.05),and is helpful for judging the prognosis of pa-tients,combination of three indexes had better prognostic value for the prognosis.Conclusion Combination detec-tion of plasmid levels of PCT,NP-pro-BNP,and cTnT can assess the severity of infection in patients with sepsis, and preliminarily judge the prognosis of patients with sepsis.
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The aim of this study is to prepare and characterize cardiac troponin T (cTnT) monoclonal antibodies (mAb), and further develop a chemiluminescence quantitative detection assay for cTnT. BALB/c mice were immunized with recombinant cTnT antigen, and specific mAbs were prepared using conventional hybridoma technique and screened by indirect ELISA method. To identify the epitopes, several cTnT peptide fragments were synthesized or expressed by genetic engineering. A double antibody sandwich ELISA method was used to screen the mAb pairs for cTnT detection, and the automatic chemiluminescence detection assay for cTnT was developed. In total 220 clinical specimens were used for system comparison between our assay and Roche cTnT assay; further performance characteristics was evaluated by testing 238 clinical samples and 784 physical examination samples. We successfully screened 33 strains of hybridoms against cTnT, and the mAbs' epitopes were identified. Mab E16H8 and C8G11 with a detection limit of 10 pg/mL cTnT antigen were selected to develop the full automatic chemiluminescence quantitative assay. The correlation coefficient of our reagent with Roche's was 0.959 9, with a coincidence rate of 95%. The assay presented a sensitivity of 97.5%, and a specificity of 99.15% in detection of clinical samples. The cTnT concentration was less than 0.080 6 ng/mL in 99% of general population, which agrees with the definition of WHO on patients with acute myocardial infarction (AMI). In summary, we developed monoclonal antibodies against predominant epitopes for diagnostics of cTnT, and an automatic tubular chemiluminescence quantitative detection assay was further developed, which presents a high coincidence rate with Roche's.
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Humans , Antibodies, Monoclonal , Allergy and Immunology , Enzyme-Linked Immunosorbent Assay , Epitopes , Allergy and Immunology , Hybridomas , Luminescent Measurements , Myocardial Infarction , Peptide Fragments , Sensitivity and Specificity , Troponin T , Allergy and ImmunologyABSTRACT
Objective: To explore the relationship between serum level of high-sensitivity cardiac troponin T (hs-cTnT) and atrial ifbrillation (AF) occurrence in patients with stable coronary artery disease (CAD). Methods: A total of 1011 patients with stable CAD treated in our hospital from 2013-01 to 2015-09 were retrospectively studied. According to quartiles of hs-cTnT, the patients were divided into 4 groups: Group① the patients with hs-cTnT≤7ng/L, n=283, Group② hs-cTnT 7-10ng/L,n=238, Group③ hs-cTnT 10-15ng/L,n=272 and Group④ hs-cTnT>15ng/L,n=218. The relationship between hs-cTnT level and AF occurrence rate was studied; the risk factors for AF occurrence were explored by multi stepwise Logistic regression analysis. Results: There were 127/1011 (12.6%) patients combining AF and 884 (87.4%) with simple type stable CAD. AF patients had the higher serum level of hs-cTnT than non-AF patients 17.0 (12.0, 25.0) ng/L vs 10.0 (7.0, 13.0) ng/L,P Conclusion: Increased serum level of hs-cTnT was closely related to AF occurrence in patients with stable CAD.
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Objective: To investigate the relationship between serum levels of high sensitivity cardiac troponin T (hs-cTnT) and the severity of coronary lesions in patients with stable coronary artery disease (SCAD). Methods: A total of 450 SCAD patients with coronary angiography (CAG) conifrmed diagnosis in our hospital were studied, and serum levels of hs-cTnT were examined at 3 days prior CAG in all patients. Based on tertiles of Gensini score, the patients were divided into 3 groups: Low score group,n=153 patients with Gensini score28. The relationships between Gensini score and hs-cTnT levels were analyzed among 3 groups. The optimal cut-off value of hs-cTnT for predicting high Gensini score and the need of revascularization were studied by ROC curve, the relationships between hs-cTnT and high Gensini score, the need of revascularization were further detected by Logistic regression analysis. Results: The median values (25%-75%) of hs-cTnT in Low score group, Intermediate score group and High score group were 6.72 (4.20, 8.93) pg/ml, 7.90 (5.74, 12.68) pg/ml and 14.99 (10.26, 24.30) pg/ml respectively, allP<0.01. ROC curve analysis indicated that the area under curve (AUC) of hs-cTnT for predicting high Gensini score was 0.837 (95% CI 0.803-0.874), for the need of revascularization was 0.772 (95% CI 0.728-0.817); the best cut-off value of hs-TnT for predicting high Gensini score was 10.04 pg/ml and for the need of revascularization was 8.56 pg/ml. Logistic regression analysis suggested that with adjusted age, gender, the history of hypertension, diabetes, smoking, blood levels of creatinine, LDL-C and hs-CRP, hs-cTnT was still an independent predictor for high Gensini score (OR=1.13, 95% CI 1.06-1.20,P<0.001) and for the need of revascularization (OR=1.19, 95% CI 1.14-1.24,P<0.001). Conclusion: Serum level of hs-cTnT has been related to severity of coronary lesions in SCAD patients, hs-cTnT might be used as one of the pre-operative predictor for severe coronary disease and for the need of revascularization.
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Cardiac deaths account for 50% of all deaths in developed and 25% in the developing world. One-sixth of world’s population lives in india and heart diseas accounts for 24% of all deaths. Sudden death accounts for two-thirds of all autopsies in Forensic Medicine Actual detection of histological. sequence of the infected myocardium will develop only after significant time of, between onsets of myocardial infarction (MI) in death. Cardiac Troponin-T is not normally present in serum unless cardiac necrosis has occurred therefore cardiac Troponin levels act as a specific and sensitive indication of myocardial infarction. The present study was conducted on cases coming for medico legal autopsy to the Forensic Medicine Department at Gandhi Medical College/Hospital, Hyderabad, Andhra Pradesh, India for a period of 1 year from January 2014 to December 2014. Total 12 cases with 6 controls were analyzed. Cardiac Troponin-T was markedly elevated >2.000 ng/ml in all except one case of suspected MI. Sensitivity was found to be 91.66% and specificity 66.66%.
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Objective To analyse the effect of different blood purification methods on serum cardiac troponinc T (cTnT), cardiac troponinⅠ(cTnI), β2-microglobulin (β2-MG) and interleukin-6 (IL-6) levels in patients with maintenance hemodialysis.Methods 60 uremic patients treated with maintenance hemodialysis were collected.All patients were randomly divided into conventional hemodialysis group (HD group) , hemodialysis and hemoperfusion group (HD+HP group) and hemodiafiltration group (HDF group) , 20 cases in each group.Corresponding dialysis treatment was given, then the serum levels of cTnT, cTnI,β2-MG and IL-6 were detected in all patients post-treatment.Results After treatment, the serum cTnT, cTnI,β2-MG and IL-6 levels in HD+HP group and HDF group were lower than those in HD group (P<0.05).Conclusions Different blood purification methods have different effects on serum cTnT, cTnI, β2-MG and IL-6 levels in patients with maintenance hemodialysis, HDF and HD +HP have better scavenging effect, which has the guiding significance to clinical application.
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Objective To investigate the diagnostic value of combined copeptin, cardiac troponin I (cTnI) and high sen?sitive cardiac troponin T (hs-TnT) in determination of acute myocardial infarction (AMI). Methods A total of 152 patients with AMI were selected as AMI group and 143 healthy examinees during the same period were selected as control group. (1) The levels of copeptin, cTnI and hs-TnT were detected at 0, 4, 6 and 12 h in two groups. (2) The combined detection of cop/cTnI and cop/hs-TnT were studied. The positive rates of these items were evaluated at different time points of AMI. ( 3) The diagnostic sensitivity, specificity and accuracy of different cardiac biomarkers for AMI were compared. Results (1) There were significant differences in copeptin at 0, 4, 6 and 12 h between two groups (P<0.05). There were no significant differ?ences in cTnI and hs-TnT between two groups. (2) cop/cTnI and cop/hs-TnT combined detection showed better positive rates than those of copeptin, cTnI or hs-TnT detection alone. (3) In addition, the combined detection of cop/cTnI and cop/cTnI improved significantly the diagnostic sensitivity of AMI. Compared to cop/cTnI combination, cop/hs-TnT combination detec?tion showed better diagnostic sensitivity, specificity and accuracy for AMI. Conclusion The combined detection of cop/cTnI and cop/hs-TnT are very helpful for early diagnosis of AMI, which shows a very good diagnostic value in clinical application.
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Objective To investigate the value of D‐dimer (D‐D) ,cardiac troponin T(cTnT) and myocardial enzymogram detec‐tions in clinical diagnosis of acute myocardial infarction (AMI) .Methods 36 cases of AMI patients (AMI group) and 20 cases of healthy people (control group) were selected as study subjects .The plasma levels of D‐D ,cTnT and myocardial enzymogram of two groups were detected ,and the sensibility and specificity of these indexes were analyzed .Results The levels of D‐D ,cTnT ,CK ,CK‐MB ,AST and LDH in AMI group were significantly higher than those of control group (P<0 .05) .The positive rates of cTnT ,D‐D and myocardial enzymogram in AMI patients were 91 .67% ,69 .44% ,and 66 .67% ,respectively .The positive rate of cTnT was significantly higher than those of D‐D and myocardial enzymogram (P<0 .05) .Both of the diagnosis sensibility and specificity of plasma cTnT were significantly higher than those of D‐D and myocardial enzymogram (P<0 .05) .Conclusion Comparing with D‐D and myocardial enzymogram ,plasma cTnT has better diagnosis sensibility and specificity .Joint detection of kinds of indexes could improve the accuracy .
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BACKGROUND: Early reperfusion can effectively treat acute myocardial infarction (AMI) and reduce the mortality significantly. This study aimed to compare the role of plasma microRNA-1 (miR-1) and cardiac troponin T (cTnT) in early diagnosis of AMI patients. METHODS: From May 2011 to May 2012, plasma samples were collected from 56 AMI patients and 28 non-AMI controls. The expression of plasma miR-1 was measured by quantitative reverse transcription-polymerase chain reaction (qRT-PCR), and the level of plasma cTnT was measured using electrochemiluminescence-based methods on an Elecsys 2010 Immunoassay Analyzer. SPSS 16.0 was used for the statistical analysis of the results. Data were expressed as mean±standard deviation unless otherwise described. The differences about clinical characteristics between the AMI patients and controls were tested using Student'st test or Fisher's exact test. The Mann-WhitneyU test was conducted to compare the expression of microRNAs between the AMI patients and controls. MicroRNAs expression between different intervals of the AMI patients was compared using Wilcoxon's signed-rank test. The receiver operating characteristic (ROC) curve was established to discriminate the AMI patients from the controls. RESULTS: In the present study, the expression of plasma miR-1 was significantly increased in the AMI patients compared with the healthy controls (P<0.01). The plasma miR-1 in the AMI patients decreased to the normal level at 14 days (P>0.05). The expression of plasma miR-1 was not related to the clinical characteristics of the study population (P>0.05). ROC curve analyses demonstrated that miR-1 was specific and sensitive for the early diagnosis of AMI, but not superior to cTnT. CONCLUSION: Plasma miR-1 could be used in the early diagnosis of AMI, but it is similar to cTnT.