ABSTRACT
Abstract Objectives: To determine the usefulness of myeloperoxidase in discriminating between patients with acute coronary syndrome and patients with chest pain by other causes. Methods: The study included all patients over 18 years of age who come consecutively to the emergency department from September 2015 to December 2015 with chest pain of non- traumatic origin. The initial patient evaluation was performed according to the study protocol for patients with suspected acute coronary syndrome (ACS) in our Emergency Department. This included the serial measurement of troponin, and in this case myeloperoxidase, with serialization on admission and at 6 h. For the determination of myeloperoxidase (MPO), a single step sandwich enzyme immunoassay by Siemens, automated on a Dimension analyser, was used. Results: Statistically significant differences were observed in the concentration of myeloperoxidase at time 0 among patients diagnosed with ACS: 505 (413) pmol/L, and non-ACS patients: 388 (195) pmol/L (p < .001), as well as at 6 h (p < .001). An area under the curve ROC of 0.824 was obtained at 6 h for ACS patients, with a confidence interval of 95% from 0.715 to 0.933 and a level of significance of p <.001. Statistically significant differences were also found in the concentration of myeloperoxidase at time 0 and at 6 h among patients with ACS and patients with heart disease other than coronary artery disease. Conclusions: The concentration of MPO helps to differentiate between ACS and non-ACS patients, as well as between ACS patients and patients with heart diseases other than coronary artery disease.
Resumen Objetivos: Conocer la utilidad de mieloperoxidasa (MPO) para discriminar entre pacientes con síndrome coronario agudo y dolor torácico de otras causas. Métodos: De septiembre a diciembre de 2015 se incluyeron todos los pacientes mayores de 18 años que acudieron de forma consecutiva al servicio de urgencias con dolor torácico de origen no traumático. La evaluación inicial del paciente se realizó de acuerdo con el protocolo de estudio para pacientes con sospecha de síndrome coronario agudo (SCA) en nuestro servicio de urgencias, que incluye la medición de troponina y en este caso MPO, con serialización al ingreso y a las 6 h. Para la determinación de MPO se utilizó un inmunoensayo enzimático de tipo sándwich, de una sola etapa de Siemens, automatizado en un equipo Dimension . Resultados: Se obtuvieron diferencias estadísticamente significativas en la concentración de MPO a tiempo 0 entre los pacientes con diagnóstico de SCA: 505 (413) pmol/l y los pacientes no SCA: 388 (195 pmol/l (p < 0.001), así como a las 6 h (p < 0.001). Se obtuvo a las 6 h un área bajo la curva ROC para pacientes con SCA de 0.824 con un intervalo de confianza del 95% de 0.715 a 0.933 y un grado de significación p < 0.001. También se obtuvieron diferencias estadísticamente significativas en la concentración de MPO tanto a tiempo 0 como a las 6 h entre pacientes con SCA y pacientes con enfermedad cardiaca diferente de enfermedad coronaria. Conclusiones: La concentración de MPO sirve para diferenciar entre pacientes SCA y pacientes que no son SCA, así como entre pacientes SCA y pacientes con otras enfermedades cardiacas diferentes a la enfermedad coronaria.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Chest Pain/etiology , Coronary Artery Disease/diagnosis , Peroxidase/metabolism , Acute Coronary Syndrome/diagnosis , Time Factors , Troponin/metabolism , Coronary Artery Disease/enzymology , Diagnosis, Differential , Emergency Service, Hospital , Acute Coronary Syndrome/enzymology , Acute Coronary Syndrome/physiopathology , Heart Diseases/diagnosis , Heart Diseases/enzymologyABSTRACT
Neurotransmitter mediating enzyme Dopamine-beta-Hydroxylase [DBH], its cofactors and other biochemical parameters such as glucose, protein, albumin serum electrolytes, enzyme profiles, lipid profiles, urea, creatinine etc. are studied at six different age groups of both sexes, namely group I [10-l5 years], group II [15-25 years], group III [25-35 years], group IV [35-45 years] group V [45-55 years] and group VI [55+ years] of diabetic heart disease patients in comparison with the age matched controls. One unit of DBH activity is expressed in nmole/min/ml serum. DBH activity decreased in both males and females in groups I, II, III, IV, V and VI. The values of DBH activity in males and females are: group I [19.95 units and 35.62 units], group II [21.42 units and 36.72 units], group III [26.48 units and 42.82 units], group IV [31.39 units and 51.53 units], group V [26.59 units and 17.95 units] and group VI [36.26 units and 41.53 units], respectively. One of the cofactors, ascorbic acid level slightly decreased in almost all groups. Another cofactor copper, increased in all groups. Triacylglycerol also increased in all the groups. HDL-cholesterol decreased in almost all the groups of both sexes, except in males of groups II, III and IV. Cholesterol and LDL-cholesterol were variabies. The cardiac enzymes such as CK-MB, GOT, LDH1 activity increased in all the groups. Other biochemical parameters such as protein, albumin, serum electrolytes, urea, creatinine, bilirubin etc. were increased in some groups and decreased in some groups, except urea, they were within their respective normal ranges