ABSTRACT
The consideration of the correct diagnosis and prognosis in acute coronary syndrome seems to be a great challenge for cardiologists. Measuring of the serum cardiac Troponin (cTI) level may help solution of this problem. According to the authors the myocardial infarction has been revealed with a great sensitivity and specificity by the cTI level (100%). Authors found a higher level of cTI even after 72 hours of the onset of symptoms of myocardial infarction. After thrombolysis the wash out phenomen was more expressive compared with the values of CK-MB enzymes. A moderate but significant increase was observed of the cTI level in unstable angina. The measuring of cTI in acute coronary syndrome gives an important information to the correct diagnosis. The prognostic considerations of cTI level in unstable angina are interpreted by authors according to relevant data of literature.
Subject(s)
Coronary Disease/blood , Creatine Kinase/blood , Isoenzymes/blood , Troponin I/blood , Acute Disease , Adult , Aged , Biomarkers/blood , Coronary Disease/drug therapy , Coronary Disease/enzymology , Coronary Disease/physiopathology , Creatine Kinase, MB Form , Diagnosis, Differential , Electrocardiography , Female , Humans , Male , Middle Aged , Predictive Value of Tests , Prognosis , Syndrome , Thrombolytic TherapyABSTRACT
In order to clarify the origin of hyperglycaemia, blood glucose, glycated haemoglobin (GHb) and protein-corrected serum fructosamine (SFA) values were simultaneously determined at admission of 65 patients with acute myocardial infarction while oral glucose tolerance test was performed later at discharge. In 29 patients no alterations in carbohydrate metabolism were found (blood glucose: 5.2 +/- 0.1 mmol/l, GHb: 4.4 +/- 0.1%, SFA: 2.20 +/- 0.08 mmol/l) while in 9 patients diabetes was already recorded in the medical history (blood glucose: 11.5 +/- 1.1 mmol/l, GHb: 7.9 +/- 0.9%, SFA: 3.36 +/- 0.31 mmol/l, p < 0.001). Undiagnosed diabetes was documented in 8 patients (blood glucose: 11.8 +/- 1.3 mmol/l, GHb: 7.3 +/- 0.6%, SFA: 3.51 +/- 0.24 mmol/l) while stress-hyperglycaemia was found in 19 patients (blood glucose: 8.4 +/- 0.3 mmol/l, GHb: 4.5 +/- 0.1%, SFA: 2.55 +/- 0.17 mmol/l). Undiagnosed diabetes could be recorded in one seventh while stress-hyperglycaemia could be found in one third of non-diabetic patients with acute myocardial infarction. Due to overlapping values SFA is not suitable to distinguish between stress-hyperglycaemia and undiagnosed diabetes in patients with acute myocardial infarction.
