A Comparative Study of Biochemical Markers in the Early Diagnosis of Acute Myocardial Infarction (AMI)

M. Sohaib, Hannana Maryam, Dr. Abid Ali, M. Fatima, Waqar Ahmad
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引用次数: 1

Abstract

Background: One of the most effective instances of readily detected biomarkers diagnosing a very big health concern is the measuring of proteins in blood to represent heart damage. The idea of utilizing a blood test to reflect organ or cell harm necessitates a chemical that is plentiful in the target cell, can reach blood, has a suitable half-life in blood, and is preferably in a particular form that only reflects the target cell in tissue. Because contraction is the primary function of the myocyte, proteins involved in contraction or the energy required to sustain it should be suitable potential indicators. The work on diagnostic tests for myofibrillar proteins begins in 1978. Different key pieces of evidence fueled in the research. In Ist-year outcomes were identical in chest pain patients whose acute myocardial infarction (AMI) was ruled out by electrocardiography and cardiac enzymes, demonstrating that the existing diagnostic tools were not beneficial for risk prediction and treatment recommendations. Second, CK and lactate dehydrogenase isoenzymes were brought into clinical practice and demonstrated to have higher specificity and sensitivity than traditional tests. All of the biomarkers used to diagnose cardiac injury are involved in contraction or energy metabolism, but the markers evolved via trial and error, beginning with transaminases in the 1950s and ending with troponins in the 1990s. This background is discussed, along with observations on my experiences establishing CK-MB and Troponin I assays. Methods: 140 individuals with AMI are included who are diagnosed using WHO criteria. A cross-sectional study with purposive sampling technique is conducted in wazirabad institute of Cardiology. This research is last around 6 months. Before the examinations, blood samples are obtained from patients by vein puncture using syringes and preserved in clot tubes. The research includes patients experiencing chest pressure, tightness, or discomfort, shortness of breath, and irregular cardiac rhythms on ECG. Patients having a normal ECG are not included in the study. Different equipments are utilized to assess appropriate heart function and to obtain serum for the identification of various cardiac biomarkers. Result: The sensitivities of all biochemical markers change depending on the time of infarction, as previously demonstrated and expected from a patho-physiologic standpoint, the blood sample of all the patients was collected and used for further investigation in the Lab. In the current study, 140 patients are enrolled, and all of the patients who had a single episode of AMI had their ECGs taken. All of the patients' ECGs are abnormal. In compared to other Bio-Cardiac Markers, the Troponin –I has a higher ratio of patients, according to the present findings. When a person undergoes AMI, the first protein that is released is troponin-I. When these tests are conducted over a period of time, they provide us with a quick assessment of the severity of AMI. As a result of the current findings, patients have a higher level of Trop-I in their blood when they experience their first episode of AMI. In this situation, the patient should go to the nearest health care center's emergency room as quickly as feasible. Conclusion: The traditional enzymatic assays of creatine kinase (CK), CK-MB (activity), and lactate dehydrogenase are rapidly being replaced by mass measurements of myoglobin, CKMB, and troponin T and troponin I (Tnl) 1 " to achieve high diagnostic sensitivity and specificity within a few hours from the onset of tissue necrosis; the ultimate goal is the early and appropriate management of patients' conditions. We compared the diagnostic sensitivity and specificity obtained by measuring various biochemical markers, some of which are widely used, and concluded that Troponin I is the first cardiac marker that releases simultaneously after the first episode of AMI when performed as single tests and in parallel and serial modes.
生化指标在急性心肌梗死(AMI)早期诊断中的比较研究
背景:检测生物标志物诊断重大健康问题最有效的例子之一是测量血液中的蛋白质来代表心脏损伤。利用血液测试来反映器官或细胞损伤的想法需要一种化学物质,这种化学物质在目标细胞中含量丰富,可以到达血液,在血液中有适当的半衰期,并且最好是一种只反映组织中目标细胞的特定形式。由于收缩是肌细胞的主要功能,参与收缩的蛋白质或维持收缩所需的能量应该是合适的潜在指标。肌原纤维蛋白的诊断试验工作始于1978年。研究中不同的关键证据。通过心电图和心肌酶检查排除急性心肌梗死(AMI)的胸痛患者的1年预后相同,表明现有的诊断工具不利于风险预测和治疗建议。其次,CK和乳酸脱氢酶同工酶被引入临床实践,具有比传统检测更高的特异性和敏感性。所有用于诊断心脏损伤的生物标志物都与收缩或能量代谢有关,但这些标志物是通过反复试验而发展起来的,从20世纪50年代的转氨酶开始,到20世纪90年代的肌钙蛋白结束。本文讨论了这一背景,并对我建立CK-MB和肌钙蛋白I测定法的经验进行了观察。方法:采用who标准诊断的AMI患者140例。在瓦济拉巴德心脏病研究所进行了一项有目的抽样技术的横断面研究。这项研究将持续6个月左右。检查前,用注射器静脉穿刺从患者身上采集血液样本,并保存在凝血管中。研究对象包括胸压、胸闷或不适、呼吸短促、心电节律不规则的患者。心电图正常的患者不包括在研究中。使用不同的设备来评估适当的心脏功能,并获得用于鉴定各种心脏生物标志物的血清。结果:所有生化指标的敏感性随梗死时间的变化而变化,正如先前所证明的和从病理生理学的角度所期望的那样,所有患者的血液样本都被收集并用于实验室的进一步研究。在目前的研究中,140名患者被纳入,所有发生过一次急性心肌梗死的患者都进行了心电图检查。所有患者的心电图均异常。根据目前的研究结果,与其他生物心脏标志物相比,肌钙蛋白- 1在患者中的比例更高。当一个人患有急性心肌梗塞时,首先释放的蛋白质是肌钙蛋白- 1。当这些测试在一段时间内进行时,它们为我们提供了对急性心肌梗塞严重程度的快速评估。根据目前的研究结果,患者在首次急性心肌梗塞发作时血液中trop - 1水平较高。在这种情况下,患者应该尽快去最近的卫生保健中心的急诊室。结论:肌酸激酶(CK)、CK- mb(活性)和乳酸脱氢酶的传统酶检测正迅速被肌红蛋白、CKMB、肌钙蛋白T和肌钙蛋白I (Tnl) 1”的质量测量所取代,以在组织坏死发生后几小时内实现高诊断敏感性和特异性;最终目标是对患者的病情进行早期和适当的管理。我们比较了通过测量各种生化标志物获得的诊断敏感性和特异性,其中一些被广泛使用,并得出结论:肌钙蛋白I是第一个在AMI首次发作后同时释放的心脏标志物,无论是单次检测还是并行和串联方式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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