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Multi-Marker Approach with the Use of Biochip Cardiac Array Technology for Early Diagnosis in Patients with Acute Coronary Syndromes
INTRODUCTION: Diagnosis of acute coronary syndrome (ACS) is frequently a challenging task while immediate risk stratification remains crucial for the prompt implementation of appropriate therapy in this setting. The prolonged release pattern of both CK-MB mass and cardiac troponins makes it difficul...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Communications and Publications Division (CPD) of the IFCC
2008
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4975262/ https://www.ncbi.nlm.nih.gov/pubmed/27683314 |
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author | Sawicki, Marcin Sypniewska, Grazyna Krintus, Magdalena Kozinski, Marek Ostrowska-Nowak, Joanna Pilaczyńska-Cemel, Marta Budzbon, Dominika Jacek, Kubica |
author_facet | Sawicki, Marcin Sypniewska, Grazyna Krintus, Magdalena Kozinski, Marek Ostrowska-Nowak, Joanna Pilaczyńska-Cemel, Marta Budzbon, Dominika Jacek, Kubica |
author_sort | Sawicki, Marcin |
collection | PubMed |
description | INTRODUCTION: Diagnosis of acute coronary syndrome (ACS) is frequently a challenging task while immediate risk stratification remains crucial for the prompt implementation of appropriate therapy in this setting. The prolonged release pattern of both CK-MB mass and cardiac troponins makes it difficult to identify the origin of recent chest pain, thus a combination of early and later biomarkers might further facilitate the differential diagnosis. The study was designed to evaluate the efficacy of multi-marker approach using biochip array technology in identifying ACS shortly after the symptom onset. MATERIAL AND METHODS: The study group consisted of 42 patients suspected for ACS. Subjects were diagnosed as presenting with unstable angina (UA), non-ST-elevation myocardial infarction (NSTEMI) or ST-elevation myocardial infarction (STEMI). Biomarkers in the serum were determined twice: on admission (≤6 hours from the chest pain onset) and after next 6 hours. Cardiac troponin I was measured by routine sensitive automated assay (STAT cTnI) while other 6 cardiac markers (heart-fatty acid binding protein - H-FABP, myoglobin, glycogen phosphorylase BB, cTn I, CK-MB mass and carbonic anhydrase III) were assessed using biochip array technology. RESULTS: STAT cTnI concentrations within 6 hours from the symptom onset were elevated over the 99(th) percentile for reference population in 83.3% of subjects but none reached the cut-off value for myocardial infarction. Instead, H-FABP demonstrated a very good efficacy in early detection of ACS (90.5%), better than myoglobin and CK-MB mass. Sensitivity of H-FABP calculated for NSTEMI/STEMI subjects reached 100%. The diagnostic efficacy of troponin, myoglobin and CK-MB mass assay markedly increased within 12 hours. It was only for the patients with UA that the cardiac panel was not efficient in the early stratification of risk. CONCLUSIONS: A multi-marker strategy with H-FABP and highly sensitive troponin included enhances the early diagnosis and decision making process in patients with ACS. A new biochip cardiac array technology may serve as a powerful tool for ACS detection in the clinical practice. |
format | Online Article Text |
id | pubmed-4975262 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2008 |
publisher | The Communications and Publications Division (CPD) of the IFCC |
record_format | MEDLINE/PubMed |
spelling | pubmed-49752622016-09-28 Multi-Marker Approach with the Use of Biochip Cardiac Array Technology for Early Diagnosis in Patients with Acute Coronary Syndromes Sawicki, Marcin Sypniewska, Grazyna Krintus, Magdalena Kozinski, Marek Ostrowska-Nowak, Joanna Pilaczyńska-Cemel, Marta Budzbon, Dominika Jacek, Kubica EJIFCC Research Article INTRODUCTION: Diagnosis of acute coronary syndrome (ACS) is frequently a challenging task while immediate risk stratification remains crucial for the prompt implementation of appropriate therapy in this setting. The prolonged release pattern of both CK-MB mass and cardiac troponins makes it difficult to identify the origin of recent chest pain, thus a combination of early and later biomarkers might further facilitate the differential diagnosis. The study was designed to evaluate the efficacy of multi-marker approach using biochip array technology in identifying ACS shortly after the symptom onset. MATERIAL AND METHODS: The study group consisted of 42 patients suspected for ACS. Subjects were diagnosed as presenting with unstable angina (UA), non-ST-elevation myocardial infarction (NSTEMI) or ST-elevation myocardial infarction (STEMI). Biomarkers in the serum were determined twice: on admission (≤6 hours from the chest pain onset) and after next 6 hours. Cardiac troponin I was measured by routine sensitive automated assay (STAT cTnI) while other 6 cardiac markers (heart-fatty acid binding protein - H-FABP, myoglobin, glycogen phosphorylase BB, cTn I, CK-MB mass and carbonic anhydrase III) were assessed using biochip array technology. RESULTS: STAT cTnI concentrations within 6 hours from the symptom onset were elevated over the 99(th) percentile for reference population in 83.3% of subjects but none reached the cut-off value for myocardial infarction. Instead, H-FABP demonstrated a very good efficacy in early detection of ACS (90.5%), better than myoglobin and CK-MB mass. Sensitivity of H-FABP calculated for NSTEMI/STEMI subjects reached 100%. The diagnostic efficacy of troponin, myoglobin and CK-MB mass assay markedly increased within 12 hours. It was only for the patients with UA that the cardiac panel was not efficient in the early stratification of risk. CONCLUSIONS: A multi-marker strategy with H-FABP and highly sensitive troponin included enhances the early diagnosis and decision making process in patients with ACS. A new biochip cardiac array technology may serve as a powerful tool for ACS detection in the clinical practice. The Communications and Publications Division (CPD) of the IFCC 2008-12-20 /pmc/articles/PMC4975262/ /pubmed/27683314 Text en Copyright © 2008 International Federation of Clinical Chemistry and Laboratory Medicine (IFCC). All rights reserved. http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Sawicki, Marcin Sypniewska, Grazyna Krintus, Magdalena Kozinski, Marek Ostrowska-Nowak, Joanna Pilaczyńska-Cemel, Marta Budzbon, Dominika Jacek, Kubica Multi-Marker Approach with the Use of Biochip Cardiac Array Technology for Early Diagnosis in Patients with Acute Coronary Syndromes |
title | Multi-Marker Approach with the Use of Biochip Cardiac Array Technology for Early Diagnosis in Patients with Acute Coronary Syndromes |
title_full | Multi-Marker Approach with the Use of Biochip Cardiac Array Technology for Early Diagnosis in Patients with Acute Coronary Syndromes |
title_fullStr | Multi-Marker Approach with the Use of Biochip Cardiac Array Technology for Early Diagnosis in Patients with Acute Coronary Syndromes |
title_full_unstemmed | Multi-Marker Approach with the Use of Biochip Cardiac Array Technology for Early Diagnosis in Patients with Acute Coronary Syndromes |
title_short | Multi-Marker Approach with the Use of Biochip Cardiac Array Technology for Early Diagnosis in Patients with Acute Coronary Syndromes |
title_sort | multi-marker approach with the use of biochip cardiac array technology for early diagnosis in patients with acute coronary syndromes |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4975262/ https://www.ncbi.nlm.nih.gov/pubmed/27683314 |
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