1
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Alizadeh-Fanalou S, Mehdipour S, Rokhsartalb-Azar S, Mohammadi F, Ghorban K, Asri S, Mousavi SH, Karami M. Evaluation of novel biomarkers for early diagnosis of bisphenol A-induced coronary artery disease. Heliyon 2024; 10:e23768. [PMID: 38234885 PMCID: PMC10792579 DOI: 10.1016/j.heliyon.2023.e23768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 01/19/2024] Open
Abstract
Introduction Bisphenol A (BPA), a ubiquitous synthetic monomer primarily used in the manufacture of polycarbonate plastic and epoxy resins and as a non-polymer additive to other plastics, can leach into the food and water supply and has been linked to cardiovascular disease (CVD). This study aimed to analyze BPA levels in patients with varying numbers of coronary artery stenosis and evaluate the prognostic value of new biomarkers cluster of differentiation 36 (CD36) and heart-type fatty acid-binding protein (H-FABP), compared to troponin I and creatine kinase (CK) MB, for detecting myocardial injury. Method Eighty nine patients undergoing angiography at Urmia Hospital from March 2019 to 2020 were included. Serum levels of BPA, CD36, H-FABP, troponin I, and CK-M were measured. Results When comparing CD36 and H-FABP with troponin I and CK-MB across coronary occlusion classes, receiver operating characteristic curves indicated CD36 and H-FABP had higher accuracy than troponin I and CK-MB for detecting stenosis stages. In patients with occlusion, significant alterations were detected in age, sex, BMI, hypertension, diabetes, dyslipidemia, and smoking. BPA serum concentration significantly increased compared to normal subjects. Conclusions Our study revealed that serum biomarkers were valuable for prognosticating myocardial injury. Among these, CD36 and H-FABP were more accurate. BPA concentration correlated with myocardial necrosis, underlying disease, and occlusion stage, suggesting BPA's harmful effects.
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Affiliation(s)
- Shahin Alizadeh-Fanalou
- Department of Biochemistry, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
- Department of Clinical Biochemistry, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Sara Mehdipour
- Department of Biochemistry, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Shirin Rokhsartalb-Azar
- Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University (TMU), Tehran, Iran
| | - Forogh Mohammadi
- Department of Veterinary, Agriculture Faculty, Kermanshah Branch, Islamic Azad University, Kermanshah, Iran
| | - Khodayar Ghorban
- Department of Medical Immunology, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Siamak Asri
- Department of Internal Medicine and Clinical Pathology, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Seyyed Hosein Mousavi
- Department of Cardiology, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Masoumeh Karami
- Department of Biochemistry, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
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Allach Y, Brugts JJ. The role of serial cardiac biomarkers in prognostication and risk prediction of chronic heart failure: additional scientific insights with hemodynamic feedback. Expert Rev Cardiovasc Ther 2023; 21:97-109. [PMID: 36744389 DOI: 10.1080/14779072.2023.2177635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Heart failure (HF) is considered as a chronic long-term and lethal disease and will continue to be a major public health problem. Studying (circulating) biomarkers is a promising field of research and could be the first step toward HF tailored prognostic strategies as well as understanding the response to HF drugs in CHF patients. AREAS COVERED In literature, there has been considerable research on elevated biomarker levels that are related to a poor prognosis for HF. Since biomarker levels change over time, it is important to study serial (repeated) biomarker measurements which may help us better understand the dynamic course of HF illness. However, the majority of research focuses predominantly on baseline values of biomarkers. Additionally, remote monitoring devices, like sensors, can be used to link hemodynamic information to freshen biomarker data in order to further ameliorate the management of HF. EXPERT OPINION Novel biomarkers and additional scientific insights with hemodynamic feedback strongly aid in the prognostication and risk prediction of chronic HF.
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Affiliation(s)
- Youssra Allach
- Department of Cardiology, Erasmus University Medical Centre; 3015 Rotterdam; The Netherlands
| | - Jasper J Brugts
- Department of Cardiology, Erasmus University Medical Centre; 3015 Rotterdam; The Netherlands
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Medina-Hernández EO, Pérez-Navarro LM, Hernández-Ruiz J, Villalobos-Osnaya A, L Hernández-Medel M, Casillas-Suárez C, Pérez-García A. Changes in lactate dehydrogenase on admission throughout the COVID-19 pandemic and possible impacts on prognostic capability. Biomark Med 2022; 16:1019-1028. [PMID: 36052694 PMCID: PMC9443787 DOI: 10.2217/bmm-2022-0364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Introduction: The enzyme lactate dehydrogenase (LDH) is a good marker of general hyperinflammation correlated with mortality for COVID-19, and is therefore used in prognosis tools. In a current COVID-19 clinical randomized trial (CRT), the blood level of LDH was selected as an inclusion criterion. However, LDH decreased during the pandemic; hence, the impact of this decrease on the prognostic value of LDH for mortality was evaluated. Methods: Data on LDH levels in 843 patients were obtained and analyzed. Relative risk, standard error and receiver operating characteristic curves were calculated for two cutoff values. Results: Relative risk lost validity and the area under the curve narrowed by trimester during the pandemic. Conclusion: The progressive decrease in LDH impacted the capacity to predict mortality in COVID-19. More studies are needed to validate this finding and its implications.
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Affiliation(s)
| | | | - Joselín Hernández-Ruiz
- 2Research Department, Hospital General de México ‘Dr Eduardo Liceaga’, Mexico,3Nephrology Department, School of Medicine, University of Utah, UT, USA
| | | | | | | | - Adolfo Pérez-García
- 2Research Department, Hospital General de México ‘Dr Eduardo Liceaga’, Mexico,Author for correspondence: Tel.: +52 (55) 2789 2000 1385;
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4
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Sepúlveda R, Saldivia M, Vásquez S. Niveles séricos de la isoenzima creatina quinasa-MB y lactato deshidrogenasa como indicadores de daño miocárdico en perros con enfermedad valvular degenerativa. REVISTA DE LA FACULTAD DE MEDICINA VETERINARIA Y DE ZOOTECNIA 2022. [DOI: 10.15446/rfmvz.v69n1.101533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Se analizaron los niveles séricos de creatina quinasa-MB (CK-MB) y lactato deshidrogenasa (LDH) en 10 perros diagnosticados con enfermedad valvular degenerativa y en seis perros clínicamente sanos, con el objetivo de evaluar si sus niveles séricos indican daño miocárdico. Las muestras de suero se analizaron mediante el método UV. Se utilizó la prueba de diferenciación de medias para determinar diferencias entre medias, y la prueba de correlación de Pearson para determinar si existe correlación entre los niveles séricos de ambas enzimas. Los valores de CK-MB y de LDH fueron significativamente diferentes entre los dos grupos de pacientes. Los niveles de CK-MB y LDH tuvieron correlación positiva, pero no significativa.
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Linares Ballesteros A, Sanguino Lobo R, Villada Valencia JC, Arévalo Leal O, Plazas Hernández DC, Aponte Barrios N, Perdomo Ramírez I. Early-onset Cardiotoxicity assessment related to anthracycline in children with leukemia. A Prospective Study. Colomb Med (Cali) 2021; 52:e2034542. [PMID: 33911320 PMCID: PMC8054707 DOI: 10.25100/cm.v52i1.4542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background: Acute leukemias are the most frequent malignancies in children. Advances in treatment have improved the overall survival to 80%. Almost 10% of children with cancer develop clinical cardiac toxicity. Total anthracycline cumulative dose is a risk factor for early-onset cardiotoxicity. Objective: To describe the incidence of early-onset cardiotoxicity in children with acute leukemia treated with chemotherapy. Methods: A prospective descriptive study of patients >1 y and <18 years diagnosed with acute leukemia. Assessed with electrocardiograma, echocardiography, and blood biomarkers at diagnosis and during the follow-up. Results: 94 patients with acute lymphoblastic leukemia and 18 with acute myeloid leukemia were included. 20 patients (17.9%) developed early-onset cardiotoxicity. Statistically significant data was seen after anthracycline dose >150 mg/m2, between the first echocardiographic evaluation and posterior analyses in the left ventricular fraction ejection with Teicholz p 0.05, Simpson p 0.018 and GLS p 0.004. In this study, there was no relation between blood biomarkers and cardiotoxicity. Conclusions: Cancer therapeutic-related cardiac dysfunction is related to anthracycline cumulative dose. In this study, echocardiographic follow-up was useful to predict risk factors for early cardiac dysfunction.
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Affiliation(s)
- Adriana Linares Ballesteros
- Universidad Nacional de Colombia, Facultad de Medicina, Departamento de Pediatría, Bogotá, Colombia Universidad Nacional de Colombia Universidad Nacional de Colombia Facultad de Medicina Departamento de Pediatría Bogotá Colombia.,Fundación Hospital Pediátrico de la Misericordia-HOMI, Oncohematología pediátrica, Bogotá Colombia Fundación Hospital Pediátrico de la Misericordia-HOMI Oncohematología pediátrica Bogotá Colombia
| | - Roy Sanguino Lobo
- Fundación Hospital Pediátrico de la Misericordia-HOMI, Cardiología pediátrica, Bogotá Colombia Fundación Hospital Pediátrico de la Misericordia-HOMI Cardiología pediátrica Bogotá Colombia
| | - Juan Camilo Villada Valencia
- Universidad Nacional de Colombia, Facultad de Medicina, Departamento de Pediatría, Bogotá, Colombia Universidad Nacional de Colombia Universidad Nacional de Colombia Facultad de Medicina Departamento de Pediatría Bogotá Colombia
| | - Oscar Arévalo Leal
- Fundación Hospital Pediátrico de la Misericordia-HOMI, Cardiología pediátrica, Bogotá Colombia Fundación Hospital Pediátrico de la Misericordia-HOMI Cardiología pediátrica Bogotá Colombia
| | - Diana Constanza Plazas Hernández
- Universidad Nacional de Colombia, Facultad de Medicina, Departamento de Pediatría, Bogotá, Colombia Universidad Nacional de Colombia Universidad Nacional de Colombia Facultad de Medicina Departamento de Pediatría Bogotá Colombia.,Fundación Hospital Pediátrico de la Misericordia-HOMI, Oncohematología pediátrica, Bogotá Colombia Fundación Hospital Pediátrico de la Misericordia-HOMI Oncohematología pediátrica Bogotá Colombia
| | - Nelson Aponte Barrios
- Fundación Hospital Pediátrico de la Misericordia-HOMI, Oncohematología pediátrica, Bogotá Colombia Fundación Hospital Pediátrico de la Misericordia-HOMI Oncohematología pediátrica Bogotá Colombia
| | - Iván Perdomo Ramírez
- Fundación Hospital Pediátrico de la Misericordia-HOMI, Unidad Cuidado Intensivo pediátrico, Bogotá Colombia Fundación Hospital Pediátrico de la Misericordia-HOMI Unidad Cuidado Intensivo pediátrico Bogotá Colombia
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Genovés P, Arias-Mutis ÓJ, Parra G, Such-Miquel L, Zarzoso M, Del Canto I, Soler C, Díaz A, Blanch E, Alberola A, Such L, Chorro FJ. Development and Long-Term Follow-Up of an Experimental Model of Myocardial Infarction in Rabbits. Animals (Basel) 2020; 10:ani10091576. [PMID: 32899601 PMCID: PMC7552163 DOI: 10.3390/ani10091576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/21/2020] [Accepted: 09/01/2020] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Ischemic heart disease is one of the leading causes of death. A series of processes occur during acute myocardial infarction that contribute to the development of ventricular dysfunction, with subsequent heart failure and ventricular arrhythmias, which account for most episodes of sudden cardiac death in these patients. These complications are associated with the adverse cardiac remodeling that occurs during the healing process following an acute episode. The remodeling causes the appearance of a substrate that can trigger life-threatening arrhythmias, such as tachycardia and/or ventricular fibrillation. The development of experimental models for analyzing the basic mechanisms involved in the pathophysiology of myocardial infarction enables the study of different therapeutic approaches aimed at improving the patient´s prognosis. The present study describes the methodology and the results obtained in a 5-week chronic infarction (one hour followed by reperfusion) in a rabbit model. The viability of the model, the care provided, the characteristics and extent of the lesions, the inducibility of arrhythmias, and the reproducibility of the methods and results have been analyzed. Abstract A chronic model of acute myocardial infarction was developed to study the mechanisms involved in adverse postinfarction ventricular remodeling. In an acute myocardial infarction (AMI), the left circumflex coronary artery of New Zealand White rabbits (n = 9) was occluded by ligature for 1 h, followed by reperfusion. A specific care protocol was applied before, during, and after the intervention, and the results were compared with those of a sham operated group (n = 7). After 5 weeks, programmed stimulation and high-resolution mapping were performed on isolated and perfused hearts using the Langendorff technique. The infarct size determined by 2,3,5-triphenyltetrazolium chloride inside of the area at risk (thioflavin-S) was then determined. The area at risk was similar in both groups (54.33% (experimental infarct group) vs. 58.59% (sham group), ns). The infarct size was 73.16% as a percentage of the risk area. The experimental infarct group had a higher inducibility of ventricular arrhythmias (100% vs. 43% in the sham group, p = 0.009). A reproducible chronic experimental model of myocardial infarction is presented in which the extent and characteristics of the lesions enable the study of the vulnerability to develop ventricular arrhythmias because of the remodeling process that occurs during cardiac tissue repair.
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Affiliation(s)
- Patricia Genovés
- INCLIVA, Institute of Health Research, 46010 Valencia, Spain; (P.G.); (Ó.J.A.-M.); (G.P.); (I.D.C.)
- Department of Physiology, Universitat de València, 46010 Valencia, Spain; (C.S.); (A.A.); (L.S.)
| | - Óscar J. Arias-Mutis
- INCLIVA, Institute of Health Research, 46010 Valencia, Spain; (P.G.); (Ó.J.A.-M.); (G.P.); (I.D.C.)
- Department of Physiology, Universitat de València, 46010 Valencia, Spain; (C.S.); (A.A.); (L.S.)
| | - Germán Parra
- INCLIVA, Institute of Health Research, 46010 Valencia, Spain; (P.G.); (Ó.J.A.-M.); (G.P.); (I.D.C.)
- Department of Physiology, Universitat de València, 46010 Valencia, Spain; (C.S.); (A.A.); (L.S.)
| | - Luis Such-Miquel
- Department of Physiotherapy, Universitat de València, 46010 Valencia, Spain; (L.S.-M.); (M.Z.)
- CIBERCV, Carlos III Health Institute, 28029 Madrid, Spain
| | - Manuel Zarzoso
- Department of Physiotherapy, Universitat de València, 46010 Valencia, Spain; (L.S.-M.); (M.Z.)
| | - Irene Del Canto
- INCLIVA, Institute of Health Research, 46010 Valencia, Spain; (P.G.); (Ó.J.A.-M.); (G.P.); (I.D.C.)
- CIBERCV, Carlos III Health Institute, 28029 Madrid, Spain
- Electronic Engineering Department, Universitat Politècnica de València, 46022 Valencia, Spain
| | - Carlos Soler
- Department of Physiology, Universitat de València, 46010 Valencia, Spain; (C.S.); (A.A.); (L.S.)
| | - Ana Díaz
- UCIM, Universitat de València, 46010 Valencia, Spain; (A.D.); (E.B.)
| | - Eva Blanch
- UCIM, Universitat de València, 46010 Valencia, Spain; (A.D.); (E.B.)
| | - Antonio Alberola
- Department of Physiology, Universitat de València, 46010 Valencia, Spain; (C.S.); (A.A.); (L.S.)
- CIBERCV, Carlos III Health Institute, 28029 Madrid, Spain
| | - Luis Such
- Department of Physiology, Universitat de València, 46010 Valencia, Spain; (C.S.); (A.A.); (L.S.)
- CIBERCV, Carlos III Health Institute, 28029 Madrid, Spain
| | - Francisco J. Chorro
- INCLIVA, Institute of Health Research, 46010 Valencia, Spain; (P.G.); (Ó.J.A.-M.); (G.P.); (I.D.C.)
- CIBERCV, Carlos III Health Institute, 28029 Madrid, Spain
- Cardiology Department, Hospital Clinico Universitario, Universitat de València, Avda. Blasco Ibañez 17, 46010 Valencia, Spain
- Correspondence:
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7
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Dong C, Chen J, Zheng J, Liang Y, Yu T, Liu Y, Gao F, Long J, Chen H, Zhu Q, He Z, Hu S, He C, Lin J, Tang Y, Zhu H. 5-Hydroxymethylcytosine signatures in circulating cell-free DNA as diagnostic and predictive biomarkers for coronary artery disease. Clin Epigenetics 2020; 12:17. [PMID: 31964422 PMCID: PMC6974971 DOI: 10.1186/s13148-020-0810-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 01/06/2020] [Indexed: 02/07/2023] Open
Abstract
Background The 5-hydroxymethylcytosine (5hmC) DNA modification is an epigenetic marker involved in a range of biological processes. Its function has been studied extensively in tumors, neurodegenerative diseases, and atherosclerosis. Studies have reported that 5hmC modification is closely related to the phenotype transformation of vascular smooth muscle cells and endothelial dysfunction. However, its role in coronary artery disease (CAD) has not been fully studied. Results To investigate whether 5hmC modification correlates with CAD pathogenesis and whether 5hmC can be used as a biomarker, we used a low-input whole-genome sequencing technology based on selective chemical capture (hmC-Seal) to firstly generate the 5hmC profiles in the circulating cell-free DNA(cfDNA) of CAD patients, including stable coronary artery disease (sCAD) patients and acute myocardial infarction (AMI) patients. We detected a significant difference of 5hmC enrichment in gene bodies from CAD patients compared with normal coronary artery (NCA) individuals. Our results showed that CAD patients can be well separated from NCA individuals by 5hmC markers. The prediction performance of the model established by differentially regulated 5hmc modified genes were superior to common clinical indicators for the diagnosis of CAD (AUC = 0.93) and sCAD (AUC = 0.93). Specially, we found that 5hmC markers in cfDNA showed prediction potential for AMI (AUC = 0.95), which was superior to that of cardiac troponin I, muscle/brain creatine kinase, and myoglobin. Conclusions Our results suggest that 5hmC markers derived from cfDNA can serve as effective epigenetic biomarkers for minimally noninvasive diagnosis and prediction of CAD.
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Affiliation(s)
- Chaoran Dong
- State Key Laboratory for Bioactive Substances and Functions of Natural Medicines, Beijing Key Laboratory of New Drug Mechanisms and Pharmacological Evaluation Study, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Xian Nong Tan Street 1, Xicheng District, Beijing, 100050, China
| | - Jiemei Chen
- State Key Laboratory for Bioactive Substances and Functions of Natural Medicines, Beijing Key Laboratory of New Drug Mechanisms and Pharmacological Evaluation Study, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Xian Nong Tan Street 1, Xicheng District, Beijing, 100050, China
| | - Jilin Zheng
- Department of Cardiology, Coronary Heart Disease Center, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing, 100037, China
| | - Yiming Liang
- College of Chemistry and Molecular Engineering, Innovation Center for Genomics, Peking University, No. 5 Yiheyuan Road Haidian District, Beijing, 100871, China
| | - Tao Yu
- State Key Laboratory of Microbial Resources, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Yupeng Liu
- Department of Cardiology, Coronary Heart Disease Center, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing, 100037, China
| | - Feng Gao
- State Key Laboratory for Bioactive Substances and Functions of Natural Medicines, Beijing Key Laboratory of New Drug Mechanisms and Pharmacological Evaluation Study, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Xian Nong Tan Street 1, Xicheng District, Beijing, 100050, China
| | - Jie Long
- State Key Laboratory for Bioactive Substances and Functions of Natural Medicines, Beijing Key Laboratory of New Drug Mechanisms and Pharmacological Evaluation Study, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Xian Nong Tan Street 1, Xicheng District, Beijing, 100050, China
| | - Hangyu Chen
- College of Chemistry and Molecular Engineering, Innovation Center for Genomics, Peking University, No. 5 Yiheyuan Road Haidian District, Beijing, 100871, China
| | - Qianhui Zhu
- State Key Laboratory of Microbial Resources, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Zilong He
- State Key Laboratory of Microbial Resources, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Songnian Hu
- State Key Laboratory of Microbial Resources, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Chuan He
- College of Chemistry and Molecular Engineering, Innovation Center for Genomics, Peking University, No. 5 Yiheyuan Road Haidian District, Beijing, 100871, China.,Department of Chemistry, Department of Biochemistry and Molecular Biology, Howard Hughes Medical Institute, The University of Chicago, Chicago, IL, 60637, USA
| | - Jian Lin
- College of Chemistry and Molecular Engineering, Innovation Center for Genomics, Peking University, No. 5 Yiheyuan Road Haidian District, Beijing, 100871, China.
| | - Yida Tang
- Department of Cardiology, Coronary Heart Disease Center, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing, 100037, China.
| | - Haibo Zhu
- State Key Laboratory for Bioactive Substances and Functions of Natural Medicines, Beijing Key Laboratory of New Drug Mechanisms and Pharmacological Evaluation Study, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Xian Nong Tan Street 1, Xicheng District, Beijing, 100050, China.
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8
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Odum EP, Young EE. Elevated cardiac troponin I, creatine kinase and myoglobin and their relationship with cardiovascular risk factors in patients with type 2 diabetes. Diabetes Metab Syndr 2018; 12:141-145. [PMID: 29254891 DOI: 10.1016/j.dsx.2017.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 12/12/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Elevated cardiac troponin I, Creatine kinase (CK-MB) and Myoglobin levels are observed in the setting of acute myocardial damage. However sub-clinical elevations occur in patients with diabetes mellitus. This study was carried out to determine the relationship between the presence of multiple cardiovascular risk factors and the metabolic syndrome and elevations in cardiac markers in patients with type2 diabetes mellitus. SUBJECTS AND METHODS Consecutive stable out-patients with type2 diabetes mellitus at the University of Port Harcourt Teaching Hospital, Nigeria were recruited. Non-diabetic individuals such as hospital staff and the general public acted as controls. Baseline demographic data collection was done and waist circumference, weight, height and blood pressure were measured. Venous samples were assayed for CTnI, CK-MB and Myoglobin levels using ELISA. Data was analysed using SPSS v 20. RESULTS There were 188 DM patients, who were older than the 200 control subjects (56.1 ± 13.1 years and 42.7 ± 5.7 years, p < 0.001). Mean duration of diabetes was 7.1(5.7) years. Hypertension was present in 59%, 84.6% had dyslipidaemia, while 76.1% had metabolic syndrome. All the cardiac markers were significantly higher in DM patients than controls. The presence of hypertension or dyslipidaemia was not significantly associated with the cardiac markers (p > 0.05 for all), however the DM patients with metabolic syndrome had higher levels of CK-MB and myoglobin but not CTnI than those without. CONCLUSION Diabetes mellitus is associated with chronic sub-clinical elevation of cardiac markers and this is more in those with multiple cardiovascular risk factors and/or the metabolic syndrome.
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Affiliation(s)
- Ehimen Phyllis Odum
- Department of Chemical Pathology, University of Port Harcourt Teaching Hospital Port Harcourt, Rivers State, Nigeria
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9
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Parizadeh SM, Ferns GA, Ghandehari M, Hassanian SM, Ghayour-Mobarhan M, Parizadeh SMR, Avan A. The diagnostic and prognostic value of circulating microRNAs in coronary artery disease: A novel approach to disease diagnosis of stable CAD and acute coronary syndrome. J Cell Physiol 2018; 233:6418-6424. [PMID: 29215707 DOI: 10.1002/jcp.26324] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 11/30/2017] [Indexed: 12/22/2022]
Abstract
Coronary artery disease (CAD) is the most common manifestation of CVD and the acute coronary syndrome (ACS) is associated with a substantial morbidity and mortality in most populations globally. There are several biomarkers for diagnosis of MI. Troponin is routinely used as a biomarker in patients with chest pain, but it lacks sensitivity in the first hours of onset of symptoms, and so there is still a clinical need for new biomarkers for the diagnosis of CAD events. Recent studies have shown that miRNAs are involved in atherosclerotic plaque formation and their expression is altered during CAD events. Whilst studies have shown that several miRNAs are not superior to troponin in the diagnosis of a MI, they may be useful in the early diagnosis and prognosis of patients with CAD, however further studies are required. In this review we have summarized the recent studies investigating circulating miRNAs as novel biomarkers for the early detection of MI, CVD risk stratification and in the assessment of the prognosis of patients with ACS.
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Affiliation(s)
- Seyed Mostafa Parizadeh
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Medical Biochemistry, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex, UK
| | - Maryam Ghandehari
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mahdi Hassanian
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Medical Biochemistry, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Modern Sciences and Technologies, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mohammad Reza Parizadeh
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Medical Biochemistry, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Avan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Modern Sciences and Technologies, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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10
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Gul SS, Huesgen KW, Wang KK, Mark K, Tyndall JA. Prognostic utility of neuroinjury biomarkers in post out-of-hospital cardiac arrest (OHCA) patient management. Med Hypotheses 2017; 105:34-47. [PMID: 28735650 DOI: 10.1016/j.mehy.2017.06.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 05/04/2017] [Accepted: 06/23/2017] [Indexed: 12/30/2022]
Abstract
Despite aggressive intervention, patients who survive an out-of-hospital cardiac arrest (OHCA) generally have very poor prognoses, with nationwide survival rates of approximately 10-20%. Approximately 90% of survivors will have moderate to severe neurological injury ranging from moderate cognitive impairment to brain death. Currently, few early prognostic indicators are considered reliable enough to support patients' families and clinicians' in their decisions regarding medical futility. Blood biomarkers of neurological injury after OHCA may be of prognostic value in these cases. When most bodily tissues are oxygen-deprived, cellular metabolism switches from aerobic to anaerobic respiration. Neurons are a notable exception, however, being dependent solely upon aerobic respiration. Thus, after several minutes without circulating oxygen, neurons sustain irreversible damage, and certain measurable biomarkers are released into the circulation. Prior studies have demonstrated value in blood biomarkers in prediction of survival and neurologic impairment after OHCA. We hypothesize that understanding peptide biomarker kinetics in the early return of spontaneous circulation (ROSC) period, especially in the setting of refractory cardiac arrest, may assist clinicians in determining prognosis earlier in acute resuscitation. Specifically, during and after immediate resuscitation and return of ROSC, clinicians and families face a series of important questions regarding patient prognosis, futility of care and allocation of scarce resources such as the early initiation of extracorporeal cardiopulmonary resuscitation (ECPR). The ability to provide early prognostic information in this setting is highly valuable. Currently available, as well as potential biomarkers that could be good candidates in prognostication of neurological outcomes after OHCA or in the setting of refractory cardiac arrest will be reviewed and discussed.
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Affiliation(s)
- S S Gul
- Department of Emergency Medicine, University of Florida, 1329, SW 16th Street, Suite 5270, Gainesville, FL 32608, United States
| | - K W Huesgen
- Department of Emergency Medicine, University of Florida, 1329, SW 16th Street, Suite 5270, Gainesville, FL 32608, United States
| | - K K Wang
- Program for Neurotrauma, Neuroproteomics & Biomarker Research, Department of Psychiatry, McKnight Brain Institute, University of Florida, 1149 Newell Drive, Gainesville, FL 32610, United States
| | - K Mark
- Department of Emergency Medicine, University of Florida, 1329, SW 16th Street, Suite 5270, Gainesville, FL 32608, United States
| | - J A Tyndall
- Department of Emergency Medicine, University of Florida, 1329, SW 16th Street, Suite 5270, Gainesville, FL 32608, United States.
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Abstract
Conventional and promising new markers of myocardial injury have become an important diagnostic tool and their prognostic significance is also recognized. In addition, they help identify patients who will derive the most benefit from therapeutic interventions. The literature was searched from the websites of the National Library of Medicine (http://www.ncbi.nlm.nih.gov/) and PubMed Central, the U.S. National Library of Medicine’s digital archive of life sciences journal literature (http://www.pubmedcentral.nih.gov/). The data were accessed from books and journals that published relevant articles in this field. The diagnosis of acute myocardial infarction (AMI) has traditionally relied on the combination of chest pain, ECG features, and elevation in serum markers. However, chest symptoms are frequently atypical or absent and ECG changes may be nonspecific or absent. Hence, the diagnosis of acute coronary syndromes has become increasingly dependent on serum markers of cardiac injury. Among them, creatine kinase (CK) is an effective and widely used test, with the recent CKMB assay offering greater specificity and sensitivity. Cardiac troponins facilitate early and rapid diagnosis, enable effective risk stratification in patients with AMI (with or without traditional criteria for MI), and identify those who will benefit from aggressive medical or surgical intervention. Recent data suggest the potential of myoglobin and CKMB isoforms as sensitive markers in the early hours after symptom onset. Cardiac-specific troponins help in rapid diagnosis, prognostication, and treatment of AMI. Troponins also facilitate early detection of recent infarction owing to their prolonged diagnostic window and also aid in the detection of “microinfarction.” CKMB is used to detect reinfarction or infarct extension, if levels rise again after declining. Finally, novel biochemical markers are receiving attention in ongoing trials. They may prove to be more effective in diagnosis and prognosis than their existing counterparts.
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Affiliation(s)
- Medha Rajappa
- Department of Biochemistry, Maulana Azad Medical College, New Delhi, India
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12
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Pascual-Figal DA, Manzano-Fernández S, Pastor F, Garrido IP, Casas T, Sánchez Mas J, Ansaldo P, Martínez P, Valdés M. Valor de la determinación seriada de troponina T en pacientes ambulatorios con insuficiencia cardiaca no isquémica. Rev Esp Cardiol 2008. [DOI: 10.1157/13123988] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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13
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Martínez Amat A, Marchal Corrales JA, Rodríguez Serrano F, Boulaiz H, Prados Salazar JC, Hita Contreras F, Caba Perez O, Carrillo Delgado E, Martín I, Aranega Jimenez A. Role of alpha-actin in muscle damage of injured athletes in comparison with traditional markers. Br J Sports Med 2007; 41:442-6. [PMID: 17317758 PMCID: PMC2465360 DOI: 10.1136/bjsm.2006.032730] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE In order to identify a reliable marker for the early detection of muscle injuries in sports, alpha-actin protein and other markers of muscle damage were studied in sera of uninjured sportspeople and those with skeletal muscle injury. METHODS Blood samples were obtained from 20 sportspeople with skeletal muscle injury and 48 uninjured sportspeople. Immunoassays were performed to determine cardiac troponin I (TnI), troponin T, lactate dehydrogenase and myoglobin concentrations. Western blot and densitometry were used to measure alpha-actin concentrations. Skeletal muscle damage was diagnosed according to physical examination, MRI findings and the biochemical criterion of a creatine kinase value >500 IU/l (Rosalki method, Beckman Instruments SL, Fullerton, California, USA). Results were also compared with previously obtained data on injured and uninjured non-sportspeople. RESULTS The mean serum concentration of alpha-actin was significantly higher in sportspeople with muscle damage (10.49 microg/ml) than in uninjured sportspeople (3.99 mcirog/ml). Sera from injured sportspeople showed higher levels of alpha-actin than of troponin or myoglobin. No significant difference in TnI levels was observed between the groups. CONCLUSIONS According to these results, alpha-actin is a new and reliable marker of skeletal muscle damage in sportspeople which can be used for the detection of muscle injury. Possible cross interference between skeletal and cardiac muscle damage can be discriminated by the combined use of alpha-actin and TnI. These data suggest that early measurement of alpha-actin in sportspeople with suspected muscle damage will allow them to receive earlier and more effective treatment and to return sooner to the practice of their sport.
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14
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Martínez-Amat A, Boulaiz H, Prados J, Marchal JA, Padial Puche P, Caba O, Rodríguez-Serrano F, Aránega A. Release of alpha-actin into serum after skeletal muscle damage. Br J Sports Med 2006; 39:830-4. [PMID: 16244192 PMCID: PMC1725075 DOI: 10.1136/bjsm.2004.017566] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The skeletal muscle protein alpha-actin was investigated in the serum of subjects with severe skeletal muscle damage to assess its utility as a reliable and predictive marker of muscle damage. METHODS Serum samples were obtained from 33 healthy controls and 33 patients with severe skeletal muscle damage, defined by a total creatine kinase value of >500 IU/l (Rosalki method). Troponin I, troponin T, and myoglobin concentrations were determined by immunoassay and alpha-actin concentrations by Western blot and densitometry. RESULTS The mean serum concentration of alpha-actin in controls and patients with skeletal muscle damage was 600.9 and 1968.51 ng/ml, respectively, a statistically significant difference. Sera of patients with muscle damage showed higher levels of alpha-actin than of troponin or myoglobin. No significant difference in troponin I levels was observed between the groups. CONCLUSIONS According to these results, alpha-actin was the most significant skeletal muscle damage marker analysed and may be an ideal candidate for the identification of all types of myofibre injury, including sports injuries. Our findings support the use of alpha-actin as a marker alongside other currently used biological proteins.
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Affiliation(s)
- A Martínez-Amat
- Department of Health Sciences, University of Jaén, E-23071 Jaén, Spain
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15
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Obrador D, Santalo M. Evaluation of patients with suspected acute coronary syndromes in the emergency department. Nucl Med Commun 2003; 24:1041-8. [PMID: 14508159 DOI: 10.1097/00006231-200310000-00003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Patients complaining of chest pain (CP) who visit the emergency department (ED) represent the second cause of consultation in this department, and 20-30% of hospital admissions for medical reasons. These patients form a somewhat heterogeneous group with many different aetiologies and degrees of severity. In this setting, the clinical objectives include the prompt identification of patients with acute coronary syndromes (ACSs), the prompt evaluation of the immediate risk (i.e., initial risk stratification) of cardiovascular complications in order to tailor the treatment for each individual patient and to make the best use of hospital resources, and the prompt identification of patients with other potentially severe diseases. The diagnosis of ACS in patients coming to the ED for CP or any equivalent angina is one of the most difficult diagnostic challenges facing physicians in the ED. The correct diagnosis and risk stratification of these patients has clinical consequences, as well as very important legal and economic implications. The only methodology with a clear clinical impact on diagnosis, risk stratification and initial management is clinical evaluation based on data obtained by questioning the patient, carrying out a physical examination, and interpreting the results of a standard 12-lead electrocardiogram (ECG). Nevertheless, its combined diagnostic efficiency for ACS is imperfect and additional strategies are emerging which include serial ECG, the detection of serum biochemical markers of myocardial necrosis, exercise testing, and radionuclide myocardial perfusion imaging.
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Affiliation(s)
- D Obrador
- Cardiology and Emergency Departments, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
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