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Singh G, Bamba H, Inban P, Chandrasekaran SH, Priyatha V, John J, Prajjwal P. The prognostic significance of pro-BNP and heart failure in acute pulmonary embolism: A systematic review. Dis Mon 2024:101783. [PMID: 38955637 DOI: 10.1016/j.disamonth.2024.101783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
Pulmonary embolism (PE) is the third most common type of cardiovascular disease and carries a high mortality rate of 30% if left untreated. Although it is commonly known that individuals who suffer heart failure (HF) are more likely to experience a pulmonary embolism, little is known concerning the prognostic relationship between acute PE and HF. This study aims to evaluate the prognostic usefulness of heart failure and pro-BNP in pulmonary embolism cases. A scientific literature search, including PubMed, Medline, and Cochrane reviews, was used to assess and evaluate the most pertinent research that has been published. The findings showed that increased N-terminal brain natriuretic peptide (NT-proBNP) levels could potentially identify pulmonary embolism patients with worse immediate prognoses and were highly predictive of all-cause death. Important prognostic information can be obtained from NT-proBNP and Heart-type Fatty Acid Binding Proteins (H-FABP) when examining individuals with PE. The heart, distal tubular cells of the renal system, and skeletal muscle are where H-FABP is primarily found, with myocardial cells having the highest concentration. Recent studies have indicated that these biomarkers may also help assess the severity of PE and its long-term risk.
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Affiliation(s)
- Gurmehar Singh
- Government Medical College and Hospital, Chandigarh, India
| | - Hyma Bamba
- Government Medical College and Hospital, Chandigarh, India
| | - Pugazhendi Inban
- Internal Medicine, St. Mary's General Hospital and Saint Clare's Health, NY, USA.
| | | | | | - Jobby John
- Dr. Somervell Memorial CSI Medical College and Hospital Karakonam, Trivandrum, India
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Li X, Sun L, Xi S, Hu Y, Yu Z, Liu H, Sun H, Jing W, Yuan L, Liu H, Li T. V-A ECMO for neonatal coxsackievirus B fulminant myocarditis: a case report and literature review. Front Cardiovasc Med 2024; 11:1364289. [PMID: 38836060 PMCID: PMC11148355 DOI: 10.3389/fcvm.2024.1364289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 05/09/2024] [Indexed: 06/06/2024] Open
Abstract
Background Neonatal (enteroviral) myocarditis (NM/NEM) is rare but unpredictable and devastating, with high mortality and morbidity. We report a case of neonatal coxsackievirus B (CVB) fulminant myocarditis successfully treated with veno-arterial extracorporeal membrane oxygenation (V-A ECMO). Case presentation A previously healthy 7-day-old boy presented with fever for 4 days. Progressive cardiac dysfunction (weak heart sounds, hepatomegaly, pulmonary edema, ascites, and oliguria), decreased left ventricular ejection fraction (LVEF) and fractional shortening (FS), transient ventricular fibrillation, dramatically elevated creatine kinase-MB (405.8 U/L), cardiac troponin I (25.85 ng/ml), and N-terminal pro-brain natriuretic peptide (NT-proBNP > 35,000 ng/L), and positive blood CVB ribonucleic acid indicated neonatal CVB fulminating myocarditis. It was refractory to mechanical ventilation, fluid resuscitation, inotropes, corticosteroids, intravenous immunoglobulin, and diuretics during the first 4 days of hospitalization (DOH 1-4). The deterioration was suppressed by V-A ECMO in the next 5 days (DOH 5-9), despite the occurrence of bilateral grade III intraventricular hemorrhage on DOH 7. Within the first 4 days after ECMO decannulation (DOH 10-13), he continued to improve with withdrawal of mechanical ventilation, LVEF > 60%, and FS > 30%. In the subsequent 4 days (DOH 14-17), his LVEF and FS decreased to 52% and 25%, and further dropped to 37%-38% and 17% over the next 2 days (DOH 18-19), respectively. There was no other deterioration except for cardiomegaly and paroxysmal tachypnea. Through strengthening fluid restriction and diuresis, and improving cardiopulmonary function, he restabilized. Finally, notwithstanding NT-proBNP elevation (>35,000 ng/L), cardiomegaly, and low LVEF (40%-44%) and FS (18%-21%) levels, he was discharged on DOH 26 with oral medications discontinued within 3 weeks postdischarge. In nearly three years of follow-up, he was uneventful, with interventricular septum hyperechogenic foci and mild mitral/tricuspid regurgitation. Conclusions Dynamic cardiac function monitoring via real-time echocardiography is useful for the diagnosis and treatment of NM/NEM. As a lifesaving therapy, ECMO may improve the survival rate of patients with NM/NEM. However, the "honeymoon period" after ECMO may cause the illusion of recovery. Regardless of whether the survivors of NM/NEM have undergone ECMO, close long-term follow-up is paramount to the prompt identification and intervention of abnormalities.
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Affiliation(s)
- Xingchao Li
- Department of Pediatrics, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
- Institute of Pediatric Research, Hubei University of Medicine, Shiyan, Hubei Province, China
- Institute of Pediatric Research, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
| | - Li Sun
- Department of Pediatrics, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
| | - Shibing Xi
- Department of Pediatrics, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
- Institute of Pediatric Research, Hubei University of Medicine, Shiyan, Hubei Province, China
- Institute of Pediatric Research, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
| | - Yaofei Hu
- Department of Pediatrics, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
| | - Zhongqin Yu
- Department of Pediatrics, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
| | - Hui Liu
- Department of Pediatrics, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
| | - Hui Sun
- Department of Pediatrics, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
| | - Weili Jing
- Department of Pediatrics, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
| | - Li Yuan
- Department of Pediatrics, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
| | - Hongyan Liu
- Department of Neonatology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Tao Li
- Department of Pediatrics, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
- Institute of Pediatric Research, Hubei University of Medicine, Shiyan, Hubei Province, China
- Institute of Pediatric Research, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
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Goliniewski J, Czuba M, Płoszczyca K, Chalimoniuk M, Gajda R, Niemaszyk A, Kaczmarczyk K, Langfort J. The Impact of Normobaric Hypoxia and Intermittent Hypoxic Training on Cardiac Biomarkers in Endurance Athletes: A Pilot Study. Int J Mol Sci 2024; 25:4584. [PMID: 38731803 PMCID: PMC11083773 DOI: 10.3390/ijms25094584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 04/15/2024] [Accepted: 04/20/2024] [Indexed: 05/13/2024] Open
Abstract
This study explores the effects of normobaric hypoxia and intermittent hypoxic training (IHT) on the physiological condition of the cardiac muscle in swimmers. Hypoxia has been reported to elicit both beneficial and adverse changes in the cardiovascular system, but its impact on the myocardium during acute exercise and altitude/hypoxic training remains less understood. We aimed to determine how a single bout of intense interval exercise and a four-week period of high-intensity endurance training under normobaric hypoxia affect cardiac marker activity in swimmers. Sixteen young male swimmers were divided into two groups: one undergoing training in hypoxia and the other in normoxia. Cardiac markers, including troponin I and T (cTnI and cTnT), heart-type fatty acid-binding protein (H-FABP), creatine kinase-MB isoenzyme (CK-MB), and myoglobin (Mb), were analyzed to assess the myocardium's response. We found no significant differences in the physiological response of the cardiac muscle to intense physical exertion between hypoxia and normoxia. Four weeks of IHT did not alter the resting levels of cTnT, cTnI, and H-FABP, but it resulted in a noteworthy decrease in the resting concentration of CK-MB, suggesting enhanced cardiac muscle adaptation to exercise. In contrast, a reduction in resting Mb levels was observed in the control group training in normoxia. These findings suggest that IHT at moderate altitudes does not adversely affect cardiac muscle condition and may support cardiac muscle adaptation, affirming the safety and efficacy of IHT as a training method for athletes.
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Affiliation(s)
- Jakub Goliniewski
- Department of Sports Theory, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland; (J.G.); (J.L.)
| | - Miłosz Czuba
- Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, 00-968 Warsaw, Poland; (K.P.); (A.N.); (K.K.)
| | - Kamila Płoszczyca
- Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, 00-968 Warsaw, Poland; (K.P.); (A.N.); (K.K.)
| | - Małgorzata Chalimoniuk
- Department of Tourism and Health in Biała Podlaska, The Józef Piłsudski University of Physical Education, 00-968 Warsaw, Poland;
| | - Robert Gajda
- Department of Kinesiology and Health Prevention, Jan Dlugosz University, 42-200 Czestochowa, Poland;
- Center for Sports Cardiology at the Gajda-Med Medical Center in Pultusk, 06-100 Pultusk, Poland
| | - Adam Niemaszyk
- Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, 00-968 Warsaw, Poland; (K.P.); (A.N.); (K.K.)
| | - Katarzyna Kaczmarczyk
- Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, 00-968 Warsaw, Poland; (K.P.); (A.N.); (K.K.)
| | - Józef Langfort
- Department of Sports Theory, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland; (J.G.); (J.L.)
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Zhao Y, Zhuang L, Tian P, Ma M, Wu G, Zhang Y. Rapid diagnosis of acute myocardial infarction based on reverse transcription-accelerated strand exchange amplification of miR-208a. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2023; 15:4442-4451. [PMID: 37610127 DOI: 10.1039/d3ay01116j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Acute myocardial infarction (AMI) is a prevalent cardiovascular disease associated with high morbidity and mortality, posing a significant threat to human health. Therefore, early diagnosis of AMI has become a focal point of research. MiR-208 is specifically expressed in the heart and is involved in the regulation of cardiomyocyte hypertrophy, cardiac fibrosis, and other myocardial gene expressions. It is expected to be applied in the clinical detection of AMI due to its release by damaged myocardial cells within 3 hours of AMI. In this study, we developed a denatured bubble-mediated reverse transcription-accelerated strand exchange amplification (RT-ASEA) method to detect the early biomarker miR-208a of AMI. The novel approach allowed rapid amplification of miR-208a in 15 minutes, with good performance in terms of repeatability (CV < 6%), determination limit (1 × 100 pmol L-1), and linearity (R2 = 0.9690). Based on the analysis of 42 clinical samples, a strong correlation was observed between the Ct value of miR-208a detected by the RT-ASEA method and the cTnI concentration, considered the gold standard for diagnosis of AMI. The research suggested that the RT-ASEA method could be applied to distinguish between AMI and healthy groups. The area under the receiver operating characteristic curve (AUC) was 0.9976, with a sensitivity of 96% and a specificity of 100%. Optimized RT-ASEA is a reliable and efficient method for miRNA detection. Furthermore, this study provides crucial data support for the development of miR-208a as an early biomarker for AMI, which is of great significance in life and health.
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Affiliation(s)
- Ying Zhao
- State Key Laboratory of Digital Medical Engineering, Jiangsu Key Laboratory for Biomaterials and Devices, School of Biological Science and Medical Engineering & Collaborative Innovation Center of Suzhou Nano Science and Technology, Southeast University, Nanjing 210096, P. R. China.
| | - Linlin Zhuang
- State Key Laboratory of Digital Medical Engineering, Jiangsu Key Laboratory for Biomaterials and Devices, School of Biological Science and Medical Engineering & Collaborative Innovation Center of Suzhou Nano Science and Technology, Southeast University, Nanjing 210096, P. R. China.
| | - Peilong Tian
- State Key Laboratory of Digital Medical Engineering, Jiangsu Key Laboratory for Biomaterials and Devices, School of Biological Science and Medical Engineering & Collaborative Innovation Center of Suzhou Nano Science and Technology, Southeast University, Nanjing 210096, P. R. China.
| | - Ming Ma
- State Key Laboratory of Digital Medical Engineering, Jiangsu Key Laboratory for Biomaterials and Devices, School of Biological Science and Medical Engineering & Collaborative Innovation Center of Suzhou Nano Science and Technology, Southeast University, Nanjing 210096, P. R. China.
| | - Guoqiu Wu
- Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing 210009, P. R. China.
| | - Yu Zhang
- State Key Laboratory of Digital Medical Engineering, Jiangsu Key Laboratory for Biomaterials and Devices, School of Biological Science and Medical Engineering & Collaborative Innovation Center of Suzhou Nano Science and Technology, Southeast University, Nanjing 210096, P. R. China.
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5
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Du D, Wang J, Guo M, Shu J, Nie W, Bian Z, Yang D, Cui H. Charge-Dependent Signal Changes for Label-Free Electrochemiluminescence Immunoassays. Anal Chem 2022; 94:16436-16442. [DOI: 10.1021/acs.analchem.2c03872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Dexin Du
- CAS Key Laboratory of Soft Matter Chemistry, iChEM (Collaborative Innovation Center of Chemistry for Energy Materials), Department of Chemistry, University of Science and Technology of China, Hefei, Anhui 230026, P. R. China
| | - Jue Wang
- CAS Key Laboratory of Soft Matter Chemistry, iChEM (Collaborative Innovation Center of Chemistry for Energy Materials), Department of Chemistry, University of Science and Technology of China, Hefei, Anhui 230026, P. R. China
| | - Mingquan Guo
- CAS Key Laboratory of Soft Matter Chemistry, iChEM (Collaborative Innovation Center of Chemistry for Energy Materials), Department of Chemistry, University of Science and Technology of China, Hefei, Anhui 230026, P. R. China
| | - Jiangnan Shu
- CAS Key Laboratory of Soft Matter Chemistry, iChEM (Collaborative Innovation Center of Chemistry for Energy Materials), Department of Chemistry, University of Science and Technology of China, Hefei, Anhui 230026, P. R. China
| | - Wei Nie
- CAS Key Laboratory of Soft Matter Chemistry, iChEM (Collaborative Innovation Center of Chemistry for Energy Materials), Department of Chemistry, University of Science and Technology of China, Hefei, Anhui 230026, P. R. China
| | - Zhiping Bian
- Institute of Cardiovascular Disease, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P. R. China
| | - Di Yang
- Institute of Cardiovascular Disease, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P. R. China
| | - Hua Cui
- CAS Key Laboratory of Soft Matter Chemistry, iChEM (Collaborative Innovation Center of Chemistry for Energy Materials), Department of Chemistry, University of Science and Technology of China, Hefei, Anhui 230026, P. R. China
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6
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Komarova N, Panova O, Titov A, Kuznetsov A. Aptamers Targeting Cardiac Biomarkers as an Analytical Tool for the Diagnostics of Cardiovascular Diseases: A Review. Biomedicines 2022; 10:biomedicines10051085. [PMID: 35625822 PMCID: PMC9138532 DOI: 10.3390/biomedicines10051085] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 02/04/2023] Open
Abstract
The detection of cardiac biomarkers is used for diagnostics, prognostics, and the risk assessment of cardiovascular diseases. The analysis of cardiac biomarkers is routinely performed with high-sensitivity immunological assays. Aptamers offer an attractive alternative to antibodies for analytical applications but, to date, are not widely practically implemented in diagnostics and medicinal research. This review summarizes the information on the most common cardiac biomarkers and the current state of aptamer research regarding these biomarkers. Aptamers as an analytical tool are well established for troponin I, troponin T, myoglobin, and C-reactive protein. For the rest of the considered cardiac biomarkers, the isolation of novel aptamers or more detailed characterization of the known aptamers are required. More attention should be addressed to the development of dual-aptamer sandwich detection assays and to the studies of aptamer sensing in alternative biological fluids. The universalization of aptamer-based biomarker detection platforms and the integration of aptamer-based sensing to clinical studies are demanded for the practical implementation of aptamers to routine diagnostics. Nevertheless, the wide usage of aptamers for the diagnostics of cardiovascular diseases is promising for the future, with respect to both point-of-care and laboratory testing.
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7
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Triantafyllou GA, O'Corragain O, Rivera-Lebron B, Rali P. Risk Stratification in Acute Pulmonary Embolism: The Latest Algorithms. Semin Respir Crit Care Med 2021; 42:183-198. [PMID: 33548934 DOI: 10.1055/s-0041-1722898] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Pulmonary embolism (PE) is a common clinical entity, which most clinicians will encounter. Appropriate risk stratification of patients is key to identify those who may benefit from reperfusion therapy. The first step in risk assessment should be the identification of hemodynamic instability and, if present, urgent patient consideration for systemic thrombolytics. In the absence of shock, there is a plethora of imaging studies, biochemical markers, and clinical scores that can be used to further assess the patients' short-term mortality risk. Integrated prediction models incorporate more information toward an individualized and precise mortality prediction. Additionally, bleeding risk scores should be utilized prior to initiation of anticoagulation and/or reperfusion therapy administration. Here, we review the latest algorithms for a comprehensive risk stratification of the patient with acute PE.
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Affiliation(s)
- Georgios A Triantafyllou
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Oisin O'Corragain
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine, Temple University Hospital, Philadelphia, Pennsylvania
| | - Belinda Rivera-Lebron
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Parth Rali
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine, Temple University Hospital, Philadelphia, Pennsylvania
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Wu Y, Pan N, An Y, Xu M, Tan L, Zhang L. Diagnostic and Prognostic Biomarkers for Myocardial Infarction. Front Cardiovasc Med 2021; 7:617277. [PMID: 33614740 PMCID: PMC7886815 DOI: 10.3389/fcvm.2020.617277] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 12/29/2020] [Indexed: 01/12/2023] Open
Abstract
The incidence of myocardial infarction (MI) increases every year worldwide. Better diagnostic and prognostic biomarkers for clinical applications are the consistent pursuit of MI research. In addition to electrocardiogram, echocardiography, coronary angiography, etc., circulating biomarkers are essential for the diagnosis, prognosis, and treatment effect monitoring of MI patients. In this review, we assessed both strength and weakness of MI circulating biomarkers including: (1) originated from damaged myocardial tissues including current golden standard cardiac troponin, (2) released from non-myocardial tissues due to MI-induced systems reactions, and (3) preexisted in blood circulation before the occurrence of MI event. We also summarized newly reported MI biomarkers. We proposed that the biomarkers preexisting in blood circulation before MI incidents should be emphasized in research and development for MI prevention in near future.
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Affiliation(s)
- Yuling Wu
- Systems Biology & Medicine Center for Complex Diseases, Center for Clinical Research, Affiliated Hospital of Qingdao University, Qingdao, China.,Department of Cardiology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Nana Pan
- Department of Cardiology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yi An
- Department of Cardiology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Mengyuan Xu
- Department of Cardiology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lijuan Tan
- Department of Cardiology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lijuan Zhang
- Systems Biology & Medicine Center for Complex Diseases, Center for Clinical Research, Affiliated Hospital of Qingdao University, Qingdao, China
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Berezin AE, Berezin AA. Circulating Cardiac Biomarkers in Diabetes Mellitus: A New Dawn for Risk Stratification-A Narrative Review. Diabetes Ther 2020; 11:1271-1291. [PMID: 32430864 PMCID: PMC7261294 DOI: 10.1007/s13300-020-00835-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Indexed: 02/06/2023] Open
Abstract
The aim of this narrative review is to update the current knowledge on the differential choice of circulating cardiac biomarkers in patients with prediabetes and established type 2 diabetes mellitus (T2DM). There are numerous circulating biomarkers with unconfirmed abilities to predict clinical outcomes in pre-DM and DM individuals; the prognostication ability of the cardiac biomarkers reported here has been established, and they are still being studied. The conventional cardiac biomarkers, such as natriuretic peptides (NPs), soluble suppressor tumorigenisity-2, high-sensitivity circulating cardiac troponins and galectin-3, were useful to ascertain cardiovascular (CV) risk. Each cardiac biomarker has its strengths and weaknesses that affect the price of usage, specificity, sensitivity, predictive value and superiority in face-to-face comparisons. Additionally, there have been confusing reports regarding their abilities to be predictably relevant among patients without known CV disease. The large spectrum of promising cardiac biomarkers (growth/differential factor-15, heart-type fatty acid-binding protein, cardiotrophin-1, carboxy-terminal telopeptide of collagen type 1, apelin and non-coding RNAs) is discussed in the context of predicting CV diseases and events in patients with known prediabetes and T2DM. Various reasons have been critically discussed related to the variable findings regarding biomarker-based prediction of CV risk among patients with metabolic disease. It was found that NPs and hs-cTnT are still the most important tools that have an affordable price as well as high sensitivity and specificity to predict clinical outcomes among patients with pre-DM and DM in routine clinical practice, but other circulating biomarkers need to be carefully investigated in large trials in the future.
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Affiliation(s)
- Alexander E Berezin
- Internal Medicine Department, Ministry of Health of Ukraine, State Medical University, Zaporozhye, 69035, Ukraine.
| | - Alexander A Berezin
- Internal Medicine Department, Medical Academy of Post-Graduate Education, Ministry of Health of Ukraine, Zaporozhye, 69096, Ukraine
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Mohan S, Shaheen E, El-Amir Y, Khadashi H, Ncibi S, Farasani A, Abdelwahab S. Catha edulis-induced skeletal muscle toxicity in experimental rats via regulation of rhabdomyolysis biomarkers. Pharmacogn Mag 2019. [DOI: 10.4103/pm.pm_142_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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11
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Singh N, Rathore V, Mahat RK, Rastogi P. Glycogen Phosphorylase BB: A more Sensitive and Specific Marker than Other Cardiac Markers for Early Diagnosis of Acute Myocardial Infarction. Indian J Clin Biochem 2018; 33:356-360. [PMID: 30072837 DOI: 10.1007/s12291-017-0685-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Accepted: 07/21/2017] [Indexed: 11/25/2022]
Abstract
Cardiac markers are used to evaluate functions of heart. However, there are no satisfactory cardiac biomarkers for the diagnosis of acute myocardial infarction (AMI) within 4 h of onset of chest pain. Among novel cardiac markers, glycogen phosphorylase BB (GPBB) is of particular interest as it is increased in the early hours after AMI. The present study was conducted with the objective to find out the sensitivity and specificity of GPBB over other cardiac markers i.e. myoglobin and CKMB in patients of AMI within 4 h after the onset of chest pain. The study includes 100 AMI patients and 100 normal healthy individuals as controls. In all the cases and controls, serum GPBB and myoglobin concentrations were measured by ELISA where as CK-MB was measured by diagnostic kit supplied by ERBA. The sensitivity and specificity of glycogen phosphorylase BB (GPBB) were greater than CK-MB and myoglobin in patients of AMI within 4 h after the onset of chest pain. Hence, glycogen phosphorylase BB (GPBB) can be used as additional biomarker for the early diagnosis of AMI.
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Affiliation(s)
- Neelima Singh
- Department of Biochemistry, Gajra Raja Medical College and J.A. Group of Hospitals, Gwalior, MP India
| | - Vedika Rathore
- Department of Biochemistry, Gajra Raja Medical College and J.A. Group of Hospitals, Gwalior, MP India
| | - Roshan Kumar Mahat
- Department of Biochemistry, Gajra Raja Medical College and J.A. Group of Hospitals, Gwalior, MP India
| | - Puneet Rastogi
- Department of Cardiology, Gajra Raja Medical College and J.A. Group of Hospitals, Gwalior, MP India
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12
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Diagnostic and prognostic value of H-FABP in acute coronary syndrome: Still evidence to bring. Clin Biochem 2018; 58:1-4. [DOI: 10.1016/j.clinbiochem.2018.04.021] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 04/20/2018] [Accepted: 04/23/2018] [Indexed: 11/19/2022]
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13
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Risk stratification of acute pulmonary embolism based on clinical parameters, H-FABP and multidetector CT. Int J Cardiol 2018; 265:223-228. [DOI: 10.1016/j.ijcard.2018.04.066] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 02/05/2018] [Accepted: 04/16/2018] [Indexed: 12/17/2022]
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14
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Naroo GY, Ali SM, Butros V, Haj AA, Mohammed I, Alosert M, Terris J, Fikree M. Elevated Heart-Type Fatty Acid-Binding Protein Predicts Early Myocardial Injury and Aids in the Diagnosis of Non-St Elevation Myocardial Infarction. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490790901600303] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Biomarkers play an important role in the early diagnosis, risk stratification and management of patients with the acute coronary syndrome. Objective The objective of this study was to evaluate the clinical reliability of heart-type fatty acid-binding protein (h-FABP) in identifying patients with the acute coronary syndrome in the early hours of chest pain. Methods Creatine kinase (CK-MB) (in laboratory), troponin T (in laboratory) and h-FABP (with point-of-care test CardioDetect®) were performed on 791 patients who presented with chest pain with duration since onset ranging from 20 minutes to 12 hours. Results Data of the 791 patients were analysed. h-FABP had a higher sensitivity of 75.76% and a specificity of 96.97% compared with 58.59% and 98.84% for troponin T and 68.69% and 97.54% for CK-MB respectively (in the first 6 hours). Conclusion: h-FABP was found to be a better biomarker of cardiac necrosis in the early hours in the diagnosis of non-conclusive ECG in patients with acute myocardial infarction. (Hong Kong j.emerg.med. 2009;16:141–147)
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Affiliation(s)
| | - S Mohamed Ali
- Rashid Hospital Trauma Center, Cardiology Department, Dubai, United Arab Emirates Sameera Mohamed Ali, MBBS, MRCP(UK)
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Beysel S, Kizilgul M, Ozbek M, Caliskan M, Kan S, Apaydin M, Ozcelik O, Cakal E. Heart-type fatty acid binding protein levels in elderly diabetics without known cardiovascular disease. Clin Interv Aging 2017; 12:2063-2068. [PMID: 29255351 PMCID: PMC5722006 DOI: 10.2147/cia.s137247] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background Cardiovascular disease (CVD) is reported to be higher in elderly diabetics. Serum heart-type fatty acid binding protein (H-FABP) is a serum marker of myocardial ischemia. We aimed to investigate the association between serum H-FABP level and conventional cardiovascular risk factors, inflammatory markers and subclinical atherosclerosis in elderly diabetics without overt CVD. Patients and methods A total of 50 elderly diabetic patients without overt CVD and 30 age-, sex- and body mass index (BMI)-matched healthy controls were enrolled. Anthropometric and biochemical parameters, serum H-FABP, high-sensitivity C-reactive protein (hs-CRP), fibrinogen and carotid intima-media thickness (CIMT) were measured. Logistic regression analyses (adjustments for age, sex, hypertension, smoking, diabetes, BMI, blood pressure, lipid, blood glucose, hemoglobin A1c, hs-CRP and fibrinogen) were performed to evaluate the association between H-FABP and cardiovascular risk factors and atherosclerosis indices. Results Serum fibrinogen (421.50±85.52 mg/dL vs 319.17±30.77 mg/dL, p=0.023), CIMT (0.70±0.12 mm vs 0.59±0.06 mm, p<0.001) and hs-CRP (5.72±4.50 mg/dL vs 1.60±0.72 mg/dL, p<0.001) were significantly higher in diabetic patients than controls. The mean serum H-FABP level did not differ between groups (1571.79±604.60 ng/mL vs 1500.25±463.35 ng/mL, p=0.905). H-FABP was positively correlated with fibrinogen (r2=0.473, p<0.001), hs-CRP (r2=0.323, p=0.003) and CIMT (r2=0.467, p<0.001). After full adjustments, the serum H-FABP level was independently associated with an increase in the fibrinogen level (odds ratio [OR] =4.21, 95% confidence level [CI] =1.49–11.90). Conclusion Serum H-FABP was similar in the elderly diabetic patients without known CVD when compared with the nondiabetic control group. H-FABP does not possess a high diagnostic value as a cardiovascular marker when used alone; however, it may add supplementary information in patients with a high fibrinogen level.
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Affiliation(s)
- Selvihan Beysel
- Department of Endocrinology and Metabolism, Eskisehir State Hospital, Eskisehir.,Department of Medical Biology, Baskent University, Ankara
| | - Muhammed Kizilgul
- Department of Endocrinology and Metabolism, Kilis State Hospital, Kilis
| | - Mustafa Ozbek
- Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Teaching and Research Hospital, Ankara
| | - Mustafa Caliskan
- Department of Endocrinology and Metabolism, Düzce Ataturk State Hospital, Duzce
| | - Seyfullah Kan
- Department of Endocrinology and Metabolism, Denizli State Hospital, Denizlim
| | - Mahmut Apaydin
- Department of Endocrinology and Metabolism, Yozgat State Hospital, Yozgat
| | - Ozgur Ozcelik
- Department of Endocrinology and Metabolism, Igdir State Hospital, Igdir, Turkey
| | - Erman Cakal
- Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Teaching and Research Hospital, Ankara
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16
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Agnello L, Bivona G, Novo G, Scazzone C, Muratore R, Levantino P, Bellia C, Lo Sasso B, Ciaccio M. Heart-type fatty acid binding protein is a sensitive biomarker for early AMI detection in troponin negative patients: a pilot study. Scandinavian Journal of Clinical and Laboratory Investigation 2017. [PMID: 28650717 DOI: 10.1080/00365513.2017.1335880] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Early detecting AMI in individuals presenting to the ED with chest pain continues to be a challenge. cTn is the gold standard for AMI diagnosis but early presenters (<1 hours from symptom onset) maybe cTn negative on admission. We analysed the diagnostic value of h-FABP and hs-TnI in patients presenting to ED with chest pain and no cTnI elevations. METHODS 28 AMI and 28 no-AMI individuals both presented to ED within one hour from pain onset were included. Blood donors were analysed for h-FABP cut-off identification. Among AMI patients, 55% were positive for h-FABP and 34.6% were positive for hs-TnI (p = .015), thus 21% were positive only for h-FABP. The diagnostic accuracy was assessed by ROC curve. h-FABP showed a higher sensitivity but lower specificity than hs-TnI. CONCLUSIONS In our study, the frequency of h-FABP positivity among AMI patients was higher than that of hs-TnI, which would have missed six of them; however, hs-TnI AUC was superior to that of h-FABP. These preliminary findings might confirm that h-FABP may be a good candidate for AMI rule-in/rule-out within the ED context.
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Affiliation(s)
- Luisa Agnello
- a Sezione Biochimica Clinica e Medicina Molecolare, Dipartimento di Biopatologia e Biotecnologie Mediche , Università degli studi di Palermo , Palermo , Italy
| | - Giulia Bivona
- a Sezione Biochimica Clinica e Medicina Molecolare, Dipartimento di Biopatologia e Biotecnologie Mediche , Università degli studi di Palermo , Palermo , Italy
| | - Giuseppina Novo
- b Cattedra e Divisione di Cardiologia , Università degli Studi di Palermo , Palermo , Italy
| | - Concetta Scazzone
- a Sezione Biochimica Clinica e Medicina Molecolare, Dipartimento di Biopatologia e Biotecnologie Mediche , Università degli studi di Palermo , Palermo , Italy
| | - Roberto Muratore
- c UOC Medicina di Laboratorio-CoreLab , AOUP Policlinico P. Giaccone , Palermo , Italy
| | - Piero Levantino
- b Cattedra e Divisione di Cardiologia , Università degli Studi di Palermo , Palermo , Italy
| | - Chiara Bellia
- a Sezione Biochimica Clinica e Medicina Molecolare, Dipartimento di Biopatologia e Biotecnologie Mediche , Università degli studi di Palermo , Palermo , Italy
| | - Bruna Lo Sasso
- a Sezione Biochimica Clinica e Medicina Molecolare, Dipartimento di Biopatologia e Biotecnologie Mediche , Università degli studi di Palermo , Palermo , Italy
| | - Marcello Ciaccio
- a Sezione Biochimica Clinica e Medicina Molecolare, Dipartimento di Biopatologia e Biotecnologie Mediche , Università degli studi di Palermo , Palermo , Italy.,c UOC Medicina di Laboratorio-CoreLab , AOUP Policlinico P. Giaccone , Palermo , Italy
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17
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Barcan A, Suciu Z, Rapolti E. Monitoring Acute Myocardial Infarction Complicated with Cardiogenic Shock — from the Emergency Room to Coronary Care Units. JOURNAL OF CARDIOVASCULAR EMERGENCIES 2017. [DOI: 10.1515/jce-2017-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Cardiogenic shock remains the leading cause of death in patients hospitalized for acute myocardial infarction, despite many advances encountered in the last years in reperfusion, mechanical, and pharmacological therapies addressed to stabilization of the hemodynamic condition of these critical patients. Such patients require immediate initiation of the most effective therapy, as well as a continuous monitoring in the Coronary Care Unit. Novel biomarkers have been shown to improve diagnosis and risk stratification in patients with cardiogenic shock, and their proper use may be especially important for the identification of the critical condition, leading to prompt therapeutic interventions. The aim of this review was to evaluate the current literature data on complex biomarker assessment and monitoring of patients with acute myocardial infarction complicated with cardiogenic shock in the Coronary Care Unit.
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Affiliation(s)
| | | | - Emese Rapolti
- Cardiovascular Rehabilitation Hospital , Covasna, Romania
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18
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Zálešák M, BlaŽíček P, Pancza D, Gablovský I, Štrbák V, Ravingerová T. Hyperosmotic environment blunts effectivity of ischemic preconditioning against ischemia-reperfusion injury and improves ischemic tolerance in non-preconditioned isolated rat hearts. Physiol Res 2017; 65:1045-1051. [PMID: 27959577 DOI: 10.33549/physiolres.933362] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Several studies have shown that diabetes mellitus modulates heart resistance to ischemia and abrogates effectivity of cardioprotective interventions, such as ischemic preconditioning (IP). The aim of this study was to evaluate whether the effect of hyperglycemic conditions on the severity of ischemia-reperfusion (I/R) injury in preconditioned and non-preconditioned hearts (controls, C) is related to changes in osmotic activity of glucose. Experiments were performed in isolated rat hearts perfused according to Langendorff exposed to 30-min coronary occlusion/120-min reperfusion. IP was induced by two cycles of 5-min coronary occlusion/5-min reperfusion, prior to the long-term I/R. Hyperosmotic (HO) state induced by an addition of mannitol (11 mmol/l) to a standard Krebs-Henseleit perfusion medium significantly decreased the size of infarction and also suppressed a release of heart fatty acid binding protein (h-FABP - biomarker of cell injury) from the non-IP hearts nearly to 50 %, in comparison with normoosmotic (NO) mannitol-free perfusion. However, IP in HO conditions significantly increased the size of infarction and tended to elevate the release of h-FABP to the effluent from the heart. The results indicate that HO environment plays a cardioprotective role in the ischemic myocardium. On the other hand, increased osmolarity, similar to that in the hyperglycemic conditions, may play a pivotal role in a failure of IP to induce cardioprotection in the diabetic myocardium.
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Affiliation(s)
- M Zálešák
- Institute for Heart Research, Slovak Academy of Science, Bratislava, Slovak Republic.
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19
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Qian HY, Huang J, Yang YJ, Yang YM, Li ZZ, Zhang JM. Heart-type Fatty Acid Binding Protein in the Assessment of Acute Pulmonary Embolism. Am J Med Sci 2016; 352:557-562. [PMID: 27916210 DOI: 10.1016/j.amjms.2016.08.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 08/08/2016] [Accepted: 08/25/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To explore the predictive value of heart-type fatty acid binding protein (H-FABP) in the stratification and prognosis of patients with acute pulmonary embolism (APE). METHODS According to risk stratification, 69 patients with APE admitted into the emergency department within 24 hours after onset were divided into the following 3 groups: high-risk group, moderate-risk group and low-risk group. H-FABP- and cardiac troponin I (cTNI)-positive rates of all groups were analyzed and compared, and the correlation between major adverse events (death, endotracheal intubation and cardiopulmonary resuscitation) and the cardiac markers (heart rate, arterial partial pressure of oxygen, right ventricular dimension, pulmonary arterial pressure, etc.) during the in-hospital period were statistically analyzed. Then the prognosis (death, embolic pulmonary hypertension, right heart failure and recurrence of APE) at 6 months after onset of APE was followed-up on and compared between groups. RESULTS The admission time of high-risk group patients was earlier than non-high-risk group (7.1 ± 2.9 versus 13.5 ± 6.7 versus 15.2 ± 10.7 hours, P = 0.001), had larger right ventricular dimension (33.1 ± 10.4 versus 26.7 ± 7.3 versus 20.5 ± 8.9mm, P = 0.002) and higher pulmonary arterial pressure (45.8 ± 14.6 versus 29.4 ± 13.9 versus 23.1 ± 12.6mmHg, P = 0.001). The major adverse events during in-hospital period, including death, endotracheal intubation and cardiopulmonary resuscitation, were more prevalent in the high-risk group than those in the other 2 risk groups. Further analysis indicated that the positive rate of H-FABP was remarkably higher than cTNI (52/69, 75.4% versus 28/69, 40.6%, P = 0.003). The H-FABP (r = 0.881, P = 0.020) was significantly correlated to the major adverse events; however, this was not so regarding cTNI (r = 0.115, P = 0.059). At 6 months after onset of APE, the follow-up data indicated that cTNI and H-FABP were both significantly correlated with the major adverse events. CONCLUSIONS The positive rate of H-FABP was higher than cTNI during the 24 hours after the onset of APE. The H-FABP was significantly correlated to the major adverse events during hospitalization and to the primary prognosis at 6 months after onset of APE.
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Affiliation(s)
- Hai-Yan Qian
- Center for Coronary Heart Disease, Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ji Huang
- 15th Ward, Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing, PR China.
| | - Yue-Jin Yang
- Center for Coronary Heart Disease, Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan-Min Yang
- Center for Coronary Heart Disease, Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhi-Zhong Li
- 15th Ward, Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing, PR China
| | - Jing-Mei Zhang
- 15th Ward, Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing, PR China
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20
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Labib M, Sargent EH, Kelley SO. Electrochemical Methods for the Analysis of Clinically Relevant Biomolecules. Chem Rev 2016; 116:9001-90. [DOI: 10.1021/acs.chemrev.6b00220] [Citation(s) in RCA: 555] [Impact Index Per Article: 69.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Mahmoud Labib
- Department
of Pharmaceutical Sciences, University of Toronto, Toronto, Ontario M5S 3M2, Canada
| | | | - Shana O. Kelley
- Department
of Pharmaceutical Sciences, University of Toronto, Toronto, Ontario M5S 3M2, Canada
- Institute
of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario M5S 3G4, Canada
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21
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Pyati AK, Devaranavadagi BB, Sajjannar SL, Nikam SV, Shannawaz M, Patil S. Heart-Type Fatty Acid-Binding Protein, in Early Detection of Acute Myocardial Infarction: Comparison with CK-MB, Troponin I and Myoglobin. Indian J Clin Biochem 2016; 31:439-45. [PMID: 27605741 DOI: 10.1007/s12291-015-0544-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Accepted: 12/18/2015] [Indexed: 11/25/2022]
Abstract
The study aimed to investigate whether heart-type fatty acid binding protein (H-FABP) measurement provides additional diagnostic value to that of conventional cardiac markers in acute myocardial infarction (AMI) within first 6 h after the onset of symptoms. The study included 120 subjects: 60 AMI cases and 60 age and sex matched controls. The cases and controls were further divided into 2 subgroups depending on the time since onset of chest pain as (1) subjects within 3 h and (2) between 3 and 6 h of onset of chest pain. In all the cases and controls, serum H-FABP concentration was measured by Immunoturbidimetric method, serum Troponin I and myoglobin concentrations by Chemiluminescence immunoassay and serum CK-MB concentration by Immuno-inhibition method. The sensitivity, specificity, positive and negative predictive values of H-FABP were significantly greater than CK-MB and myoglobin but were lesser than Troponin I in patients with suspected AMI in both within 3 h and 3-6 h groups. Receiver operating characteristic curves demonstrated greatest diagnostic ability for Troponin I (AUC = 0.99, p < 0.001) followed by H-FABP (AUC = 0.906, p < 0.001) within 3 h and 3-6 h after the onset of chest pain. In conclusion, the diagnostic value of H-FABP is greater than CK-MB and myoglobin but slightly lesser than troponin I for the early diagnosis of AMI within first 6 h of chest pain. H-FABP can be used as an additional diagnostic tool for the early diagnosis of AMI along with troponin I.
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Affiliation(s)
- Anand K Pyati
- Department of Biochemistry, BLDE University's Shri B M Patil Medical College, Hospital and Research Centre, Vijayapur, Karnataka India ; Department of Biochemistry, Belagavi Institute of Medical Sciences (BIMS), Dr B R Ambedkar Road, Belagavi, Karnataka 590001 India
| | - Basavaraj B Devaranavadagi
- Department of Biochemistry, BLDE University's Shri B M Patil Medical College, Hospital and Research Centre, Vijayapur, Karnataka India
| | - Sanjeev L Sajjannar
- Department of Cardiology, BLDE University's Shri B M Patil Medical College, Hospital and Research Centre, Vijayapur, Karnataka India
| | - Shashikant V Nikam
- Department of Biochemistry, Belagavi Institute of Medical Sciences (BIMS), Dr B R Ambedkar Road, Belagavi, Karnataka 590001 India
| | - Mohd Shannawaz
- Department of Community Medicine, BLDE University's Shri B M Patil Medical College, Hospital and Research Centre, Vijayapur, Karnataka India
| | - Satish Patil
- Department of Physiology, BLDE University's Shri B M Patil Medical College, Hospital and Research Centre, Vijayapur, Karnataka India
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22
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Altara R, Manca M, Sabra R, Eid AA, Booz GW, Zouein FA. Temporal cardiac remodeling post-myocardial infarction: dynamics and prognostic implications in personalized medicine. Heart Fail Rev 2015; 21:25-47. [PMID: 26498937 DOI: 10.1007/s10741-015-9513-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Despite dramatic improvements in short-term mortality rates following myocardial infarction (MI), long-term survival for MI patients who progress to heart failure remains poor. MI occurs when the left ventricle (LV) is deprived of oxygen for a sufficient period of time to induce irreversible necrosis of the myocardium. The LV response to MI involves significant tissue, cellular, and molecular level modifications, as well as substantial hemodynamic changes that feedback negatively to amplify the response. Inflammation to remove necrotic myocytes and fibroblast activation to form a scar are key wound healing responses that are highly variable across individuals. Few biomarkers of early remodeling stages are currently clinically adopted. The discovery of underlying pathophysiological mechanisms and associated novel biomarkers has the potential of improving prognostic capability and therapeutic monitoring. Combining these biomarkers with other prominent ones could constitute a powerful diagnostic and prognostic tool that directly reflects the pathophysiological remodeling of the LV. Understanding temporal remodeling at the tissue, cellular, and molecular level and its link to a well-defined set of biomarkers at early stages post-MI is a prerequisite for improving personalized care and devising more successful therapeutic interventions. Here we summarize the integral mechanisms that occur during early cardiac remodeling in the post-MI setting and highlight the most prominent biomarkers for assessing disease progression.
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Affiliation(s)
- Raffaele Altara
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA.,Department of Pharmacology and Toxicology, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Marco Manca
- DG-DI, Medical Applications, CERN, Geneva, Switzerland
| | - Ramzi Sabra
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Assaad A Eid
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - George W Booz
- Department of Pharmacology and Toxicology, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Fouad A Zouein
- Department of Pharmacology and Toxicology, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA. .,Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
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23
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Kamendi H, Zhou Y, Crosby M, Keirstead N, Snow D, Bentley P, Patel N, Barthlow H, Luo W, Dragan Y, Bialecki R. Doxorubicin: Comparison between 3-h continuous and bolus intravenous administration paradigms on cardio-renal axis, mitochondrial sphingolipids and pathology. Toxicol Appl Pharmacol 2015; 289:560-72. [PMID: 26450648 DOI: 10.1016/j.taap.2015.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 09/22/2015] [Accepted: 10/03/2015] [Indexed: 01/29/2023]
Abstract
Doxorubicin (DOX) is a potent and effective broad-spectrum anthracycline antitumor agent, but its clinical usefulness is restricted by cardiotoxicity. This study compared pharmacokinetic, functional, structural and biochemical effects of single dose DOX bolus or 3-h continuous iv infusion (3-h iv) in the Han–Wistar rat to characterize possible treatment-related differences in drug safety over a 72 h observation period. Both DOX dosing paradigms significantly altered blood pressure, core body temperature and QA interval (indirect measure of cardiac contractility); however, there was no recovery observed in the bolus iv treatment group. Following the 3-h iv treatment, blood pressures and QA interval normalized by 36 h then rose above baseline levels over 72 h. Both treatments induced biphasic changes in heart rate with initial increases followed by sustained decreases. Cardiac injury biomarkers in plasma were elevated only in the bolus iv treatment group. Tissue cardiac injury biomarkers, cardiac mitochondrial complexes I, III and V and cardiac mitochondrial sphingolipids were decreased only in the bolus iv treatment group. Results indicate that each DOX dosing paradigm deregulates sinus rhythm.However, slowing the rate of infusion allows for functional compensation of blood pressure and may decrease the likelihood of cardiac myocyte necrosis via a mechanism associated with reduced mitochondrial damage.
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Affiliation(s)
- Harriet Kamendi
- Drug Safety and Metabolism, AstraZeneca, Waltham, MA 02451, USA.
| | - Ying Zhou
- Oncology Innovative Medicines and Early Development, AstraZeneca, Waltham, MA 02451, USA.
| | - Meredith Crosby
- Drug Safety and Metabolism, AstraZeneca, Waltham, MA 02451, USA.
| | | | - Debra Snow
- Drug Safety and Metabolism, AstraZeneca, Waltham, MA 02451, USA.
| | - Patricia Bentley
- Drug Safety and Metabolism, AstraZeneca, Waltham, MA 02451, USA.
| | - Nilaben Patel
- Drug Safety and Metabolism, AstraZeneca, Waltham, MA 02451, USA.
| | - Herbert Barthlow
- Drug Safety and Metabolism, AstraZeneca, Waltham, MA 02451, USA.
| | - Wenli Luo
- Discovery Sciences, Innovative Medicines, AstraZeneca, Waltham, MA 02451, USA.
| | - Yvonne Dragan
- Drug Safety and Metabolism, AstraZeneca, Waltham, MA 02451, USA.
| | - Russell Bialecki
- Drug Safety and Metabolism, AstraZeneca, Waltham, MA 02451, USA.
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24
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Bajaj A, Rathor P, Sehgal V, Shetty A, Kabak B, Hosur S. Risk stratification in acute pulmonary embolism with heart-type fatty acid–binding protein: A meta-analysis. J Crit Care 2015; 30:1151.e1-7. [DOI: 10.1016/j.jcrc.2015.05.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Revised: 05/14/2015] [Accepted: 05/20/2015] [Indexed: 10/23/2022]
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25
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Pyati AK, Devaranavadagi BB, Sajjannar SL, Nikam SV, Shannawaz M, Sudharani. Heart-Type Fatty Acid Binding Protein: A Better Cardiac Biomarker than CK-MB and Myoglobin in the Early Diagnosis of Acute Myocardial Infarction. J Clin Diagn Res 2015; 9:BC08-11. [PMID: 26557510 DOI: 10.7860/jcdr/2015/15132.6684] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Accepted: 08/17/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Early diagnosis and therapeutic intervention can improve the outcome of acute myocardial infarction (AMI). However, there are no satisfactory cardiac biomarkers for the diagnosis of AMI within 6 hours of onset of symptoms. Among novel biochemical markers of AMI, heart-type fatty acid binding protein (H-FABP) is of particular interest. AIM To compare the diagnostic value of H-FABP with that of CK-MB and myoglobin in suspected AMI patients within first 6 hours after the onset of symptoms. SETTINGS AND DESIGN The study includes 40 AMI cases and 40 non-cardiac chest pain otherwise healthy controls. The cases and controls were further divided into 2 groups depending on the time since chest pain as those subjects within 3 hours and those between 3-6 hours of onset of chest pain. MATERIALS AND METHODS In all the cases and controls, serum H-FABP, CK-MB and myoglobin concentrations were measured by Immunoturbidimetric method, immuno-inhibition method and Chemiluminescence immunoassay respectively. STATISTICAL ANALYSIS Data is presented as mean ± SD values. Differences between means of two groups were assessed by Student t-test. Sensitivity, Specificity, Positive predictive value, Negative predictive values were calculated and ROC curve analysis was done to assess the diagnostic validity of each study parameter. RESULTS The sensitivity, specificity, PPV, NPV of H-FABP were greater than CK-MB and myoglobin and ROC curve analysis demonstrated highest area under curve for H-FABP followed by myoglobin and CK-MB in patients with suspected AMI both within 3 hours and 3-6 hours after the onset of chest pain. CONCLUSION The diagnostic efficiency of H-FABP is greater than CK-MB and myoglobin for the early diagnosis of AMI within first 6 hours of chest pain. H-FABP can be used as an additional diagnostic tool for the early diagnosis of AMI.
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Affiliation(s)
- Anand K Pyati
- Ph.D Scholar, Department of Biochemistry, BLDE University's Shri B M Patil Medical College, Hospital & Research Centre , Vijayapur, Karnataka, India
| | - Basavaraj B Devaranavadagi
- Professor and Head, Department of Biochemistry, BLDE University's Shri B M Patil Medical College, Hospital & Research Centre , Vijayapur, Karnataka, India
| | - Sanjeev L Sajjannar
- Assistant Professor, Department of Cardiology, BLDE University's Shri B M Patil Medical College , Hospital & Research Centre, Vijayapur, Karnataka, India
| | - Shashikant V Nikam
- Professor and Head, Department of Biochemistry, Belagavi Institute of Medical Sciences , Belagavi, Karnataka, India
| | - Mohd Shannawaz
- Lecturer, Statistics, Department of Community Medicine, BLDE University's Shri B M Patil Medical College, Hospital & Research Centre , Vijayapur, Karnataka, India
| | - Sudharani
- Post Graduate Student, Department of Pedodontics and Preventive Dentistry, Navodaya Dental College , Raichur, India
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26
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Alcohol and the Heart: A Proteomics Analysis of Pericardium and Myocardium in a Swine Model of Myocardial Ischemia. Ann Thorac Surg 2015; 100:1627-35; discussion 1635. [PMID: 26242211 DOI: 10.1016/j.athoracsur.2015.05.040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 04/30/2015] [Accepted: 05/05/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND Previous studies have demonstrated that moderate alcohol consumption is cardioprotective and reduces postoperative pericardial adhesions; however, the mechanism is not fully understood. Using proteomic analysis, we sought to objectively investigate the effects of daily moderate alcohol consumption in the pericardium and myocardium in a swine model of chronic myocardial ischemia. METHODS Fourteen swine underwent placement of an ameroid constrictor to induce chronic myocardial ischemia. Animals were supplemented with 90 mL of ethanol daily (ETOH) or 80 g of sucrose of equal caloric value (SUC). After 7 weeks, the ischemic myocardium and pericardium were harvested for proteomics analysis. RESULTS Pericardial proteomics analysis yielded 397 proteins, of which 23 were unique to SUC and 52 were unique to ETOH. Of the 322 common proteins, 71 were statistically significant and 23 were characterized (p < 0.05). Alcohol supplementation increased structural proteins, and decreased immune protease inhibitors and coagulation proteins in the pericardium (p < 0.01). Myocardial proteomics analysis yielded 576 proteins, of which 32 were unique to SUC and 21 were unique to ETOH. Of the 523 common proteins, 85 were significant, and 32 were characterized (p < 0.05). Alcohol supplementation decreased cardiac remodeling proteins, cell death proteins and motor proteins, and increased metabolic proteins (p < 0.05). CONCLUSIONS The results suggest that daily moderate alcohol consumption affects numerous pathways that contribute to cardioprotection, including cardiac remodeling, metabolism, and cell death. Our findings reveal the biosignature of myocardial and pericardial protein expression in the setting of chronic myocardial ischemia and daily moderate alcohol consumption.
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Ischemic biomarker heart-type fatty acid binding protein (hFABP) in acute heart failure - diagnostic and prognostic insights compared to NT-proBNP and troponin I. BMC Cardiovasc Disord 2015; 15:50. [PMID: 26072112 PMCID: PMC4488120 DOI: 10.1186/s12872-015-0026-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Accepted: 04/21/2015] [Indexed: 01/12/2023] Open
Abstract
Background To evaluate diagnostic and long-term prognostic values of hFABP compared to NT-proBNP and troponin I (TnI) in patients presenting to the emergency department (ED) suspected of acute heart failure (AHF). Methods 401 patients with acute dyspnea or peripheral edema, 122 suffering from AHF, were prospectively enrolled and followed up to 5 years. hFABP combined with NT-proBNP versus NT-proBNP alone was tested for AHF diagnosis. Prognostic value of hFABP versus TnI was evaluated in models predicting all-cause mortality (ACM) and AHF related rehospitalization (AHF-RH) at 1 and 5 years, including 11 conventional risk factors plus NT-proBNP. Results Additional hFABP measurements improved diagnostic specificity and positive predictive value (PPV) of sole NT-proBNP testing at the cutoff <300 ng/l to “rule out” AHF. Highest hFABP levels (4th quartile) were associated with increased ACM (hazard ratios (HR): 2.1–2.5; p = 0.04) and AHF-RH risk at 5 years (HR 2.8–8.3, p = 0.001). ACM was better characterized in prognostic models including TnI, whereas AHF-RH was better characterized in prognostic models including hFABP. Cox analyses revealed a 2 % increase of ACM risk and 3–7 % increase of AHF-RH risk at 5 years by each unit increase of hFABP of 10 ng/ml. Conclusions Combining hFABP plus NT-proBNP (<300 ng/l) only improves diagnostic specificity and PPV to rule out AHF. hFABP may improve prognosis for long-term AHF-RH, whereas TnI may improve prognosis for ACM. Trial registration ClinicalTrials.gov identifier: NCT00143793.
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Maznyczka A, Kaier T, Marber M. Troponins and other biomarkers in the early diagnosis of acute myocardial infarction. Postgrad Med J 2015; 91:322-30. [DOI: 10.1136/postgradmedj-2014-133129] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Accepted: 05/08/2015] [Indexed: 12/24/2022]
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Sari M, Kilic H, Karakurt Ariturk O, Yazihan N, Akdemir R. Diabetic patients have increased perioperative cardiac risk in heart-type fatty acid-binding protein-based assessment. Med Princ Pract 2015; 24:53-7. [PMID: 25472624 PMCID: PMC5588199 DOI: 10.1159/000368756] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 09/30/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To test the potential role of heart-type fatty acid-binding protein (H-FABP) in detecting increased perioperative cardiac risk in comparison with cardiac troponin I (cTnI) in the early postoperative period. SUBJECTS AND METHODS Sixty-seven patients who had clinical risk factors and underwent elective intermediate - or high-risk noncardiac surgery were included in this study. Serum specimens were analyzed for H-FABP and cTnI levels before and at 8 h after surgery. None of the patients had chest pain; 27 had a history of ischemic heart disease, 3 of heart failure, 5 of cerebrovascular diseases, 40 of diabetes and 46 of hypertension. RESULTS The mean duration of the operations was 2.33 ± 1.27 h (range 1-6). In the postoperative period, 27 (40.3%) patients had increased H-FABP levels (≥7.5 ng/ml); the median preoperative serum H-FABP level was 0.13 ng/ml (<0.1-5.9) and the median postoperative H-FABP level was 6.86 ng/ml (<0.1-13.7). Only 1 (1.5%) patient had cTnI >0.1 µg/l during the postoperative period. Correlation analysis revealed that the presence of diabetes was associated with an increased H-FABP level (r = 0.30, p = 0.01). Of the 27 patients with H-FABP ≥7.5 ng/ml, 21 (87%) had diabetes. There was no significant correlation with other clinical risk factors, type or duration of surgery. CONCLUSION The H-FABP levels significantly increased in the postoperative period. Most patients with increased postoperative H-FABP levels were diabetic. High H-FABP levels could alert clinicians to increased perioperative cardiovascular risk and could prevent underdiagnosis, especially in diabetic patients.
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Affiliation(s)
- Munevver Sari
- Cardiology Clinic, Ministry of Health, Birecik State Hospital, Sanliurfa, Turkey
- *Munevver Sari, MD, Cardiology Clinic, Ministry of Health, Birecik State Hospital, TR–63400 Sanliurfa (Turkey), E-Mail
| | - Harun Kilic
- Department of Cardiology, Sakarya University School of Medicine, Sakarya, Turkey
| | | | - Nuray Yazihan
- Department of Pathophysiology, Pathophysiology and Molecular Biology Research and Development Unit, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Ramazan Akdemir
- Department of Cardiology, Sakarya University School of Medicine, Sakarya, Turkey
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Liu M, Yuan X, Qiu X, Shan X, Lin D, Zhu L. Prognostic Role of Heart-type Fatty Acid Binding Protein in Pulmonary Embolism: a Meta-analysis. Thromb Res 2015; 135:20-5. [DOI: 10.1016/j.thromres.2014.10.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Revised: 09/25/2014] [Accepted: 10/07/2014] [Indexed: 11/15/2022]
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Dursunoğlu N, Dursunoğlu D, Yıldız Aİ, Rota S. Evaluation of cardiac biomarkers and right ventricular dysfunction in patients with acute pulmonary embolism. Anatol J Cardiol 2014; 16:276-82. [PMID: 26645262 PMCID: PMC5368438 DOI: 10.5152/akd.2014.5828] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Right ventricular dysfunction (RVD) with myocardial damage may lead to fatal complications in patients with acute pulmonary embolism (PE). Cytoplasmic heart-type fatty acid-binding protein (HFABP) and the N-terminal fragment of its prohormone (NT-proBNP) are sensitive and specific biomarkers of myocardial damage. We evaluated RVD and cardiac biomarkers for myocardial damage and short-term mortality in patients with acute PE. METHODS We analyzed 41 patients (24 females, 17 males) with confirmed acute PE prospective. Three groups (massive, submassive, and non-massive) of patients were defined, based on systemic systolic blood pressure measured on admission and RVD by transthoracic echocardiography (TTE). Also, systolic (s) and mean (m) pulmonary artery pressures (PAPs) were recorded by TTE, and plasma concentrations of cardiac troponin T (cTn-T), NT-proBNP, and HFABP were evaluated 6 month follow-up. RESULTS Seventeen (41.5%) patients experienced a complicated clinical course in the 6-month follow-up for the combined end-point, including at least one of the following: death (n=12, 29.3%; 3 PE-related), chronic PE (n=4, 9.8%), pulmonary hypertension (n=2, 4.9%), and recurrent PE (n=1, 2.4%). Multivariate hazard ratio analysis revealed HFABP, NT-proBNP, and PAPs as the 6-month mortality predictors (HR 1.02, 95% CI 1.01-1.05; HR 1.01, 95% CI 1.01-1.04; and HR 1.02, 95% CI 1.02-1.05, respectively). CONCLUSION HFABP, NT-proBNP, and PAPs measured on admission may be useful for short-term risk stratification and in the prediction of 6-month PE-related mortality in patients with acute PE.
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Affiliation(s)
- Neşe Dursunoğlu
- Department of Chest, Faculty of Medicine, Pamukkale University, Denizli-Turkey.
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Kim M, Cha SI, Choi KJ, Shin KM, Lim JK, Yoo SS, Lee J, Lee SY, Kim CH, Park JY, Yang DH. Prognostic value of serum growth differentiation factor-15 in patients with chronic obstructive pulmonary disease exacerbation. Tuberc Respir Dis (Seoul) 2014; 77:243-50. [PMID: 25580140 PMCID: PMC4286781 DOI: 10.4046/trd.2014.77.6.243] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 08/01/2014] [Accepted: 09/16/2014] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Information regarding prognostic value of growth differentiation factor 15 (GDF-15) and heart-type fatty acid-binding protein (H-FABP) in patients with chronic obstructive pulmonary disease (COPD) exacerbation is limited. The aim of this study was to investigate whether serum levels of GDF-15 and H-FABP predict an adverse outcome for COPD exacerbation. METHODS Clinical variables, including serum GDF-15 and H-FABP levels were compared in prospectively enrolled patients with COPD exacerbation that did or did not experience an adverse outcome. An adverse outcome included 30-day mortality and need for endotracheal intubation or inotropic support. RESULTS Ninety-seven patients were included and allocated into an adverse outcome (n=10) or a control (n=87) group. Frequencies of mental change and PaCO2>37 mm Hg were significantly higher in the adverse outcome group (mental change: 30% vs. 6%, p=0.034 and PaCO2>37 mm Hg: 80% vs. 22%, p<0.001, respectively). Serum GDF-15 elevation (>1,600 pg/mL) was more common in the adverse outcome group (80% vs. 43%, p=0.041). However, serum H-FABP level and frequency of serum H-FABP elevation (>755 pg/mL) did not differ between the two groups. Multivariate analysis showed that an elevated serum GDF-15 and PaCO2>37 mm Hg were significant predictors of an adverse outcome (odds ratio [OR], 25.8; 95% confidence interval [CI], 2.7-243.8; p=0.005 and OR, 11.8; 95% CI, 1.2-115.3; p=0.034, respectively). CONCLUSION Elevated serum GDF-15 level and PaCO2>37 mm Hg were found to predict an adverse outcome independently in patients with COPD exacerbation, suggesting the possibility that serum GDF-15 could be used as a prognostic biomarker of COPD exacerbation.
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Affiliation(s)
- Miyoung Kim
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Seung-Ick Cha
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Keum-Ju Choi
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Kyung-Min Shin
- Department of Radiology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jae-Kwang Lim
- Department of Radiology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Seung-Soo Yoo
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jaehee Lee
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Shin-Yup Lee
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Chang-Ho Kim
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jae-Yong Park
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Dong Heon Yang
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
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Ruan LB, He L, Zhao S, Zhu P, Li WY. Prognostic Value of Plasma Heart-Type Fatty Acid-Binding Protein in Patients With Acute Pulmonary Embolism. Chest 2014; 146:1462-1467. [DOI: 10.1378/chest.13-1008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Huang JX, Blaskovich MA, Cooper MA. Cell- and biomarker-based assays for predicting nephrotoxicity. Expert Opin Drug Metab Toxicol 2014; 10:1621-35. [DOI: 10.1517/17425255.2014.967681] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Lauque D, Maupas-Schwalm F, Bounes V, Juchet H, Bongard V, Roshdy A, Botella JM, Charpentier S. Predictive value of the heart-type fatty acid-binding protein and the Pulmonary Embolism Severity Index in patients with acute pulmonary embolism in the emergency department. Acad Emerg Med 2014; 21:1143-50. [PMID: 25308138 DOI: 10.1111/acem.12484] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 06/07/2014] [Accepted: 06/08/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Heart-type fatty acid-binding protein (h-FABP), sensitive troponins, natriuretic peptides, and clinical scores such as the Pulmonary Embolism Severity Index (PESI) are candidates for risk stratification of patients with acute pulmonary embolism (PE). The aim was to compare their respective prognostic values to predict an adverse outcome at 1 month. METHODS The authors prospectively included 132 consecutive patients with confirmed acute PE. On admission to the emergency department (ED), plasma concentrations of h-FABP, sensitive cardiac troponin I-Ultra (cTnI-Ultra), and brain natriuretic peptide (BNP) were measured and the PESI calculated in all patients. The combined 30-day outcomes of interest were death, cardiac arrest, mechanical ventilation, use of catecholamines, and recurrence of acute PE. RESULTS During the first 30 days, 14 (10.6%) patients suffered complications. Among the biomarkers, h-FABP above 6 μg/L was a stronger predictor of an unfavorable outcome (odds ratio [OR] = 17.5, 95% confidence interval [CI] = 4.2 to 73.3) than BNP > 100 pg/mL (OR = 5.7, 95% CI = 1.6 to 20.4) or cTnI-Ultra > 0.05 μg/L (OR = 3.4, 95% CI = 1.1 to 10.9). The PESI classified 83 of 118 patients (70.3%) with favorable outcomes and only one of 14 (7%) with adverse outcomes in low class I or II (OR = 30.8, 95% CI = 3.2 to 299.7). The areas under the receiver operating characteristic (ROC) curves (AUCs) were 0.90 (95% CI = 0.81 to 0.98) for h-FABP, 0.89 (95% CI = 0.82 to 0.96) for PESI, 0.79 (95% CI = 0.67 to 0.90) for BNP, and 0.76 (95% CI = 0.64 to 0.87) for cTnI-Ultra. The combination of h-FABP with PESI was a particularly useful prognostic indicator because none of the 79 patients (59.8%) with h-FABP < 6 ng/mL and PESI class < III had an adverse outcome. CONCLUSIONS h-FABP and the PESI are superior to BNP and cTnI-Ultra as markers for risk stratification of patients with acute PE. The high sensitivity of their combination identified a large number of low-risk patients in the ED.
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Affiliation(s)
- Dominique Lauque
- The Emergency Department; Rangueil University Hospital; Toulouse France
- University Toulouse 3; Toulouse France
| | - Françoise Maupas-Schwalm
- The Department of Biochemistry; Rangueil University Hospital; Toulouse France
- University Toulouse 3; Toulouse France
| | - Vincent Bounes
- The Emergency Department; Rangueil University Hospital; Toulouse France
| | - Henry Juchet
- The Emergency Department; Rangueil University Hospital; Toulouse France
| | - Vanina Bongard
- The Department of Epidemiology; Health Economics and Public Health University; Toulouse France
- INSERM UMR1027; Toulouse France
| | - Ashraf Roshdy
- The Cardiothoracic Intensive Therapy Unit; St. George's Hospital; London UK
| | - Jean Marie Botella
- The Department of Biochemistry; Rangueil University Hospital; Toulouse France
| | - Sandrine Charpentier
- The Emergency Department; Rangueil University Hospital; Toulouse France
- University Toulouse 3; Toulouse France
- INSERM UMR1027; Toulouse France
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The prognostic and risk-stratified value of heart-type fatty-acid-binding protein in community acquired pneumonia in emergency department. BIOMED RESEARCH INTERNATIONAL 2014; 2014:753070. [PMID: 25136618 PMCID: PMC4124791 DOI: 10.1155/2014/753070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Revised: 07/01/2014] [Accepted: 07/01/2014] [Indexed: 11/18/2022]
Abstract
Objective. To evaluate the prognostic and risk stratified ability of heart-type fatty-acid-binding protein (H-FABP) in patients with community acquired pneumonia (CAP) in emergency department (ED) and to compare it with Pneumonia Severity Index (PSI) and CURB-65. Methods. Consecutive adult CAP patients admitted to the ED of Beijing Chao-Yang Hospital were enrolled. Circulating H-FABP and troponin I were measured. PSI and CURB-65 were calculated in all patients. The differences in 28-day mortality and requirement for mechanical ventilation (MV) or a vasopressor within 6 h after ED arrival were compared in patients with positive H-FABP (≥7 ng/mL) and negative ones (<7 ng/mL). Receiver operating characteristic (ROC) curve and logistic regression were used to assess the predictive value of H-FABP. Results. From August to November 2012, 229 CAP patients were enrolled. The 28-day mortality, PSI, CURB-65, and incidence of using MV or a vasopressor were much higher in H-FABP-positive patients than in negative ones (P < 0.01). H-FABP was an independent predictor of the 28-day mortality. The area under the ROC curve (AUC) of H-FABP was 0.751. Combination of H-FABP and CURB-65 (AUC = 0.824) or H-FABP and PSI (AUC = 0.820) improved their prognostic performance. Conclusions. H-FABP was valuable for prognosis and risk stratification in CAP patients in ED.
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Banu S, Tanveer S, Manjunath CN. Comparative study of high sensitivity troponin T and heart-type fatty acid-binding protein in STEMI patients. Saudi J Biol Sci 2014; 22:56-61. [PMID: 25561884 DOI: 10.1016/j.sjbs.2014.05.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 05/29/2014] [Accepted: 05/29/2014] [Indexed: 10/25/2022] Open
Abstract
AIM AND BACKGROUND Heart-type fatty acid-binding proteins (H-FABP) which are detected within 2-3 h of acute myocardial infarction are involved in uptake of free fatty acids in the myocardium. Our aim in the present study is to compare window periods of H-FABP to high sensitivity troponin T (hs-Trop T) in acute ST elevation myocardial infarction (STEMI). METHODS 160 STEMI diagnosed patient's serum samples are analyzed for hs-Trop T and H-FABP. Different window periods of chest pain onset (<3 h, 3-6 h and >6 h) are compared with complications, in-hospital mortality and statistically analyzed. RESULTS From 160 patients, 53 (33%) cases are presented in <3 h, 75 (47%) in 3-6, and 32 (20%) after >6 h respectively. Accordingly sensitivity of hs-Trop T was 92%, 94% and 97% while H-FABP was 75%, 88% and 84%, respectively. Overall sensitivity was 94% and 82% respectively. Statistically significant difference between mean hs-Trop T values with respect to window period <3, 3-6 and >6 h was 0.21, 0.35 and 0.80 ng/ml respectively, p value < 0.0001. No significant difference in H-FABP values was observed. Hs-Trop T positively correlated with age (r = 0.153, P = 0.05), window period (r = 0.363, P < 0.0001), TIMI score (r = 0.208, P = 0.008), ejection fraction (r = 0.191, P = 0.008), serum H-FABP (r = 0.229, P = 0.004), and serum hs-CRP (r = 0.326, p < 0.001). There was a statistically significant difference of mean hs-Trop T values with or without in hospital mortality (0.35 vs. 0.85 ng/ml, respectively, p = 0.008). No significant correlation to age, TIMI score, ejection fraction and hs-CRP values for H-FABP was observed. CONCLUSION It appears that hs-Trop T is a more sensitive marker than H-FABP in early hours of AMI and higher hs-Trop T predicts increase in-hospital mortality.
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Affiliation(s)
- Shaheena Banu
- Department of Biochemistry, Sri Jayadeva Institute of Cardiovascular Sciences and Research, India
| | - Syed Tanveer
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, India
| | - C N Manjunath
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, India
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Zálešák M, Blažíček P, Pancza D, Ledvényiová V, Barteková M, Nemčeková M, Čarnická S, Ziegelhöffer A, Ravingerová T. Severity of lethal ischemia/reperfusion injury in rat hearts subjected to ischemic preconditioning is increased under conditions of simulated hyperglycemia. Physiol Res 2014; 63:577-85. [PMID: 24908083 DOI: 10.33549/physiolres.932652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The aim of our study was to characterize resistance to ischemia/reperfusion (I/R) injury in Langendorff-perfused rat hearts and effectivity of ischemic preconditioning (PC) under condition of simulated acute hyperglycemia (SAHG) by perfusion of the hearts with Krebs-Henseleit (KH) solution with elevated glucose concentration (22 mmol/l). I/R injury was induced by 30-min coronary occlusion followed by 120-min reperfusion and PC by two cycles of 5-min occlusion/5-min reperfusion, prior to I/R. The severity of I/R injury was characterized by determination of the size of infarction (IS, expressed in % of area at risk size) and the amount of heart-type fatty acid binding protein (h-FABP, a marker of cell injury) released from the hearts to the effluent. Significantly smaller IS (8.8+/-1 %) and lower total amount of released h-FABP (1808+/-660 pmol) in PC group compared with IS 17.1+/-1.2 % (p<0.01) and amount of h-FABP (8803+/-2415 pmol, p<0.05) in the non-PC control hearts perfused with standard KH solution (glucose 11 mmol/l) confirmed protective effects of PC. In contrast, in SAHG groups, PC enhanced IS (21.4+/-2.2 vs. 14.3+/-1.3 %, p<0.05) and increased total amount of h-FABP (5541+/-229 vs. 3458+/-283 pmol, p<0.05) compared with respective non-PC controls. Results suggest that PC has negative effect on resistance of the hearts to I/R injury under conditions of elevated glucose in vitro.
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Affiliation(s)
- M Zálešák
- Institute for Heart Research, Slovak Academy of Science, Bratislava, Slovak Republic.
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Walder B, Robin X, Rebetez MML, Copin JC, Gasche Y, Sanchez JC, Turck N. The prognostic significance of the serum biomarker heart-fatty acidic binding protein in comparison with s100b in severe traumatic brain injury. J Neurotrauma 2014; 30:1631-7. [PMID: 23590685 DOI: 10.1089/neu.2012.2791] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The outcome after severe traumatic brain injury (TBI) is largely unfavorable, with approximately two thirds of patients suffering from severe disabilities or dying during the first 6 months. Existing predictive models displayed only limited utility for outcome prediction in individual patients. Time courses of heart-fatty acidic binding protein (H-FABP) and their association with outcome were investigated and compared with S100b. Forty-nine consecutive patients with severe TBI (sTBI; Head component of the Abbreviated Injury Scale [HAIS] >3) with mono and multiple trauma were enrolled in this study. Enzyme-linked immunosorbent assay measured blood concentrations of H-FABP and S100b at 6, 12, 24, and 48 h after TBI. Outcome measures were conscious state at 14 days (Glasgow Coma Scale), disability (Glasgow Outcome Scale Extended; GOSE), and mortality at 3 months. Univariate logistic regression analysis and receiver operating characteristic curves analysis were carried out. Maximal H-FABP and S100b concentrations were observed at 6 h after TBI (34.4±34.0 and 0.64±0.99 ng/mL, respectively). Patients with multi-trauma had significantly higher H-FABP concentrations at 24 and 48 h (22.6±25.6 and 12.4±18.2 ng/mL, respectively), compared to patients with mono trauma (6.9±5.1 and 3.7±4.2 ng/mL, respectively). In the first 48 h, H-FABP and S100b were inversely correlated with the GOSE at 3 months; H-FABP at 48 h predicted mortality with 75% sensitivity and 93% specificity. Early blood levels of H-FABP after sTBI have prognostic significance for survival and disability.
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Affiliation(s)
- Bernhard Walder
- 1 Division of Anaesthesiology, University Hospitals of Geneva , Geneva, Switzerland
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Chen YX, Li CS. The prognostic and risk-stratified value of heart-type fatty acid-binding protein in septic patients in the emergency department. J Crit Care 2014; 29:512-6. [PMID: 24768564 DOI: 10.1016/j.jcrc.2014.03.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 02/23/2014] [Accepted: 03/25/2014] [Indexed: 12/16/2022]
Abstract
PURPOSE To evaluate the prognostic and risk-stratified ability of heart-type fatty acid-binding protein (H-FABP) in septic patients in the emergency department (ED). MATERIALS AND METHODS From August to November 2012, 295 consecutive septic patients were enrolled. Circulating H-FABP was measured. The predictive value of H-FABP for 28-day mortality, organ dysfunction on ED arrival, and requirement for mechanical ventilation or a vasopressor within 6 hours after ED arrival was assessed by the receiver operating characteristic curve and logistic regression and was compared with Acute Physiology and Chronic Health Evaluation (APACHE) II score, Mortality in Emergency Department Sepsis (MEDS) score, and Sequential Organ Failure Assessment score. RESULTS The 28-day mortality, APACHE II, MEDS, and Sequential Organ Failure Assessment scores were much higher in H-FABP-positive patients. The incidence of organ dysfunction at ED arrival and requirement for mechanical ventilation or a vasopressor within 6 hours after ED arrival was higher in H-FABP-positive patients. Heart-type fatty acid-binding protein was an independent predictor of 28-day mortality and organ dysfunction. The area under the receiver operating characteristic curve for H-FABP predicting 28-day mortality and organ dysfunction was 0.784 and 0.755, respectively. Combination of H-FABP and MEDS improved the performance of MEDS in predicting organ dysfunction, and the difference of AUC was statistically significant (P<.05). The combinations of H-FABP and MEDS or H-FABP and APACHE II also improved the prognostic value of MEDS and APACHE II, but the areas under the curve were not statistically different. CONCLUSIONS Heart-type fatty acid-binding protein was helpful for prognosis and risk stratification of septic patients in the ED.
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Affiliation(s)
- Yun-Xia Chen
- Emergency Department of Beijing Chao-Yang Hospital, Affiliated to Capital Medical University, Chaoyang District, Beijing 100020, China
| | - Chun-Sheng Li
- Emergency Department of Beijing Chao-Yang Hospital, Affiliated to Capital Medical University, Chaoyang District, Beijing 100020, China.
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Chandran PA, Wani BA, Satish OS, Mohammed N. Diagnosis of Non-ST-Elevation Acute Coronary Syndrome by the Measurement of Heart-Type Fatty Acid Binding Protein in Serum: A Prospective Case Control Study. J Biomark 2014; 2014:624930. [PMID: 26317036 PMCID: PMC4437357 DOI: 10.1155/2014/624930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 12/18/2013] [Accepted: 12/19/2013] [Indexed: 12/03/2022] Open
Abstract
A prospective case control study was undertaken to evaluate the diagnostic performance of serum heart-type fatty acid binding protein (HFABP) in comparison to cardiac TnT and TnI in 33 patients admitted with chest pain, diagnosed as NSTE-ACS (non ST elevation acute coronary syndrome) and 22 healthy controls. Area under the receiver operating curve (AUC) was highest for H-FABP (AUC 0.79; 95% CI 0.66-0.89) versus cTnI (AUC 0.73; 95% CI 0.59-0.84) and cTnT (AUC 0.71; 95% CI 0.57-0.83). The H-FABP level above 6.5 ng/mL showed 56.7% (CI 37.4-74.5) sensitivity, 0.5 (95% CI 0.3-0.7) negative likelihood ratio (-LR), 100% (CI 84.6-100.0) specificity, and 100% (CI 79.4-100.0) positive predictive value (PPV), 62.9% (CI 44.9-78.5) negative predictive value (NPV). cTnI level above 0.009 μg/L had 40% (CI 22.7-59.4) sensitivity, 0.6 (95% CI 0.4-0.8) -LR, 100% (CI 84.6-100.0) specificity, 100% (CI 73.5-100.0) PPV, and 55% (CI 38.5-70.7) NPV. cTnT showed 46.7% (CI 28.3-65.7) sensitivity, 0.5 (95% CI 0.4-0.7) -LR, 100% (CI 84.6-100.0) specificity, 100% (CI 76.8-100.0) PPV, and 57.9% (CI 40.8-73.7) NPV at level above 9 μg/L. +LR were 12.5 (95% CI 1.8-86.8), 1.7 (95% CI 1.0-3.0), and 1.2 (95% CI 0.8-1.9) for H-FABP, cTnI, and cTnT respectively. In conclusion measurement of H-FABP is a valuable tool in the early diagnosis of patients with chest pain (6-8 hrs) and seems to be a preferred biomarker in the differential diagnosis of NSTE-ACS. More studies are needed to determine whether serum H-FABP further improves diagnostic performance.
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Affiliation(s)
- Priscilla Abraham Chandran
- Department of Biochemistry, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh 500082, India
| | - Basharat Ara Wani
- Department of Biochemistry, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh 500082, India
| | - Oruganti Sai Satish
- Department of Cardiology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh 500082, India
| | - Noorjahan Mohammed
- Department of Biochemistry, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh 500082, India
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Gul EE, Can I, Kayrak M, Abdulhalikov T, Erdogan HI, Altunbas G, Ozdemir K, Gok H. Thrombolysis in patients with pulmonary embolism and elevated heart-type fatty acid-binding protein levels. J Thromb Thrombolysis 2013; 37:483-9. [DOI: 10.1007/s11239-013-1008-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lankeit M, Dellas C, Benz V, Hasenfuß G, Konstantinides S. The predictive value of heart-type fatty acid-binding protein is independent from symptom duration in normotensive patients with pulmonary embolism. Thromb Res 2013; 132:543-7. [PMID: 24094603 DOI: 10.1016/j.thromres.2013.09.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 09/09/2013] [Accepted: 09/17/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Heart-type fatty acid-binding protein (H-FABP) is a useful biomarker for risk stratification of patients with pulmonary embolism (PE). In patients with acute myocardial infarction, H-FABP plasma concentrations rise after 30 minutes and return to normal within 20-24 hours. We tested whether the predictive value of H-FABP is affected by the duration of symptoms prior to diagnosis in patients with PE. MATERIAL AND METHODS We prospectively studied 257 consecutive normotensive patients with confirmed symptomatic PE. RESULTS Patients with acute (<24 hours; n=150) symptom onset presented more often with syncope (28.7% vs. 6.5%; p<0.001) compared to patients with symptoms ≥ 24 hours (n=107); other baseline characteristics, comorbidities, and risk factors were distributed equally. Patients with an adverse 30-day outcome (6.6%) had higher H-FABP levels (11.84 [3.57-19.62] ng/ml) compared to patients with a favorable course (3.42 [1.92-5.42] ng/ml; p<0.001). However, the proportion of patients with H-FABP levels ≥ 6 ng/ml did not differ among patients with acute symptom onset and late presentation (p=0.104). Only tachycardia and elevation of H-FABP were associated with an increased risk of an adverse 30-day outcome both in patients with acute symptom onset (H-FABP: OR, 5.8; 95% CI, 1.4-24.5; p=0.016; tachycardia: 7.0 [1.4-36.0]; p=0.018) and late presentation (H-FABP: 9.3 [2.0-43.2]; p=0.004 and tachycardia: 12.3 [1.5-103.6]; p=0.021). The prognostic value could further be improved by the use of a simple H-FABP-based clinical prediction score. CONCLUSIONS Our findings indicate that H-FABP is a useful biomarker for risk stratification of normotensive patients with PE regardless of symptom duration prior to diagnosis.
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Affiliation(s)
- Mareike Lankeit
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, Johannes Gutenberg University of Mainz, Germany; Department of Cardiology and Pulmonology, Heart Center of the Georg August University of Göttingen, Germany.
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Tong C, Zhang Z. Evaluation factors of pulmonary embolism severity and prognosis. Clin Appl Thromb Hemost 2013; 21:273-84. [PMID: 24023267 DOI: 10.1177/1076029613501540] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Management of pulmonary embolism (PE) is still unclear. We summarized 16 kinds of evaluation factors of PE severity and prognosis, and we analyzed the single and joint value for short-term and long-term prognosis. Among them, biomarkers such as brain natriuretic peptide or N-terminal probrain natriuretic peptide, troponin, and heart-type fatty acid-binding protein are the best indicators of PE severity and short-term prognosis. They might replace imaging detections in evaluating PE severity. But the positive predictive value of all the biomarkers is low, and we need to improve each value through joint detection. The PE severity index and simplified PE severity index are more suitable for evaluating the overall risk and long-term prognosis. They could be used as complements of indicators of the PE severity, especially in identifying low-risk group. Integrated risk stratification and strategies of management should be established based on the 2 aspects mentioned previously.
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Affiliation(s)
- ChunRan Tong
- Department of Respiratory Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - ZhongHe Zhang
- Department of Respiratory Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
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Chan CPY, Rainer TH. Pathophysiological roles and clinical importance of biomarkers in acute coronary syndrome. Adv Clin Chem 2013; 59:23-63. [PMID: 23461132 DOI: 10.1016/b978-0-12-405211-6.00002-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Early diagnosis of acute coronary syndrome (ACS) is important to guide appropriate therapy at a time when it is most likely to be of value. Accurate prognostic and risk stratification will facilitate high-risk patients to have early advanced diagnostic investigations and early appropriate interventions in a cost-effective and efficient manner, while those patients at low risk of ACS complications do not need such costly diagnostic tests and unnecessary hospital admission. Recent investigations have demonstrated that elevation of biomarkers upstream from acute-phase biomarkers, biomarkers of plaque destabilization and rupture, biomarkers of myocardial ischemia, necrosis, and dysfunction may provide an earlier assessment of patient risk and identify patients with higher risk of having an adverse event. This review provides an overview of the pathophysiology and clinical characteristics of several well-established biomarkers as well as emerging biomarkers that may have potential clinical utility in patients with ACS. Such emerging biomarkers hold promise and need to be more thoroughly evaluated before utilization in routine clinical practice.
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Affiliation(s)
- Cangel Pui-Yee Chan
- Accident and Emergency Medicine Academic Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Sha Tin, NT, Hong Kong SAR, PR China.
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Toker A, Aribas A, Yerlikaya FH, Tasyurek E, Akbuğa K. Serum and saliva levels of ischemia-modified albumin in patients with acute myocardial infarction. J Clin Lab Anal 2013; 27:99-104. [PMID: 23400892 DOI: 10.1002/jcla.21569] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 12/14/2012] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Ischemia-modified albumin (IMA) is a novel marker for diagnosis of myocardial ischemia and it is considered as a serum marker. The aim of the study was to evaluate salivary IMA levels in patients with acute myocardial infarction (AMI) and to determine the relation between serum and salivary IMA levels. METHODS A total of 60 patients with AMI and 40 control subjects who are age and sex matched with AMI group were included in our study. The diagnosis of AMI was based on the WHO classification criteria. All patients underwent the clinical assessment, consisting of electrocardiography, and serum cardiac markers. Serum and salivary IMA levels were measured at the first and second days of AMI by using a colorimetric method. RESULTS Serum IMA levels were significantly higher in the first and second day of AMI patients, however, salivary IMA levels were significantly higher in the first day of AMI patients compared to the control (P < 0.05). There was a positive correlation between salivary IMA levels and serum IMA levels both in the first and second day of AMI patients (r = 0.298, P < 0.05; r = 0.319, P < 0.05, respectively). CONCLUSION We concluded that salivary IMA levels at the first day of AMI could be used as an alternative marker to serum IMA levels for diagnosis of AMI.
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Affiliation(s)
- Aysun Toker
- Department of Biochemistry, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey.
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Kakoti A, Goswami P. Heart type fatty acid binding protein: structure, function and biosensing applications for early detection of myocardial infarction. Biosens Bioelectron 2013; 43:400-11. [PMID: 23357005 DOI: 10.1016/j.bios.2012.12.057] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 12/20/2012] [Accepted: 12/27/2012] [Indexed: 12/16/2022]
Abstract
Heart type fatty acid binding protein (HFABP) as an early marker of cardiac injury holds a promising future with studies indicating surpassing performance as compared to myoglobin. As a plasma marker, this cytoplasmic protein owing to its small size (∼15kDa) and water solubility, appears readily in the blood-stream following cardiomyocyte damage, reaching peak levels within 6h of symptom onset. Low plasma levels of HFABP as compared to tissue levels indicate that minute amounts of the protein when released during myocardial infarction leads to a greater proportional rise. These parameters of kinetic release make it an ideal candidate for rapid assessment of acute myocardial infarction (AMI). The need for development of rapid immunoassays and immunotests so as to use HFABP as an early marker for AMI exclusion is tremendous. In the present review, we outline the various immunoassays and immunosensors developed so far for the detection of HFABP in buffer, plasma or whole blood. The principles behind the detection techniques along with their performance parameters compared to standard ELISA techniques are elucidated.
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Affiliation(s)
- Ankana Kakoti
- Department of Biotechnology, Indian Institute of Technology Guwahati, Guwahati 781039, Assam, India
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The value of human heart-type fatty acid binding protein in diagnosis of patients with acute chest pain. Egypt Heart J 2012. [DOI: 10.1016/j.ehj.2012.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Feng LN, Bian ZP, Peng J, Jiang F, Yang GH, Zhu YD, Yang D, Jiang LP, Zhu JJ. Ultrasensitive multianalyte electrochemical immunoassay based on metal ion functionalized titanium phosphate nanospheres. Anal Chem 2012; 84:7810-5. [PMID: 22913388 DOI: 10.1021/ac301438v] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
A novel multianalyte electrochemical immunoassay was developed for ultrasensitive detection of human cardiopathy biomarkers cardiac troponin I (cTnI) and human heart-type fatty-acid-binding protein (FABP) using metal ion functionalized titanium phosphate nanospheres (TiP-metal ion) as labels. The metal ions could be detected directly through square wave voltammetry (SWV) without metal preconcentration, and the distinct voltammetric peaks had a close relationship with each sandwich-type immunoreaction. The position and size of the peaks reflected the identity and level of the corresponding antigen. The large amount of metal ions loading on the TiP nanospheres greatly amplified the detection signals, and the good biocompatibility of graphene nanoribbons (GONRs) retained good stability for the sandwich-type immunoassay. The proposed immunoassay exhibited high sensitivity and selectivity for the detection of cTnI and FABP. The linear relationships between electrochemical signals and the concentrations of cTnI and FABP were obtained in the range of 0.05 pg/mL-50 ng/mL and 0.05 pg/mL-50 ng/mL, respectively. The detection limits of cTnI and HIgG were 1 and 3 fg/mL (S/N = 3), respectively. Moreover, the immunoassay accurately detected the concentrations of cTnI and FABP in human serum samples, which were demonstrated to have excellent correlations with the standard enzyme linked immunosorbent assay (ELISA) method. The results suggested that the electrochemical immunoassay would be promising in the point-of-care diagnostics application of clinical screening of acute myocardial infarction (AMI) biomarkers.
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Affiliation(s)
- Li-Na Feng
- State Key Lab of Analytical Chemistry for Life Science, School of Chemistry and Chemical Engineering, Nanjing University, PR China
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