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Khaksarinejad R, Arabpour Z, RezaKhani L, Parvizpour F, Rasmi Y. Biomarker based biosensors: An opportunity for diagnosis of COVID-19. Rev Med Virol 2022; 32:e2356. [PMID: 35478470 PMCID: PMC9111147 DOI: 10.1002/rmv.2356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/16/2022] [Accepted: 03/26/2022] [Indexed: 01/08/2023]
Abstract
Early diagnosis and treatment of diseases are crucial research areas of human health. For early diagnosis, one method that has proven efficient is the detection of biomarkers which can provide real-time and accurate biological information. Most biomarker detection is currently carried out at localised dedicated laboratories using large and automated analysers, increasing waiting time and costs. Smaller, faster, and cheaper devices could potentially replace these time-consuming laboratory analyses and make analytical results available as point-of-care diagnostics. Innovative biosensor-based strategies could allow biomarkers to be tested reliably in a decentralised setting. Early diagnosis of COVID-19 patients has a key role in order to use quarantine and treatment strategies in a timely manner. Raised levels of several biomarkers in COVID-19 patients are associated with respiratory infections or dysfunction of various organs. Through clinical studies of COVID-19 patient biomarkers such as ferritin, Interleukins, albumin and …are found to reveals significant differences in their excretion ranges from healthy patients and patients with SARS-CoV-2, in addition to the development of biomarkers based biosensor such as stated biomarkers can be used and to investigate more specific biomarkers further proteomic analysis can be performed. This review presents several biomarker alterations in COVID-19 patients such as salivary, circulatory, coagulation, cardiovascular, renal, liver, C-reactive protein (CRP), immunological and inflammatory biomarkers. Also, biomarker sensors based on electrochemical, optical, and lateral flow characteristics which have potential applications for SARS-COV-2 in the recent COVID-19 pandemic, will be discussed.
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Affiliation(s)
- Reza Khaksarinejad
- Department of ToxicologyFaculty of Medical SciencesTarbiat Modares UniversityTehranIran
| | - Zohreh Arabpour
- Iranian Tissue Bank and Research CenterTehran University of Medical SciencesTehranIran
| | - Leila RezaKhani
- Fertility and Infertility Research CenterHealth Technology InstituteKermanshah University of Medical SciencesKermanshahIran
- Department of Tissue EngineeringSchool of MedicineKermanshah University of Medical SciencesKermanshahIran
| | - Farzad Parvizpour
- Iranian Tissue Bank and Research CenterTehran University of Medical SciencesTehranIran
| | - Yousef Rasmi
- Department of BiochemistryFaculty of MedicineUrmia University of Medical SciencesUrmiaIran
- Cellular and Molecular Research CenterUrmia University of Medical SciencesUrmiaIran
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2
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A sliver deposition signal-enhanced optical biomolecular detection device based on reduced graphene oxide. Talanta 2022; 249:123691. [PMID: 35732104 DOI: 10.1016/j.talanta.2022.123691] [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: 02/26/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 11/20/2022]
Abstract
The development of high-sensitive biomolecular detection system is of great significance for diseases early diagnosis. The novel optical sensor based on the polarization-sensitive absorption of graphene has a great potential in biological detection. However, the detection sensitivity of the device can hardly meet the needs of clinical analysis currently. This study applies sliver deposition signal amplification to the optical biomolecular detection device based on reduced graphene oxide for the sensitive immunoassay. In redox cycling enzymatic silver deposition reaction, the more alkaline phosphatase label bound on chip surface will cause a faster silver deposition rate. The specific antibody detection confirms that the sliver deposition can enhance the detection signal significantly. In cardiac biomarker Creatine Kinase-MB measurement, the minimum detection concentration is 0.1 ng/mL. To be more important, within the range from detection limit to 10 ng/mL, the signal intensity is highly correlated with target protein concentration, so the biomolecular detection device can meet clinical assay requirements. The signal-enhanced optical biomolecular detection device based on reduced graphene oxide shows excellent sensitivity and selectivity, and provides a new strategy for biomolecules detection, which can be applied in diseases accurate prediction and diagnosis.
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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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4
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Świerczewski M, Kaczmarska E, Bobrowski R, Zieliński K, Pręgowski J, Norwa-Otto B, Ciszewski M, Dąbrowski M, Chmielak Z, Demkow M, Witkowski A, Kalińczuk Ł, Rużyłło W. Comparison of myocardial tissue reperfusion of inferior wall and a right ventricle among patients after primary angioplasty for an inferior myocardial infarction with right ventricular infarction. Minerva Cardiol Angiol 2020; 69:502-509. [PMID: 32657554 DOI: 10.23736/s2724-5683.20.05223-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Impaired myocardial tissue reperfusion affects prognosis of patients with ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI) and can be identified by ST-segment analysis. To date, evaluation of the myocardial tissue reperfusion of the right ventricle (RV) among the patients treated with PCI for inferior STEMI with right ventricular infarction (RVI) has not been made yet. METHODS Patients with inferior STEMI were screened for RVI. Tissue reperfusion was evaluated by maximal residual ST-segment deviation post PCI, independently for the RV and for inferior wall. Myocardial injury was assessed by the peak creatine kinase-mb (CK-MB) value. RESULTS Among 456 patients with inferior STEMI, concomitant RVI occurred in 153 (33.5%) subjects (59.86±10.35 years old, 71.9% females). Tissue reperfusion of LV was present in 75 (49%), whereas 55 (35.9%) had both successful LV and RV reperfusion. Among 97 (63.4%) with successful tissue reperfusion of RV, 55 (56.7%) had associated successful tissue reperfusion of inferior wall. Adequate LV reperfusion was accompanied by RV in over 73.3% of patients (P=0.006). Mean peak CK-MB was lower in the group with adequate versus impaired RV tissue-perfusion (197±143 vs. 305±199 U/L, P=0.021 respectively). CONCLUSIONS Impaired reperfusion of RV is observed in more than one third of inferior STEMIs with RVI and is not strictly associated with impaired reperfusion of inferior wall and clinical or angiographic variables, therefore ST-segment analysis for RV is mandatory.
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Prognostic Value of Cardiovascular Biomarkers in COVID-19: A Review. Viruses 2020; 12:v12050527. [PMID: 32403242 PMCID: PMC7290838 DOI: 10.3390/v12050527] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/26/2020] [Accepted: 05/09/2020] [Indexed: 02/06/2023] Open
Abstract
In early December 2019, the coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first emerged in Wuhan, China. As of May 10th, 2020, a total of over 4 million COVID-19 cases and 280,000 deaths have been reported globally, reflecting the raised infectivity and severity of this virus. Amongst hospitalised COVID-19 patients, there is a high prevalence of established cardiovascular disease (CVD). There is evidence showing that COVID-19 may exacerbate cardiovascular risk factors and preexisting CVD or may lead to cardiovascular complications. With intensive care units operating at maximum capacity and such staggering mortality rates reported, it is imperative during this time-sensitive COVID-19 outbreak to identify patients with an increased risk of adverse outcomes and/or myocardial injury. Preliminary findings from COVID-19 studies have shown the association of biomarkers of acute cardiac injury and coagulation with worse prognosis. While these biomarkers are recognised for CVD, there is emerging prospect that they may aid prognosis in COVID-19, especially in patients with cardiovascular comorbidities or risk factors that predispose to worse outcomes. Consequently, the aim of this review is to identify cardiovascular prognostic factors associated with morbidity and mortality in COVID-19 and to highlight considerations for incorporating laboratory testing of biomarkers of cardiovascular performance in COVID-19 to optimise outcomes.
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Abbate A, Trankle CR, Buckley LF, Lipinski MJ, Appleton D, Kadariya D, Canada JM, Carbone S, Roberts CS, Abouzaki N, Melchior R, Christopher S, Turlington J, Mueller G, Garnett J, Thomas C, Markley R, Wohlford GF, Puckett L, Medina de Chazal H, Chiabrando JG, Bressi E, Del Buono MG, Schatz A, Vo C, Dixon DL, Biondi-Zoccai GG, Kontos MC, Van Tassell BW. Interleukin-1 Blockade Inhibits the Acute Inflammatory Response in Patients With ST-Segment-Elevation Myocardial Infarction. J Am Heart Assoc 2020; 9:e014941. [PMID: 32122219 PMCID: PMC7335541 DOI: 10.1161/jaha.119.014941] [Citation(s) in RCA: 168] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background ST‐segment–elevation myocardial infarction is associated with an intense acute inflammatory response and risk of heart failure. We tested whether interleukin‐1 blockade with anakinra significantly reduced the area under the curve for hsCRP (high sensitivity C‐reactive protein) levels during the first 14 days in patients with ST‐segment–elevation myocardial infarction (VCUART3 [Virginia Commonwealth University Anakinra Remodeling Trial 3]). Methods and Results We conducted a randomized, placebo‐controlled, double‐blind, clinical trial in 99 patients with ST‐segment–elevation myocardial infarction in which patients were assigned to 2 weeks treatment with anakinra once daily (N=33), anakinra twice daily (N=31), or placebo (N=35). hsCRP area under the curve was significantly lower in patients receiving anakinra versus placebo (median, 67 [interquartile range, 39–120] versus 214 [interquartile range, 131–394] mg·day/L; P<0.001), without significant differences between the anakinra arms. No significant differences were found between anakinra and placebo groups in the interval changes in left ventricular end‐systolic volume (median, 1.4 [interquartile range, −9.8 to 9.8] versus −3.9 [interquartile range, −15.4 to 1.4] mL; P=0.21) or left ventricular ejection fraction (median, 3.9% [interquartile range, −1.6% to 10.2%] versus 2.7% [interquartile range, −1.8% to 9.3%]; P=0.61) at 12 months. The incidence of death or new‐onset heart failure or of death and hospitalization for heart failure was significantly lower with anakinra versus placebo (9.4% versus 25.7% [P=0.046] and 0% versus 11.4% [P=0.011], respectively), without difference between the anakinra arms. The incidence of serious infection was not different between anakinra and placebo groups (14% versus 14%; P=0.98). Injection site reactions occurred more frequently in patients receiving anakinra (22%) versus placebo (3%; P=0.016). Conclusions In patients presenting with ST‐segment–elevation myocardial infarction, interleukin‐1 blockade with anakinra significantly reduces the systemic inflammatory response compared with placebo. Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT01950299.
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Affiliation(s)
- Antonio Abbate
- Virginia Commonwealth University Pauley Heart Center MedStar Washington Hospital Center Washington DC.,"Kenneth and Dianne Wright" Center for Clinical and Translational Research MedStar Washington Hospital Center Washington DC
| | - Cory R Trankle
- Virginia Commonwealth University Pauley Heart Center MedStar Washington Hospital Center Washington DC
| | - Leo F Buckley
- Department of Pharmacotherapy and Outcomes Science MedStar Washington Hospital Center Washington DC
| | - Michael J Lipinski
- Medstar Heart and Vascular Institute MedStar Washington Hospital Center Washington DC
| | | | - Dinesh Kadariya
- Virginia Commonwealth University Pauley Heart Center MedStar Washington Hospital Center Washington DC
| | - Justin M Canada
- Virginia Commonwealth University Pauley Heart Center MedStar Washington Hospital Center Washington DC
| | - Salvatore Carbone
- Virginia Commonwealth University Pauley Heart Center MedStar Washington Hospital Center Washington DC
| | - Charlotte S Roberts
- Virginia Commonwealth University Pauley Heart Center MedStar Washington Hospital Center Washington DC
| | - Nayef Abouzaki
- Virginia Commonwealth University Pauley Heart Center MedStar Washington Hospital Center Washington DC
| | - Ryan Melchior
- Virginia Commonwealth University Pauley Heart Center MedStar Washington Hospital Center Washington DC.,Virginia Cardiovascular Specialists Richmond VA
| | - Sanah Christopher
- Virginia Commonwealth University Pauley Heart Center MedStar Washington Hospital Center Washington DC
| | - Jeremy Turlington
- Virginia Commonwealth University Pauley Heart Center MedStar Washington Hospital Center Washington DC
| | - George Mueller
- Virginia Commonwealth University Pauley Heart Center MedStar Washington Hospital Center Washington DC.,Virginia Cardiovascular Specialists Richmond VA
| | | | - Christopher Thomas
- Virginia Commonwealth University Pauley Heart Center MedStar Washington Hospital Center Washington DC.,Virginia Cardiovascular Specialists Richmond VA
| | - Roshanak Markley
- Virginia Commonwealth University Pauley Heart Center MedStar Washington Hospital Center Washington DC
| | - George F Wohlford
- Department of Pharmacotherapy and Outcomes Science MedStar Washington Hospital Center Washington DC
| | - Laura Puckett
- Virginia Commonwealth University Pauley Heart Center MedStar Washington Hospital Center Washington DC.,Virginia Cardiovascular Specialists Richmond VA
| | - Horacio Medina de Chazal
- Virginia Commonwealth University Pauley Heart Center MedStar Washington Hospital Center Washington DC
| | - Juan G Chiabrando
- Virginia Commonwealth University Pauley Heart Center MedStar Washington Hospital Center Washington DC
| | - Edoardo Bressi
- Virginia Commonwealth University Pauley Heart Center MedStar Washington Hospital Center Washington DC
| | - Marco Giuseppe Del Buono
- Virginia Commonwealth University Pauley Heart Center MedStar Washington Hospital Center Washington DC
| | - Aaron Schatz
- Virginia Commonwealth University Pauley Heart Center MedStar Washington Hospital Center Washington DC
| | - Chau Vo
- Virginia Commonwealth University Pauley Heart Center MedStar Washington Hospital Center Washington DC
| | - Dave L Dixon
- Virginia Commonwealth University Pauley Heart Center MedStar Washington Hospital Center Washington DC.,Department of Pharmacotherapy and Outcomes Science MedStar Washington Hospital Center Washington DC
| | - Giuseppe G Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies Sapienza' University of Rome Latina Italy.,Mediterranea Cardiocentro Napoli Italy
| | - Michael C Kontos
- Virginia Commonwealth University Pauley Heart Center MedStar Washington Hospital Center Washington DC
| | - Benjamin W Van Tassell
- Virginia Commonwealth University Pauley Heart Center MedStar Washington Hospital Center Washington DC.,Department of Pharmacotherapy and Outcomes Science MedStar Washington Hospital Center Washington DC
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Tan Y, Ji X, Mo Z, Zhou Y. Serum YKL-40 positively correlates with MMP-9 and CRP in patients with acute ST segment elevation myocardial infarction following emergency treatment. Medicine (Baltimore) 2019; 98:e17950. [PMID: 31764795 PMCID: PMC6882559 DOI: 10.1097/md.0000000000017950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE To investigate the role of YKL-40 in ST segment elevation myocardial infarction (STEMI) and its relationship to C-reactive protein (CRP) and matrix metalloproteinase-9 (MMP-9). METHODS This prospective study included 358 STEMI patients who were sent to the Emergency Department of our hospital from April 2014 to December 2017. Serum levels of YKL-40, CRP and MMP-9 were determined using commercially available Enzyme linked immunosorbent assay (ELISA) kits. Major adverse cardiovascular events (MACE) and overall survival time were analyzed. RESULTS GRACE scores (P < .001) and the levels of YKL-40 (P < .001), MMP-9 (P < .001), and CRP (P < .001) were significantly higher in deceased patients compared to those that survived. The levels of CRP (P = .007) and MMP-9 (P = .022) were significantly higher in the high YKL-40 group. The GRACE scores were also significantly elevated (P = .011, 95% CI 2.1 (-9.7 to -1.3)). Cumulative MACE rates and cardiac death rates were significantly higher in the high YKL-40 group (P < .001, 95% CI 3.9 (1.9-8.2)). Overall survival times were significantly longer in patients with lower YKL-40 levels (P < .0001). CONCLUSION Elevated YKL-40 levels positively correlate with CRP and MMP-9 levels and are associated with clinical outcomes including MACE and 6-month survival in STEMI patients.
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8
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Inhibiting the Inflammatory Injury After Myocardial Ischemia Reperfusion With Plasma-Derived Alpha-1 Antitrypsin: A Post Hoc Analysis of the VCU-α1RT Study. J Cardiovasc Pharmacol 2019; 71:375-379. [PMID: 29634656 DOI: 10.1097/fjc.0000000000000583] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite the benefits of reperfusion in limiting myocardial injury, the infarct size continues to expand after reperfusion because of secondary inflammatory injury. Plasma-derived alpha-1 antitrypsin (AAT) inhibits the inflammatory injury in myocardial ischemia and reperfusion. To explore the effects of plasma-derived AAT on the inflammatory response to ischemia-reperfusion injury, we analyzed time-to-reperfusion and enzymatic infarct size estimates in a post hoc analysis of the VCU-α1RT clinical trial (clinicaltrials.gov NCT01936896). METHODS Ten patients with ST-segment elevation acute myocardial infarction (STEMI) were enrolled in an open-label, single-arm treatment study of Prolastin C, plasma-derived AAT, at 60 mg/kg infused intravenously within 12 hours of reperfusion. Biomarkers were measured serially over the first 72 hours, and patients were followed clinically for the occurrence of new-onset heart failure, recurrent MI, or death. Twenty patients with STEMI who had been enrolled in previous randomized trials with identical inclusion/exclusion criteria and had been assigned to placebo served as historical controls. RESULTS Time to percutaneous coronary intervention and time to drug did not significantly differ between groups. AAT-treated patients had a significantly shorter time-to-peak creatine kinase myocardial band (CK-MB) values (525 [480-735] vs. 789 [664-959] minute, P = 0.005) and CK-MB area under the curve (from 1204 [758-2728] vs. 2418 [1551-4289] U·day, P = 0.035), despite no differences in peak CK-MB (123 [30-196] vs. 123 [71-213] U/mL, P = 0.71). CONCLUSIONS A single administration of Prolastin C given hours after reperfusion in patients with STEMI led to a significant shorter time to peak and area under the curve for CK-MB, despite similar peak CK-MB values. These preliminary data support the hypothesis that Prolastin C shortens the duration of the ischemia-reperfusion injury in patients with STEMI.
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9
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Heart-type fatty acid binding protein (H-FABP) as a biomarker for acute myocardial injury and long-term post-ischemic prognosis. Acta Pharmacol Sin 2018; 39:1155-1163. [PMID: 29770799 DOI: 10.1038/aps.2018.37] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 02/28/2018] [Indexed: 12/11/2022] Open
Abstract
Acute myocardial infarction (AMI) is a life-threatening event. Even with timely treatment, acute ischemic myocardial injury and ensuing ischemia reperfusion injury (IRI) can still be difficult issues to tackle. Apart from radiological and other auxiliary examinations, laboratory tests of applicable cardiac biomarkers are also necessary for early diagnosis and close monitoring of this disorder. Heart-type fatty acid binding protein (H-FABP), which mainly exists inside cardiomyocytes, has recently emerged as a potentially promising biomarker for myocardial injury. In this review we discuss the sensitivity and specificity of H-FABP in the assessment of myocardial injury and IRI, especially in the early stage, and its long-term prognostic value in comparison with other commonly used cardiac biomarkers, including myoglobin (Mb), cardiac troponin I (cTnI), creatine kinase MB (CK-MB), C-reactive protein (CRP), glycogen phosphorylase isoenzyme BB (GPBB), and high-sensitivity cardiac troponin T (hs-cTnT). The potential and value of combined application of H-FABP with other biomarkers are also discussed. Finally, the prospect of H-FABP is summarized; several technical issues are discussed to facilitate wider application of H-FABP in clinical practice.
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10
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Meng J, Qu X, Huang H, Zhang S, Zhao W, He G, Song Z, Hu H. Intracoronary electrocardiogram during alcohol septal ablation for hypertrophic obstructive cardiomyopathy predicts myocardial injury size. Clin Exp Pharmacol Physiol 2015; 43:75-80. [PMID: 26473435 DOI: 10.1111/1440-1681.12502] [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: 04/02/2015] [Revised: 09/28/2015] [Accepted: 10/05/2015] [Indexed: 11/29/2022]
Abstract
Alcohol septal ablation (ASA) has been used widely to treat patients with hypertrophic obstructive cardiomyopathy (HOCM). During the routine ASA procedure, it is difficult to detect the septal injury in real-time. The aim of the present study is to assess myocardial injury during ASA by recording intracoronary electrocardiogram (IC-ECG). From 2012 to 2015, 31 HOCM patients were treated with ASA, and IC-ECG was recorded in 21 patients successfully before and after ethanol injection. The elevation of ST-segment on IC-ECG after ethanol injection was expressed as its ratio to the level before injection or the absolute increasing value. Blood samples were collected before and after ASA for measuring changes in cardiac biomarkers. The ratio value of ST-segment elevation was positively correlated with both the amount of ethanol injected (r = 0.645, P = 0.001) and the myocardial injury size (creatine kinase-MB area under the curve (AUC) of CK-MB) (r = 0.466, P = 0.017). The absolute increment of ST-segment was also positively associated with both the amount of ethanol (r = 0.665, P = 0.001) and AUC of CK-MB (0.685, P = 0.001). However, there was no statistical correlation between the reduction of left ventricular outflow tract gradient and ST-segment elevation. Additionally no severe ASA procedure-related complications were observed in our patients. In conclusion, myocardial injury induced by ethanol injection can be assessed immediately by ST-segment elevation on IC-ECG. This study is the first to show that IC-ECG is a useful method for predicting myocardial injury during ASA in real-time.
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Affiliation(s)
- Jing Meng
- Department of Cardiology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Xiaolong Qu
- Department of Cardiology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Haiyun Huang
- Department of Ultrasonography, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Shanwen Zhang
- Department of Cardiology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Weibo Zhao
- Department of Cardiology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Guoxiang He
- Department of Cardiology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Zhiyuan Song
- Department of Cardiology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Houyuan Hu
- Department of Cardiology, Southwest Hospital, Third Military Medical University, Chongqing, China
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Shavadia J, Zheng Y, Dianati Maleki N, Huber K, Halvorsen S, Goldstein P, Gershlick AH, Wilcox R, Van de Werf F, Armstrong PW. Infarct Size, Shock, and Heart Failure: Does Reperfusion Strategy Matter in Early Presenting Patients With ST-Segment Elevation Myocardial Infarction? J Am Heart Assoc 2015; 4:e002049. [PMID: 26304934 PMCID: PMC4599463 DOI: 10.1161/jaha.115.002049] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background A pharmacoinvasive (PI) strategy for early presenting ST-segment elevation myocardial infarction nominally reduced 30-day cardiogenic shock and congestive heart failure compared with primary percutaneous coronary intervention (PPCI). We evaluated whether infarct size (IS) was related to this finding. Methods and Results Using the peak cardiac biomarker in patients randomized to PI versus PPCI within the Strategic Reperfusion Early After Myocardial Infarction (STREAM) trial, IS was divided into 3 groups: small (≤2 times the upper limit normal [ULN]), medium (>2 to ≤5 times the upper limit normal) and large (>5 times the upper limit normal). The association between IS and 30-day shock and congestive heart failure was subsequently examined. Data on 1701 of 1892 (89.9%) patients randomized to PI (n=853, 50.1%) versus PPCI (n=848, 49.9%) within STREAM were evaluated. A higher proportion of PPCI patients had a large IS (PI versus PPCI: small, 49.8% versus 50.2%; medium, 56.9% versus 43.1%; large, 48.4% versus 51.6%; P=0.035), despite comparable intergroup ischemic times for each reperfusion strategy. As IS increased, a parallel increment in shock and congestive heart failure occurred in both treatment arms, except for the small IS group. The difference in shock and congestive heart failure in the small IS group (4.4% versus 11.6%, P=0.026) in favor of PI likely relates to higher rates of aborted myocardial infarction with the PI strategy (72.7% versus 54.3%, P=0.005). After adjustment, a trend favoring PI persisted in this subgroup (relative risk 0.40, 95% CI 0.15 to 1.06, P=0.064); no difference in treatment-related outcomes was evident in the other 2 groups. Conclusion A PI strategy appears to alter the pattern of IS after ST-segment elevation myocardial infarction, resulting in more medium and fewer large infarcts compared with PPCI. Despite a comparable number of small infarcts, PI patients in this group had more aborted myocardial infarctions and less 30-day shock and congestive heart failure. Clinical Trial Registration URL: http://ClinicalTrials.gov. Unique identifier: NCT00623623.
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Affiliation(s)
- Jay Shavadia
- Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada (J.S., Y.Z., N.D.M., P.W.A.)
| | - Yinggan Zheng
- Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada (J.S., Y.Z., N.D.M., P.W.A.)
| | - Neda Dianati Maleki
- Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada (J.S., Y.Z., N.D.M., P.W.A.)
| | - Kurt Huber
- Department of Cardiology, University of Vienna, Austria (K.H.)
| | - Sigrun Halvorsen
- Department of Cardiology, Oslo University Hospital HF Ullevål, Oslo, Norway (S.H.)
| | - Patrick Goldstein
- Centre Hospitalier Régional et Universitaire, Lille Cedex, France (P.G.)
| | - Anthony H Gershlick
- Department of Academic Cardiology, University Hospitals of Leicester, Leicester, United Kingdom (A.H.G.)
| | - Robert Wilcox
- Department Cardiovascular Medicine, University Hospital, Nottingham, United Kingdom (R.W.)
| | - Frans Van de Werf
- Department of Cardiology, University Hospital Gasthuisberg, Leuven, Belgium (F.V.W.)
| | - Paul W Armstrong
- Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada (J.S., Y.Z., N.D.M., P.W.A.)
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Kucherenko IS, Soldatkin OO, Lagarde F, Jaffrezic-Renault N, Dzyadevych SV, Soldatkin AP. Determination of total creatine kinase activity in blood serum using an amperometric biosensor based on glucose oxidase and hexokinase. Talanta 2015; 144:604-11. [PMID: 26452867 DOI: 10.1016/j.talanta.2015.06.079] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 06/24/2015] [Accepted: 06/26/2015] [Indexed: 10/23/2022]
Abstract
Creatine kinase (CK: adenosine-5-triphosphate-creatine phosphotransferase) is an important enzyme of muscle cells; the presence of a large amount of the enzyme in blood serum is a biomarker of muscular injuries, such as acute myocardial infarction. This work describes a bi-enzyme (glucose oxidase and hexokinase based) biosensor for rapid and convenient determination of CK activity by measuring the rate of ATP production by this enzyme. Simultaneously the biosensor determines glucose concentration in the sample. Platinum disk electrodes were used as amperometric transducers. Glucose oxidase and hexokinase were co-immobilized via cross-linking with BSA by glutaraldehyde and served as a biorecognition element of the biosensor. The biosensor work at different concentrations of CK substrates (ADP and creatine phosphate) was investigated; optimal concentration of ADP was 1mM, and creatine phosphate - 10 mM. The reproducibility of the biosensor responses to glucose, ATP and CK during a day was tested (relative standard deviation of 15 responses to glucose was 2%, to ATP - 6%, to CK - 7-18% depending on concentration of the CK). Total time of CK analysis was 10 min. The measurements of creatine kinase in blood serum samples were carried out (at 20-fold sample dilution). Twentyfold dilution of serum samples was chosen as optimal for CK determination. The biosensor could distinguish healthy and ill people and evaluate the level of CK increase. Thus, the biosensor can be used as a test-system for CK analysis in blood serum or serve as a component of multibiosensors for determination of important blood substances. Determination of activity of other kinases by the developed biosensor is also possible for research purposes.
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Affiliation(s)
- I S Kucherenko
- Laboratory of Biomolecular Electronics, Institute of Molecular Biology and Genetics of National Academy of Sciences of Ukraine, 150 Zabolotny Str., Kyiv 03680, Ukraine; Taras Shevchenko National University of Kyiv, 64 Volodymyrska Str., 01003 Kyiv, Ukraine; Institute of Analytical Sciences, UMR5280 CNRS/UCBL/ENS, 5 rue de la Doua, 69100 Villeurbanne, France.
| | - O O Soldatkin
- Laboratory of Biomolecular Electronics, Institute of Molecular Biology and Genetics of National Academy of Sciences of Ukraine, 150 Zabolotny Str., Kyiv 03680, Ukraine; Taras Shevchenko National University of Kyiv, 64 Volodymyrska Str., 01003 Kyiv, Ukraine
| | - F Lagarde
- Institute of Analytical Sciences, UMR5280 CNRS/UCBL/ENS, 5 rue de la Doua, 69100 Villeurbanne, France
| | - N Jaffrezic-Renault
- Institute of Analytical Sciences, UMR5280 CNRS/UCBL/ENS, 5 rue de la Doua, 69100 Villeurbanne, France
| | - S V Dzyadevych
- Laboratory of Biomolecular Electronics, Institute of Molecular Biology and Genetics of National Academy of Sciences of Ukraine, 150 Zabolotny Str., Kyiv 03680, Ukraine; Taras Shevchenko National University of Kyiv, 64 Volodymyrska Str., 01003 Kyiv, Ukraine
| | - A P Soldatkin
- Laboratory of Biomolecular Electronics, Institute of Molecular Biology and Genetics of National Academy of Sciences of Ukraine, 150 Zabolotny Str., Kyiv 03680, Ukraine; Taras Shevchenko National University of Kyiv, 64 Volodymyrska Str., 01003 Kyiv, Ukraine
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13
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Dong YM, Liu XX, Wei GQ, Da YN, Cha L, Ma CS. Prediction of long-term outcome after acute myocardial infarction using circulating miR-145. Scandinavian Journal of Clinical and Laboratory Investigation 2014; 75:85-91. [PMID: 25465803 DOI: 10.3109/00365513.2014.981855] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Recent reports have shown that miR-145 concentration correlates with infarct size. In this paper, we attempt to predict heart failure and cardiovascular death after acute myocardial infarction using circulating miR-145 concentration. METHODS We assessed 246 patients with first ST-segment-elevation myocardial infarction who underwent successful percutaneous coronary intervention. We measured circulating miR-145, N-terminal fragment of the precursor B-type natriuretic peptide, myocardial-band creatine kinase, and cardiac troponin-I concentrations on day 5 after primary percutaneous coronary intervention and assessed their correlations with long-term clinical outcome. RESULTS During the one-year follow-up period, 72 patients experienced primary composite cardiac events (cardiac death or hospitalization for worsening heart failure). Multivariable Cox proportional hazards analysis indicated that circulating miR-145 (hazard ratio 7.174, 95% confidence interval 4.208-12.229); p < 0.0001) was a significant independent predictor of cardiac events after adjustment for multiple confounders. CONCLUSION Circulating miR-145 may be a novel biomarker for predicting long-term outcome after acute myocardial infarction.
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Affiliation(s)
- Yu-Mei Dong
- Department of Cardiology, Center for Atrial Fibrillation, Beijing Anzhen Hospital, Capital Medical University , Beijing
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14
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Touboul C, Angoulvant D, Mewton N, Ivanes F, Muntean D, Prunier F, Ovize M, Bejan-Angoulvant T. Ischaemic postconditioning reduces infarct size: systematic review and meta-analysis of randomized controlled trials. Arch Cardiovasc Dis 2014; 108:39-49. [PMID: 25453717 DOI: 10.1016/j.acvd.2014.08.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 07/29/2014] [Accepted: 08/28/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND Infarct size (IS) is a major determinant of patient outcome after acute ST-segment elevation myocardial infarction (STEMI). Interventions aimed at reducing reperfusion injury, such as cardiac ischaemic postconditioning (IPost), may reduce IS and improve clinical outcomes. IPost has been shown to be feasible in patients with STEMI treated by primary percutaneous coronary intervention (PPCI). AIMS To provide an updated summary of the efficacy of IPost, assessed by analysing accurate surrogate markers of IS. METHODS We performed a meta-analysis of randomized controlled trials that evaluated the efficacy of IPost in STEMI patients undergoing PPCI. The main outcome was area under the curve of serum creatine kinase release (CK-AUC). Secondary outcomes were other surrogate biomarkers of IS, complete ST-segment resolution, direct measurement of IS by single-photon emission computed tomography and estimation of IS by cardiac magnetic resonance (CMR-IS). RESULTS Eleven studies were retrieved, including 1313 STEMI patients undergoing PPCI with or without IPost. Compared with controls, we observed a significant reduction in CK-AUC (standard mean difference [SMD] -2.84 IU/L, 95% CI -5.43 to -0.25 IU/L; P=0.03). Other surrogate markers, such as CMR-IS (SMD -0.36, 95% CI -0.88 to 0.15; P=0.16), showed a non-significant IS reduction in the IPost group. CONCLUSIONS This meta-analysis, dealing with accurate surrogate markers of IS, suggests that IPost reduces IS. However, results should be interpreted cautiously because of limited sample sizes and significant heterogeneity. Whether this translates into improvements in cardiac function and patient prognosis still needs to be demonstrated in larger prospective randomized controlled studies that are powered sufficiently.
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Affiliation(s)
- Caroline Touboul
- CHRU de Tours, ICCU & Cardiology department, Trousseau Hospital, 37000 Tours, France
| | - Denis Angoulvant
- CHRU de Tours, ICCU & Cardiology department, Trousseau Hospital, 37000 Tours, France; Université François Rabelais, EA 4245 Cellules Dendritiques Immunomodulation et Greffes, FHU "SUPORT", 37000 Tours, France.
| | - Nathan Mewton
- Inserm U1060-CarMeN, service d'explorations fonctionnelles cardiovasculaires, centre d'investigation clinique, 1407, université Claude-Bernard Lyon 1, Louis-Pradel Hospital, CHU de Lyon, Lyon, France
| | - Fabrice Ivanes
- CHRU de Tours, ICCU & Cardiology department, Trousseau Hospital, 37000 Tours, France; Université François Rabelais, EA 4245 Cellules Dendritiques Immunomodulation et Greffes, FHU "SUPORT", 37000 Tours, France
| | - Danina Muntean
- Department of Pathophysiology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Fabrice Prunier
- EA 3860 cardioprotection remodelage et thrombose, Cardiology Department, université d'Angers, CHU d'Angers, Angers, France
| | - Michel Ovize
- Inserm U1060-CarMeN, service d'explorations fonctionnelles cardiovasculaires, centre d'investigation clinique, 1407, université Claude-Bernard Lyon 1, Louis-Pradel Hospital, CHU de Lyon, Lyon, France
| | - Theodora Bejan-Angoulvant
- CHRU de Tours, department of Pharmacology, Tours, France; CNRS UMR 7292, Tours, France; Université François Rabelais, GICC, Tours, France
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15
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Bagai A, Schulte PJ, Granger CB, Mahaffey KW, Christenson RH, Bell G, Lopes RD, Green CL, Lincoff AM, Armstrong PW, Roe MT. Prognostic implications of creatine kinase-MB measurements in ST-segment elevation myocardial infarction patients treated with primary percutaneous coronary intervention. Am Heart J 2014; 168:503-511.e2. [PMID: 25262260 DOI: 10.1016/j.ahj.2014.06.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 06/05/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Peak creatine kinase (CK)-MB concentration is related to reperfusion success and clinical outcomes after fibrinolytic therapy for acute myocardial infarction. However, prognostic implications of CK-MB measurements after primary percutaneous coronary intervention (PCI), which provides more predictable and consistent reperfusion, are unknown. METHODS We pooled 2,042 primary PCI-treated ST-segment elevation myocardial infarction (STEMI) patients from 3 trials with serial core laboratory-determined CK-MB measurements; 1,799 patients (88.1%) who survived to 36 hours and had ≥4 CK-MB measurements were studied. Cox regression modeling was performed to quantify the association between peak CK-MB concentration (and area under the time-concentration curve [AUC]) and mortality at 6 months, and death or congestive heart failure at 90 days. RESULTS The median (25th-75th percentiles) peak CK-MB concentration and AUC measurement through 36 hours were 239 (109-429) ng/mL and 4,263 (2,081-7,124) ng/(mL h), respectively. By multivariable analysis, peak CK-MB concentration and AUC measurement were independently associated with 6-month mortality (adjusted hazard ratio [HR] 1.15, 95% CI 1.05-1.25, per 100-ng/mL increase, P = .002; and adjusted HR 1.09, 95% CI 1.03-1.14, per 1,000-ng/[mL h] increase, P < .001, respectively) and 90-day death or congestive heart failure (adjusted HR 1.26, 95% CI 1.18-1.34, P < .001; and adjusted HR 1.15, 95% CI 1.11-1.19, P < .001, respectively). CONCLUSIONS Peak CK-MB concentration and AUC measurement are independent predictors of 3- to 6-month cardiovascular outcomes in primary PCI-treated STEMI patients. Our findings guide application of these measurements as efficacy end points in early-phase studies evaluating new therapies for STEMI.
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Affiliation(s)
- Akshay Bagai
- St. Michael's Hospital, University of Toronto, Ontario, Canada
| | | | | | | | | | | | | | | | - A Michael Lincoff
- Cleveland Clinic Foundation/Cleveland Clinical Coordinating Center for Clinical Research (C5Research), Cleveland, OH
| | - Paul W Armstrong
- Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada
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