Biomarker profiles that differentiate type-1 and type 2 myocardial infarction.

• Tác giả: Natale Daniele Brunetti, Maria Delia Corbo, Michele Correale, Damiano D'Alessandro, Davide Diomede, Laura Giannetti, Michele Granatiero, Paola Imbrici, Antonella Liantonio, Michele Magnesa, Francesco Mautone, Antonietta Mele, Marco Mele, Gianpaolo Palmieri, Ilaria Ragnatela, Luciano Umberto Rossi, Francesco Santoro, Enrica Vitale
• Ngôn ngữ: eng
• Ký hiệu phân loại: 623.45194 Ordnance
• Thông tin xuất bản: United States : Heart & lung : the journal of critical care , 2025
• Bộ sưu tập: NCBI
• ID: 496345

Tóm tắt

 BACKGROUND: It is crucial to distinguish type-1 myocardial infarction (T1MI) from type-2 myocardial infarction (T2MI) at admission and during hospitalization to avoid unnecessary invasive exams and inappropriate admissions to the acute cardiac care unit. OBJECTIVES: The purpose of the study was to define a simple profile derived from commonly used biomarkers to differentiate T1MI from T2MI. METHODS: We prospectively enrolled in an observational study 213 iconsecutive patients with a provisional diagnosis of non-ST-elevation acute myocardial infarction (NSTEMI) admitted to the Cardiology Department. A final diagnosis of T1MI, T2MI, and non-ischemic acute myocardial injury (NAMI) was given based on clinical and instrumental findings. We assessed high-sensitivity Troponin I (hs-cTnI), Creatine Kinase MB (CK-MB), C-reactive protein (CRP), procalcitonin (PCT), N-Terminal prohormone of brain natriuretic peptide (NTproBNP). RESULTS: A final diagnosis of T1MI was assigned to 77 patients, T2MI to 60 patients, and NAMI to 76 patients
  mean age was not significantly different between groups (73 vs. 71 years), female were more prevalent in the T2MI/NAMI group (53 % vs. 34 %, p <
  0.01). Hs-cTnI peak/upper limit of normal (ULN) (559 ± 770 vs. 286 ± 429
  p = 0.04), hs-cTnI peak/CRP ratio (114 ± 337 vs. 83 ± 430
  p <
  0.001), hs-cTnI peak/PCT ratio (12,592 ± 21,467 vs. 4,609 ± 17,284
  p <
  0.001), and hs-cTnI peak/NTproBNP ratio (0.7 ± 1.6 vs. 0.3 ± 0.6
  p <
  0.01) differentiated T1MI from T2MI Hs-cTnI peak/ULN (559 ± 770 vs. 271 ± 412
  p <
  0.01), hs-cTnI peak/PCT ratio (12,592 ± 21,468 vs. 3,570 ± 12,469
  p <
  0.001), hs-cTnI peak/NTproBNP ratio (0.7 ± 1.6 vs. 0.3 ± 1.3
  p <
  0.001) and hs-cTnI peak/CRP (114 ± 337 vs. 48 ± 288
  p <
  0.001) differentiated T1MI from T2MI + NAMI. Hs-cTnI peak/PCT ratio was a predictor of T1MI, a multivariable logistic regression analysis (OR 1.03, 95 % CI 1.01-1.06, p <
  0.05) with an accuracy of 0.704 (95 % CI 0.626-0.782, p <
  0.001). No significant differences between T2MI and NAMI were detected. CONCLUSIONS: Admission biomarker profile may differentiate T1MI from T2MI in patients admitted for NSTEMI.