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Titolo:
BIOCHEMICAL MARKERS OF MYOCARDIAL DAMAGE
Autore:
BHAYANA V; HENDERSON AR;
Indirizzi:
UNIV WESTERN ONTARIO HOSP,DEPT LAB MED LONDON ON N6A 5A5 CANADA UNIV WESTERN ONTARIO HOSP,DEPT LAB MED LONDON ON N6A 5A5 CANADA
Titolo Testata:
Clinical biochemistry
fascicolo: 1, volume: 28, anno: 1995,
pagine: 1 - 29
SICI:
0009-9120(1995)28:1<1:BMOMD>2.0.ZU;2-X
Fonte:
ISI
Lingua:
ENG
Soggetto:
CREATINE-KINASE-MB; CARDIAC TROPONIN-T; LACTATE-DEHYDROGENASE ISOENZYME-1; MYOSIN LIGHT-CHAINS; CORONARY-ARTERY REPERFUSION; UNSTABLE ANGINA-PECTORIS; LATEX-AGGLUTINATION-TEST; CARBONIC ANHYDRASE-III; SERUM MYOGLOBIN LEVELS; ACUTE CHEST PAIN;
Keywords:
SENSITIVITY; SPECIFICITY; RECEIVER OPERATING CHARACTERISTIC CURVES; MYOCARDIAL INFARCTION; MYOCARDIAL ISCHEMIA; MYOCARDIAL REPERFUSION; ASPARTATE AMINOTRANSFERASE; LACTATE DEHYDROGENASE ISOENZYMES; CREATINE KINASE ISOENZYMES; MUSCLE PROTEINS;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
208
Recensione:
Indirizzi per estratti:
Citazione:
V. Bhayana e A.R. Henderson, "BIOCHEMICAL MARKERS OF MYOCARDIAL DAMAGE", Clinical biochemistry, 28(1), 1995, pp. 1-29

Abstract

Objective: To assess various biochemical markers of myocardial damage. Methods and Results: Before routinely using any test as a biochemical marker of myocardial damage, the published evidence for its diagnostic utility must be critically assessed. Such assessment includes receiver operator curve (ROC) curve analyses, confidence interval estimatesof claimed sensitivity and specificity values, and the effects of testing in serial and parallel modes. It is also necessary to establish the test's rule-in (high specificity) and rule-out (high sensitivity) decision thresholds that may vary with time after the onset of symptoms. The spectrum of ischemic heart disease includes acute (sudden death,non-Q- and Q-wave infarctions) and chronic (stable, unstable, and variant angina) conditions. Biochemical markers of myocardial damage are of most value in the diagnosis of acute ischemic heart disease, although increasingly some of these markers are being found to possess a prognostic value in chronic ischemic heart disease. The markers of enzymatic activity include aspartate aminotransferase, creatine kinase (together with isoenzymes and isoforms), and lactate dehydrogenase and isoenzymes. Creatine kinase isoenzyme-2 may also be measured immunologically, and this type of assay is in increasing use both because of its speed and because its blood levels rise earlier than the corresponding activities. The commercially available nonenzymatic markers are myoglobin and troponin T; troponin I is expected to become available in late 1995. While myoglobin is a nonspecific indicator of myocardial damage,its diagnostic value is due to its early appearance in blood. Troponin T is more cardiac specific, but the published data appears to suggest that the cardiac specificity of troponin I is superior. Troponin levels become abnormal at about the same time after the onset of symptomsas mass assays of creatine kinase isoenzyme-2; therefore, they are not useful as early markers of myocardial damage. Conclusion: The availability of these nonenzymatic markers of myocardial damage must force areassessment of the continued use of the enzymatic markers. Are they necessary, and if so, which ones should be retained?

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 18/09/20 alle ore 19:22:44