Document Detail


Utility of cardiac biomarkers for the diagnosis of type V myocardial infarction after coronary artery bypass grafting: insights from serial cardiac MRI.
MedLine Citation:
PMID:  21378388     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To examine, using cardiac magnetic resonance (CMR), the utility of cardiac biomarkers for the determination of myocyte necrosis and function after coronary artery bypass grafting (CABG), and to test the recently updated guidelines for the diagnosis of postoperative myocardial infarction (type V MI).
METHODS AND RESULTS: Forty patients included in a single-centre randomised trial of two surgical techniques for performing CABG underwent serial assessment with CMR biochemical markers. Cine and delayed enhancement CMR (DE-CMR) for assessment of left ventricular (LV) function and irreversible myocyte necrosis was performed and levels of troponin I (TnI) and creatine kinase-MB isoform (CK-MB) were determined. The area under the curve for TnI strongly correlated with the mass of new myocyte necrosis as assessed by DE-CMR (r = 0.83, p<0.001), compared with CK-MB (r=0.39, p=0.06). Furthermore, routine assessment of TnI alone at 24 h (> 6.6 μg/l) predicted type V MI on DE-CMR with a sensitivity of 88% and specificity of 97%, whereas CK-MB predicted type V MI with a sensitivity of 75% and specificity of 87%.
CONCLUSIONS: Biomarkers alone (TnI), at an appropriate threshold appear robust for the detection of type V MI, independently of supplementary evidence, as suggested by the ESC/ACCF/AHA/WHF criteria. Clinical trial registration information The study is listed on the Current Controlled Trials Registry: ISRCTN41388968. URL: http://www.controlled-trials.com.
Authors:
Tammy J Pegg; Zoe Maunsell; Theodoros D Karamitsos; Richard P Taylor; Tim James; Jane M Francis; David P Taggart; Harvey White; Stefan Neubauer; Joseph B Selvanayagam
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2011-03-04
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  97     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-25     Completed Date:  2011-07-01     Revised Date:  2014-06-10    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  810-6     Citation Subset:  AIM; IM    
Data Bank Information
Bank Name/Acc. No.:
ISRCTN/ISRCTN41388968
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MeSH Terms
Descriptor/Qualifier:
Aged
Biological Markers / metabolism
Coronary Artery Bypass*
Creatine Kinase, MB Form / metabolism*
Female
Humans
Magnetic Resonance Angiography / methods
Magnetic Resonance Imaging, Cine
Male
Middle Aged
Myocardial Infarction / diagnosis*
Myocytes, Cardiac / pathology*
Necrosis
Postoperative Complications / diagnosis*
Prospective Studies
Troponin I / metabolism*
Grant Support
ID/Acronym/Agency:
090532//Wellcome Trust; PG/05/037//British Heart Foundation
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Troponin I; EC 2.7.3.2/Creatine Kinase, MB Form

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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