Study of prognostic value of various biomarkers (creatinine phosphokinase - MB, C - reactive protein) and admission neutrophil lymphocyte ratio in early outcome of patients with acute myocardial infarction
Journal Title: International Archives of Integrated Medicine - Year 2015, Vol 2, Issue 2
Abstract
Introduction: Coronary artery disease (CAD) continues to be a major cause of morbidity and mortality in developed as well as developing countries. The time course of bio-marker (protein) release during acute myocardial infarction provides diagnostic information which in turn is helpful in evaluating therapeutic interventions. The three easily measurable markers e.g. creatinine phosphokinase - MB (CPK-MB), C -reactive protein (CRP) and neutrophil lymphocyte ratio (N: L) in patients of acute myocardial infarction (AMI) can be used for diagnosis as well as prognosis. Material and methods: Patients of acute myocardial infarction admitted in intensive coronary care unit (ICCU) of a General Hospital were included in the present study. Detailed clinical examination of each patient was done and after initiating oxygen inhalation and pain relieving therapy, following investigations were sent; hemoglobin level, total white blood cell (WBC) count, differential count, CPK -MB, CRP level. Observation: Significantly high CPK - MB levels (>60 IU/L) were observed in 24% of patients who had or later developed complication of MI while only 7% of uncomplicated MI patients had significantly elevated levels of CPK - MB. Similarly more patients in complicated MI had higher values of CRP and N: L ratio as compared to uncomplicated MI patients. Conclusion: Blood levels of biomarker CPK - MB and inflammation markers CRP and N: L ratio at the time of hospital admission does have a direct correlation with chances of development of complications and/or mortality in early post-infarct period. These bio-chemical markers are important not only for diagnosis but also have prognostic values and help in risk stratification and decision making regarding further early therapeutic intervention.
Authors and Affiliations
Harikrishna R. Rathwa, Mubassir Saiyad, Harshit Acharya, Hiren Parmar
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