Validity of Cardiac Markers as Diagnostic and Prognostic Indicators of Complications in Patients undergoing Percutaneous Coronary Intervention
Journal Title: Sultan Qaboos University Medical Journal - Year 2010, Vol 10, Issue 1
Abstract
Te aim of this study was to assess the diagnostic and prognostic value of heart-type fatty acid-binding protein (H-FABP) in elective percutaneous coronary intervention (PCI) and compare it with standard cardiac markers. Methods: A prospective evaluation was done of 80 consecutive patients admitted for elective PCI. Serum cardiac troponin T (cTnT), cardiac troponin I (cTnI), creatine kinase-MB (CK-MB mass), myoglobin, and H-FABP were determined pre-angioplasty and 1, 2, 4, and 16–24 hrs post-angioplasty. Elevated cardiac markers were correlated with demographic, angiographic and procedural variables. Patients were followed up for 20–26 months. Results: H-FABP peaked early at 2 hours and was useful for the early detection of evolving AMI within 1–3 hours after angioplasty. Cardiac-TnI, myoglobin, H-FABP, CK-MB mass, and cTnT concentrations were elevated in 46.25%, 17.5%, 13.3%, 11.25%, and 7.5% respectively. Cardiac-TnI was the most sensitive marker for detecting all complications and was superior to all other markers. Elevated cardiac markers were correlated with old age (P < 0.02); chest pain ± ECG changes of ischaemia (P < 0.003); use of stents (P < 0.019) and major complications such as major dissection (P < 0.004); transient vessel closure (P < 0.022); bail out stent (P < 0.003), and AMI (P < 0.042). Elevated cardiac markers were associated with a reduction of event-free survival (16.92 versus 20.67 months, P < 0.03). Conclusion: Heart-type-FABP measurements at 1 hour (or thereafter) post-PCI may offer an early chance of detecting evolving AMI; cTnI was the most sensitive marker for the detection of major complications in patients undergoing PCI. Measurements of cTnI 16–24 hours post-PCI should be part of the routine management of patients following elective PCI.
Authors and Affiliations
Hafdh A Alhadi| Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman, Keith A A Fox| University of Edinburgh Cardiovascular Research Unit, Royal Infrmary of Edinburgh, UK
Erratum Notice of Author Sequence Change Spousal concordance of diabetes mellitus among women in Ajman, United Arab Emirates
Successful Use of Alternative Anticoagulants in the Management of Heparin-induced Thrombocytopenia with Thrombotic Complications Report of 5 cases and review of literature
Heparin is one of the most frequently used anticoagulants. It is easy to use, but can be associated with life-threatening side effects. One of these is heparin-induced thrombocytopenia syndrome (HITS), which develops...
Smashed to Pieces A patient’s view of a road traffc accident
Compliance of spectacle wear and its determinants among schoolchildren of Dhakhiliya region of Oman: A descriptive study
Objective: To determine the degree of compliance of spectacle wear and some of its determinants among school children of Dhakhiliya region of Oman. Methods: This was a cross-sectional descriptive study of a sample of 66...
Item Analysis of Multiple Choice Questions at the Department of Paediatrics, Arabian Gulf University, Manama, Bahrain
Objectives: The current study aimed to carry out a post-validation item analysis of multiple choice questions (MCQs) in medical examinations in order to evaluate correlations between item difficulty, item discrimination...