Cardiac biomarkers and detection methods for myocardial infarction

김상용,이진표,Shin Woo-ri,Oh In-Hwan,안지영,김양훈 대한독성 유전단백체 학회 2022 Molecular & cellular toxicology Vol.18 No.4

Background A significant heart attack known as a myocardial infarction (MI) occurs when the blood supply to the heart is suddenly interrupted, harming the heart muscles due to a lack of oxygen. The incidence of myocardial infarction is increasing worldwide. A relationship between COVID-19 and myocardial infarction due to the recent COVID-19 pandemic has also been revealed. Objective We propose a biomarker and a method that can be used for the diagnosis of myocardial infarction, and an aptamerbased approach. Results For the diagnosis of myocardial infarction, an algorithm-based diagnosis method was developed using electrocardiogram data. A diagnosis method through biomarker detection was then developed. Conclusion Myocardial infarction is a disease that is difficult to diagnose based on the aspect of a single factor. For this reason, it is necessary to use a combination of various methods to diagnose myocardial infarction quickly and accurately. In addition, new materials such as aptamers must be grafted and integrated into new ways. Purpose of Review The incidence of myocardial infarction is increasing worldwide, and some studies are being conducted on the association between COVID-19 and myocardial infarction. The key to properly treating myocardial infarction is early detection, thus we aim to do this by offering both tools and techniques as well as the most recent diagnostic techniques. Recent Findings Myocardial infarction is diagnosed using an electrocardiogram and echocardiogram, which utilize cardiac signals. It is required to identify biomarkers of myocardial infarction and use biomarker-based ELISA, SPR, gold nanoparticle, and aptamer technologies in order to correctly diagnose myocardial infarction.

지역사회 주민의 천식과 뇌졸중 및 심근경색증과 연관성 -2009년 지역사회건강조사를 바탕으로-

신승옥 ( Seung Ok Shin ),박종 ( Jong Park ),임순임 ( Sun Im Im ),권유진 ( Yu Jin Kwon ),심재순 ( Jae Soon Shim ),박문숙 ( Moon Sook Park ) 대한보건협회 2013 대한보건연구 Vol.39 No.2

Objectives: Stroke and myocardial infarction are the second and third highest causes of death in South Korea, respectively, and asthma is an inflammatory allergic disease that costs 4 trillion won annually to manage both directly and indirectly. Thus, this study was conducted to see if asthma is correlated with stroke and myocardial infarction. Methods: The subjects of this study were adults aged over 19 in 2009, of whom 4,452 people had stroke and 2,464, myocardial infarction. The investigation was done by analyzing the age, gender, education level, obesity, smoking and other diseases of the subjects, after which a logistic regression analysis was conducted to determine if there was a relation with asthma. Results: Among the stroke patients, there was a significant difference in the prevalence according to their gender, age, level of obesity, education level and smoking history. The percentage of asthma patients with stroke was 4.1%, which shows a significant difference. As for myocardial infarction, there was a significant difference in the prevalence when the patients were older, men, with a lower education level and were non-smokers. The percentage of asthma patients with myocardial infarction was 2.9%. The incidence of hypertension was 3.488 times higher in the stroke patients and 1.934 times higher in the myocardial infarction patients; of diabetes, 1.661 times higher in the stroke patients and 1.891 times higher in the myocardial infarction patients; and of hyperlipidemia, 1.569 times higher in the stroke patients and 2.899 times higher in the myocardial infarction patients. The prevalence of myocardial infarction was 2.575 times higher in the stroke group, and the prevalence of stroke was 2.470 times higher in the myocardial infarction group. In the asthma patients, the prevalence of stroke was 1.232 higher, which is 1.630 times higher than in the myocardial infarction group. Conclusion: The prevalence of asthma was 1.2 times higher in the stroke patients and 1.6 times higher in the myocardial infarction patients. Thus, asthma showed a significant correlation with stroke and myocardial infarction. However, because this study is a cross-sectional study that used questionnaires, we propose a prospective study to further investigate this relation.

Dehydroepiandrosterone Sulfate as a Risk Factor for Premature Myocardial Infarction: A Comparative Study

Mohammad Shojaie,Armin Abtahian,Armin Abtahian,Mohamed Amin Ghobadifar,Azadeh Esmail Pour,Armin Akbarzadeh 대한가정의학회 2015 Korean Journal of Family Medicine Vol.36 No.1

Ba ckground: This study aimed to evaluate some of the major risk factors of myocardial infarction including dehydroepiandrosterone sulfate in patients with premature myocardial infarction (age <50 years old) and myocardial infarction (age ≥50 years). Me thods: This is a parallel case-control study on 50 premature myocardial infarction patients and 50 myocardial infarction patients. We also recruited 50 matched participants for each of the two groups. Patients and their control groups were assessed for dehydroepiandrosterone sulfate serum level, diabetes mellitus, hyperlipidemia, hypertriglyceridemia, and hypertension. In addition, family history of cardiovascular disease and current smoking was recorded. Univariate and multivariate logistic regression analyses were performed to evaluate predictors of premature myocardial infarction and myocardial infarction. Re sults: No significant differences were observed between the demographic data of patients and their controls. The dehydroepiandrosterone sulfate serum level was significantly higher in patients with premature myocardial infarction compared with controls. Multivariate logistic regression analysis revealed only serum dehydroepiandrosterone sulfate dehydroepiandrosterone sulfate level to be significantly associated with premature myocardial infarction (odds ratio, 2.65; 95% confidence interval, 1.44 to 4.877; P = 0.002). Additionally, hypertension was found to be associated with myocardial infarction. Co nclusion: Higher levels of serum dehydroepiandrosterone sulfate level are associated with premature myocardial infarction but not with myocardial infarction, and this association is independent of the effects of other risk factors.

대기 오염 물질과 급성심근경색의 상관 관계 연구

박형준,이숙희,장태창,김균무,고승현,서영우 대한응급의학회 2020 대한응급의학회지 Vol.31 No.3

Objective: Air pollutants have attracted increasing interest worldwide, including Korea. Acute and chronic exposure to air pollutants has adverse effects on health. Therefore, this study examined the association of air pollutants with myocardial infarction. Methods: This study included 542 patients who underwent coronary angiography and were diagnosed with acute coronary artery occlusion after visiting a local emergency medical center from January 1, 2016, to December 31, 2018. The days (1,096) were divided into two groups: myocardial infarction days group (the days when symptoms of myocardial infarction developed) and non-myocardial infarction days group (the days when symptoms of myocardial infarction did not develop). This study compared the air pollutants (PM10, PM2.5, O3, SO2, CO, and NO2) and prognosis (survivor, death) from two days ago to the days between the myocardial infarction days and non-myocardial infarction days. Results: The PM10 and PM2.5 of the myocardial infarction days group were 44.332±18.892 and 25.193±12.009 μm/m3, respectively, and those of the non-myocardial infarction days group were 41.906±19.263 and 23.693±12.053 μm/m3, respectively. On day one before symptom development, the PM2.5 of the myocardial infarction days group was 25.316± 11.977 μm/m3, which was higher than that of the non-myocardial infarction days groups (23.642±12.053 μm/m3), and there were no significant differences between the gaseous air pollution and the number of occlusions, except on a 0 day of ozone. The PM2.5 (proximal, middle, and distal according to the vessel size) at day 0 was 25.747±12.361, 22.941± 11.477, and 21.486±10.924 μm/m3, respectively; the proximal group had the highest value. During the study days, the PM10 of the death and survival groups was 51.440 (±20.140)-56.924 (±25.225) μm/m3 and 41.155 (±18.544)-43.002 (±18.858) μm/m3, respectively. PM2.5 of the death and survival groups was 26.968 (±14.140)-30.145 (±12.829) and 23.770 (±11.685)-24.170 (±12.696) μm/m3, respectively. Conclusion: Myocardial infarction was found to develop more on the day with the highest PM2.5 and PM10 on day 0 and -1. A high PM2.5 is related to an occlusion of the proximal coronary artery. Therefore, PM2.5 has a stronger association with myocardial infarction than PM10. Furthermore, increased particulate air pollution for three consecutive days is associated with a poor prognosis.

Peiminine inhibits myocardial injury and fibrosis after myocardial infarction in rats by regulating mitogen-activated protein kinase pathway

Peng Chen,Dengming Zhou,Yongsheng Liu,Ping Wang,Weina Wang 대한약리학회 2022 The Korean Journal of Physiology & Pharmacology Vol.26 No.2

Myocardial infarction promotes cardiac remodeling and myocardial fibrosis, thus leading to cardiac dysfunction or heart failure. Peiminine has been regarded as a traditional anti-fibrotic Chinese medicine in pulmonary fibrosis. However, the role of peiminine in myocardial infarction-induced myocardial injury and fibrosis remained elusive. Firstly, rat model of myocardial infarction was established using ligation of the left coronary artery, which were then intraperitoneally injected with 2 or 5 mg/kg peiminine once a day for 4 weeks. Echocardiography and haemodynamic evaluation results showed that peiminine treatment reduced left ventricular end-diastolic pressure, and enhanced maximum rate of increase/decrease of left ventricle pressure (± dP/dt max) and left ventricular systolic pressure, which ameliorate the cardiac function. Secondly, myocardial infarction-induced myocardial injury and infarct size were also attenuated by peiminine. Moreover, peiminine inhibited myocardial infarction-induced increase of interleukin (IL)-1β, IL-6 and tumor necrosis factor-α production, as well as the myocardial cell apoptosis, in the rats. Thirdly, peiminine also decreased the myocardial fibrosis related protein expression including collagen I and collagen III. Lastly, peiminine reduced the expression of p38 and phosphorylation of extracellular signal-regulated kinase 1/2 in rat model of myocardial infarction. In conclusion, peiminine has a cardioprotective effect against myocardial infarction-induced myocardial injury and fibrosis, which can be attributed to the inactivation of mitogen-activated protein kinase pathway.

Q 파 심근경색증과 non - Q 파 심근경색증

이만영(Man Young Lee),승기배(Ki Bae Seung),김종진(Jong Jim Kim),노태호(Tae Ho Rho),채장성(Jang Seong Chae),김종상(Jong Sang Kim),홍순조(Soon Jo Hong),최규보(Kyu Bo Chol) 대한내과학회 1990 대한내과학회지 Vol.39 No.6

N/A To evaluate the clinical differences between Q wave myocardial infarction and non-Q wave myocardial infarction, the records of 336 patients with first myocardial infarction were reviewed. According to the presence or absence of Q waves on electrocardiogram, the patients were divided into two groups: a Q wave myocardial infarction group and a non-Q wave myocardial infarction group. The results were as follows: 1) According to standard electrocardiographic criteria, among 336 patients 271 patients (80.6%) had Q wave myocardial infarctions, and 65 patients (19.4%) had non-Q wave myocaridal infarctions. 2) The average age and male-to-female ratio were similar in the two groups. There were no significant differencres between the two groups in serum cholesterol levels and in incidences of a history of hypertension and diabetes mellitus. 3) Peak cardiac enzyme levels of CPK and LDH were significantly higher in the Q wave myocardial infarction group than in the non-Q-wave myocardial infarctions group. 4) When the complications of arrythmia, congestive heart failure and hospital mortality were compaired, incidences of AV block and congestive heart failure were significantly higher in the Q wave myocardial infarction group, but there was no difference in hospital mortality between the two groups. 5) Incidences of recurrent angina, congestive heart failure, reinfarction, death, and cause of death were not different statistically between the two groups, even though there was a tendency to have more recurrent angina and reinfarction in the non-Q wave myocardial infarction group and more congestive heart failure in the Q wave myocardial infarction group.

Q 파 심근경색과 비 - Q 파 심근경색의 임상경과 및 관동맥조영술 소견의 비교

정기영(Ki Young Chung),홍석근(Suk Keun Hong),이명룡(Myung Yong Lee),조주희(Joo Hee Zo),김준수(June Soo Kim),김치정(Chee Jeong Kim),조명찬(Myeong Chan Cho),박영배(Young Bae Park),이명묵(Myoung Mook Lee),최윤식(Yun Shik Choi),서정돈(Ju 대한내과학회 1991 대한내과학회지 Vol.40 No.1

N/A Despite of having smaller infarct size and better left ventricular function, patients with non-Q wave myocardial infarction has been reported to have an high late cardiac event rate, and long term prognosis is ultimately comparable to that of patients with Q wave myocardial infarction. This is because there is more viable tissue in the perfusion zone of infarct-related artery rendering myocardium more prone to reinfarction. To compare the prognosis and clinical characteristics of Q wave myocardial infarction with those of non-Q wave myocardial infarction, 390 patients with acute myocardial infarction were reviewed and analyzed retrospectively. Patients were classified according to electrographic results into Q wave infarction (n=336) and non-Q wave infarction (n=54). Predischarge coronary angiography, gated blood pool scan, end treadmill exercise test were performed. There was no significant difference in sex, age, angina history, previous myocardial infarction, location of infarction, and severity of coronary disease; Q wave myocardial infarction did have higher peak CK (1733.9±1432.6 vs. 511.1±588.8 IU; P<0.01) and CK-MB fraction level (334.2±371.5 vs. 78.7±128.5; P<0.01). Predischarge treadmill exercise test showed no significant difference in the exercise duration, ST segment change, and chest pain. In gated blood pool scan, ejection fraction of left ventricle did not show significant difference, but proportion of normal left ventricular wall motion was significantly higher in non-Q wave infarction. (21/257 vs. 19/42; P<0.01). The extent of coronary artery disease and degree of coronary artery stenosis was not different between two groups, but high degree obstruction (>90%) of infarct related artery was more frequent in Q wave myocardial infarction (134/187 vs. 19/35; P<0.05). During follow-up, in-hospital mortality was significantly higher in Q wave myocardial infarction (13% vs. 2%, p<0.01). But postdischarge mortality and the rate of reinfarction did not different between two groups. Further prospective studies should be performed to clarify the clinical behaviors and long-term prognosis in patients with non-Q wave myocardial infarction.

휴통과 ST분절상승을 보이는 환자에서 급성심근경색증과 비심근경색증의 심전도 분석

류진호,김용권,소정일,허탁,민용일 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Background: ST segment elevation in patient with chest pain was seen in acute myocardial infarction and in numerous other non-infarction syndromes. The causes of non-infarction syndrome were left ventricular hypertrophy, BER(benign early repolarization), and left bundle branch block in cardiac origin and were hyperkalemia and hyperventilation syndrome in metabolic origin and were others. Furthermore, the differentiation of electrocardiogram between acute myocardial infarction and non-infarction syndrome was very difficult. So, we compared and analysed characteristics of ST segment elevation of acute myocardial infarction and non-infarction syndrome that suggested the clue of early diagnosis of coronary artery disease. Method and Materials: We retrospectively reviewed the electrocardiogram of 961 patients with chest pain who visited the emergency center from January 1999 to December 1999. Acute myocardial infarction was diagnosed by clinical finding, electrocardiogram, cardiac enzyme, echocardiogram, and myocardial spect. Left ventricular hypertrophy, BER, and left bundle branch block in cardiac origin of non-infarction syndrome were diagnosed by electrocardiographic criteria suggested by William J. Brady. Acute myocarditis, acute pericarditis, and hyperventilation syndrome were diagnosed by clinical finding. Results: Among 961 patients with chest pain, 236(24.6%) patients manifested ST segment elevation who were diagnosed acute myocardial infarction in 162(68.6%) patients and non-infarction syndrome in 74(31.4%) patients. The causes of non-infarction syndrome in 74 patients were left ventricular hypertrophy(32:13.6%), BER(28:11.9%), left bundle branch block(11:4.7%), and others(3:1.3%). Three others were acute myocarditis, acute pericarditis, and hyperventilation syndrome. Electrocardiographic characteristics of ST segment elevation of non-infarction syndrome manifested almost same finding compared to William J. Brady' criteria. Conclusion: ST segment elevation in patient with chest pain visited emergency department was seen in acute myocarction(68.6%) and the other non-infarction syndromes(31.4%). Significant number of patients were not associated with acute myocardial infarction. Therefore, we must completely understand characteristics of ST segment elevation in acute myocardial infarction and the other non-infarction syndreomes to diagnose fatal early coronary artery disease and to avoid unnecessary thrombolytic therapy.

A Novel Risk Stratification Model for Patients with Non-ST Elevation Myocardial Infarction in the Korea Acute Myocardial Infarction Registry (KAMIR): Limitation of the TIMI Risk Scoring System

김주한,정명호,안영근,김영조,채성철,성인환,김종진,조명찬,승기배,박승정 전남대학교 의과학연구소 2011 전남의대학술지 Vol.47 No.1

The Thrombolysis in Myocardial Infarction (TIMI) risk score (TRS) has proven value in predicting prognosis in unstable angina/non ST-elevation myocardial infarction (NSTEMI) as well as in ST-elevation myocardial infarction. The TRS system has little implication, however, in the extent of myocardial damage in high-risk patients with NSTEMI. A total of 1621 patients (63.6±12.2 years; 1043 males) with NSTEMI were enrolled in the Korea Acute Myocardial Infarction Registry (KAMIR). We analyzed the risk for major adverse cardiac events (MACE) during a 6-month follow-up period. The TRS system showed good correlation with MACE for patients in the low and intermediate groups but had poor correlation when the high-risk group was included (p=0.128). The MACE rate was 3.8% for TRS 1, 9.4% for TRS 2, 10.7% for TRS 3, and 12.3% for TRS 4 (HR=1.29, p=0.026). Among the biomarkers and clinical risk factors,elevated N-terminal pro-brain natriuretic peptide (NT-proBNP) (HR=2.61, p=0.001)and Killip class above III showed good correlation with MACE (HR=0.302, p<0.001). The Thrombolysis in Myocardial Infarction (TIMI) risk score (TRS) has proven value in predicting prognosis in unstable angina/non ST-elevation myocardial infarction (NSTEMI) as well as in ST-elevation myocardial infarction. The TRS system has little implication, however, in the extent of myocardial damage in high-risk patients with NSTEMI. A total of 1621 patients (63.6±12.2 years; 1043 males) with NSTEMI were enrolled in the Korea Acute Myocardial Infarction Registry (KAMIR). We analyzed the risk for major adverse cardiac events (MACE) during a 6-month follow-up period. The TRS system showed good correlation with MACE for patients in the low and intermediate groups but had poor correlation when the high-risk group was included (p=0.128). The MACE rate was 3.8% for TRS 1, 9.4% for TRS 2, 10.7% for TRS 3, and 12.3% for TRS 4 (HR=1.29, p=0.026). Among the biomarkers and clinical risk factors,elevated N-terminal pro-brain natriuretic peptide (NT-proBNP) (HR=2.61, p=0.001)and Killip class above III showed good correlation with MACE (HR=0.302, p<0.001). Therefore, we revised an alternative clinical scoring system by including these two variables that reflect left ventricular dysfunction: age > 65 years, history of ischemic heart disease, Killip class above III, and elevated pro-BNP levels above the 75th percentile. This modified scoring system, when tested for validity, showed good predictive value for MACE (HR=1.64, p<0.001). Compared with the traditional TRS, the novel alternative scoring system based on age, history of ischemic heart disease, Killip class, and NT-proBNP showed a better predictive value for 6-month MACE in high-risk patients with NSTEMI.

급성 심근경색증에서 심근경색증 발생 직전에 발병한 협심증으로 유도된 허혈전조치 효과에 관한 연구

유규형,이영,김철홍 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.10