engleski

Evaluation of new biochemical markers for early detection of myocardial injury in critically ill patients

This study was carried out to assess the utility of serum troponin T (cTnT) and I (cTnI), myoglobin, total creatine kinase (CK), cretaine kinase MB isoenzyme (CK-MB), creatine kinase MB activity (CK-MBact) and mass (CK-MBmass) concentration, AST, ALT and LDH levels in the early detection of myocardial injury in critically ill patients. We compared the diagnostic performances of new biological markers in the two groups of patients. Group A included 38 consecutive patients with chest pain and suspected angina pectoris, chronic obstructive pulmonary disease, and pulmonary edema at admision to the Intensive Care Unit (ICU). Group B included 27 control patients with sepsis, thromboembolism, acute bleeding from peptic ulcer, severe acute pancreatitis, diabetic ketoacidosis, and acute poisoning with various medications. All analyses were done at the admission to the ICU. Clinical data were obtained through a strustured history and physical examination after ECG recording. No patient had evidence of acute myocardial infarction. There were no significant differences between the groups in the level of these biochemical markers (p is more than 0.05). The analysis of of the correlation matrix of the most important biological markers for cardiac injury among a total of 67 critically ill patients gave only weak positive correlation between total CK and CK MB activity (r=0.59). i.e. CK MB activity and CK MB mass (r=0.46). Significant correlation was found only between ALT and AST (r=0.94). With receiver-operator characteristic curve analysis we found that the best diagnostic performance was achieved by the use of cTnT and cTnI. These markers were the most specific serum markers for the early detection of cardiac injury in critically ill patients. These biological parameters are highly sensitive and specific markers for myocardial injury in critically ill patients admitted to the ICU.

New biochemical markers; TnT; TnI; myocardial injury; critically ill patients

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