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.

쥐의 초점성 뇌경색에서 허혈성 뇌손상에 대한 D-CPPene의 항허혈 효과의 측정에 있어 뇌부종의 영향

강석구,박춘근,강준기 대한신경외과학회 1999 Journal of Korean neurosurgical society Vol.28 No.8

급성심근경색에서 Troponin T 와 경색의 크기와의 상관관계

서창희(Chang Hee Suh),김한수(Han Soo Kim),강한걸(Han Geol Kang),신준한(Joon Han Shin),탁승제(Seung Jae Tahk),이승호(Seong Ho Lee),최병일(Byung Il William Choi) 대한내과학회 1997 대한내과학회지 Vol.52 No.1

N/A Objectives: The estimation of infarct size has been important in evaluation of prognosis of the patients who had acute myocardial infarction. The infarct size estimated by the thallium-201 SPECT has been known to correlate with the prognosis of patient. The enzymatic estimation by the total release of creatine kinase isoenzyme MB(CK-MB) has been widely used in estimating infarct size clinically, but inconvienent and not cardiospecific. Recently, serum troponin T, cardiospecific myofibrillar protein, has been used in the diagnosis of acute myocardial infarction, and used in the estimation of reperfusion following myocardial infarction. To assess the role of the late troponin T peak concentration on the estimation of infarct size, this prospective study was carried out. Methods: The patients with acute myocardial infarction who were admitted, within 48hours after the onset of chest pain, to Ajou University Hospital between April 1995 and August 1995 were evaluated. All patients were divided into anterior and inferior infarct and checked serum troponin T and CK-MB serially, and underwent stress Thallium-201 SPECT 1 week after infarction, In each group, we assessed the correlation of the late toponin T peak concentration, the total release of CK-MB, and the infarct size estimated by thallium-201 single photon emission computed tomography(SPECT). Results: 1) The eligible subjects consisted of 22 patients (17 men and 5 women), and age ranged from 29 to 77 years(mean 57.8±12.5 years). 2) The mean arrival time to the hospital after the onset of chest pain was 15.5±13.2 hours. The 19 patients had at least one risk factor for coronaryartery disease. 3) The late troponin T peak concentration and the total release of CK-MB in patients with anterior infarction were not different from those with inferior infarction. The infarct size estimated by the thallium-201 SPECT in patients with anterior infarction was larger than patients with inferior infarction The left ventricular ejection fraction in anterio infarction was lower than inferior infarction. 4) The late troponin T peak concentration ha: positive correlation with the infarct size estimated by the thallium-201 SPECT in the total patients, and both patients with anterior infarction and inferio infarction. 5) The total release of CK-MB correlated with the infarct size estimated by the thallium-20 SPECT in the total patients, and the patients of inferior infarction. Conclusion: The late troponin T peak concentration was more accurate than the total release o CK-MB in the estimation of infarct size. Therefore, when the patient arrived to the hospital less than 48hr after the onset of chest pain, the late troponin T peak concentration is useful in the decision and evaluation of therapeutic intervention and in the prediction of prognosis.

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.

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.

광화학적 뇌경색 백서 모델에서 황련의 항염증 및 운동기능 회복에 미치는 효과

이수경 ( Su Kyung Lee ),이인 ( In Lee ),신선호 ( Sun Ho Shin ),김은영 ( Eun Young Kim ),신병철 ( Byung Cheul Shin ) 대한본초학회 2009 大韓本草學會誌 Vol.24 No.1

Objectives: Coptidis Rhizoma (Coptis japonica MAKINO; CR) is a well known crude drug as antimicrobial, antibacterial, anti-inflammatory, antioxidant activity. However, there is no study of the effect of CR on brain infarction and it`s mechanism. The aim of this study was to investigate the effects on ischemic stroke induced by photothrombotic infarction by evaluating the functional & neuronal recovery after brain infarction. Materials & Methods: Male Sprague-Dawley rats (250-300 g) were induced photothrombotic brain infarction on sensorimotor cortex, and brain infarction volume by image J software (NIH, USA) after Nissl stain, also single pellet reaching task as a functional motor recovery were observed. After orally pretreated by CR (500 mg/kg) or normal saline as a sham control before 7 days from the time of photothrombotic infarction, rats were sacrificed. After then we analysed anti-inflammatory cytokines (TNF-α, IL-6, IL-1β), by RT-PCR and ELISA method, and immunohistochemistry (GFAP, connexin-43) as a marker of neural plasticity. Results: CR (100, 250, 500 mg/kg) decreased the infarction volume dose-dependently, however the effect of 500mg/kg of CR (CR 500) showed the best (P=0.051). Also, CR 500 decreased the infarction volume time-dependently, the most effective time was 3-7 days after stroke. Photothrombosis increased inflammatory cytokines after infarction, CR 500 suppressed significantly mRNA expression of IL-1β, IL-6 and TNF-α. In serum, CR 500 decreased the amount of IL-1β, 12h, 24h and 48h respectively (p<0.05), also decreased that of IL-6 and TNF-α, 12h respectively (p<0.05) after infarction. The more astrocytes were observed and neural plasticity was facilitated in the rat brain of CR 500 than that of sham control in immunohistochemistry. Conclusions: This results suggest that CR decrease infarction volume and improve functional motor recovery in acute stage in photothrombotic ischemic infarction model in the mechanism of anti-inflammation and promoting neural plasticity.

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.

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.

심근경색 부위에 따른 좌.우 심실기능의 차이 : 게이트 심장혈액풀스캔에 의한 분석 An ECG-Gated Blood Pool Study

천경아,이재태,안병철,이상우,조용근,채성철,전재은,박의현,이규보 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.6