2 edition of Biological variation of markers of cardiac damage found in the catalog.
Biological variation of markers of cardiac damage
Scott Mackenzie Ross
Written in English
Thesis (M.Sc.) - University of Surrey, 1996.
|Statement||Scott Mackenzie Ross.|
|Contributions||University of Surrey. School of Biological Sciences.|
The cutoff concentrations for most cardiac markers, such as CK-MB and myoglobin, are set such that they differentiate between non-AMI cardiac diseases such as unstable angina and cutoffs are generally higher than the upper limit of normal and are necessary because some healthy subjects can have high concentrations of these markers due to normal skeletal muscle turnover. The evaluation of myocardial damage in relation to cardiac operation from a clinical and a research perspective is of great importance, particularly for the evaluation of different cardioprotective strategies. Although measurements of serum biochemical markers have often been used, their value has been limited by their lack of sensitivity and specificity in the presence of skeletal muscle damage.
The danger created by cardiac ischemia is somewhat paradoxical in that a return of blood to the tissue, termed reperfusion, can result in further damage. The serum markers of myocardial injury are. This variation includes analytical variability, biological variability, and potentially ongoing pathology. With less-sensitive cTn assays, significant troponin elevations have to occur before a positive result is obtained and biological variation is overshadowed by the changes occurring from myocardial damage.
An elevation in the blood levels of the cardiac isoform of troponin T is a specific marker for myocardial damage 17 and is more sensitive than the conventionally used levels of creatine kinase or. Sources of variation of inflammatory markers have been studied to varying degrees. 62–64 There seems to be little seasonal or diurnal variation with hs-CRP. 65 Several factors have been identified as being associated with increased or decreased levels of hs-CRP ; this list is likely incomplete.
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Introduction. Cardiac biomarkers are central to the new definition of acute myocardial infarction (AMI) as defined by the American College of Cardiology and the European society of Cardiology.
1 A biomarker is “a characteristic that is objectively measured and quantified as an indicator of normal biological processes, pathogenic processes or pharmacological response to a therapeutic Cited by: 1. In summary, cardiac markers play a crucial rule in the approach to the undifferentiated chest pain patient.
The most important cardiac marker is the cardiac troponin, and it should be used to help risk stratify the patient for ACS.
However, even a negative troponin does not preclude the presence of obstructive CAD and day MACEs. Cardiac markers are biomarkers measured to evaluate heart function.
They can be useful in the early prediction or diagnosis of disease. Although they are often discussed in the context of myocardial infarction, other conditions can lead to an elevation in cardiac marker level.
Most of the early markers identified were enzymes, and as a result, the term "cardiac enzymes" is sometimes : The biological variation for cardiac troponins has not been established.
As such the recommendation for maximum allowable imprecision of troponin assays is arbitrarily set at 10% CV at the decision limit for AMI. From this point of view, not all troponin assays on automated platforms perform equally well in routine clinical setti 30 Cited by: A summary of the common cardiac markers, outlining the degree of cardiac specificity, speed of conducting the assay and relative cost of each, is provided in Table 1.
Troponin T It is a highly sensitive marker and can be useful when there are no apparent ECG changes suggestive of cardiac. Biochemical cardiac markers are the signals from the injured myocardium and are released in case of damage at the cardiac muscle.
The most common causes of injury are acute coronary syndromes (MI, non Q-wave MI, unstable angina pectoris) and other conditions affecting Biological variation of markers of cardiac damage book muscle including trauma, cardiac surgery, myocarditis etc.
called cardiac markers, myocardial injury mark-ers or biochemical markers of myocardial injury. This article will present a brief overview of the most significant cardiac markers and it will dis-cuss the use of those markers for the diagnosis of cardiac diseases but it will not talk in details about the non-laboratory diagnostic modalities.
INTRODUCTION. Cardiac troponin I (cTnI) and cTnT are the biomarkers of choice for the diagnosis of myocardial damage, because they are the most sensitive and cardiac-specific biomarkers currently available[1,2].Recommendations for the use of cTn measurement in acute cardiac care and practical clinical considerations in the interpretation of cTn elevations have been published recently.
Wilson M, O’Hanlon R, Prasad S, Oxborough D, Godfrey R, Alpendurada F, et al. Biological markers of cardiac damage are not related to measures of cardiac systolic and diastolic function using cardiovascular magnetic resonance and echocardiography after an acute bout of prolonged endurance exercise.
Br J Sports Med. ; –4. Cardiac troponins (cTn) The evolving story of cTn to diagnose acute myocardial damage is as fascinating as it is beguiling. The troponin era began with the development of a double antibody, two-step enzyme immunoassay for TnT in .Evolution of these developments now has cTn as the central component of the definition of an AMI .The superior diagnostic power of cTn is demonstrated.
Cardiac markers are central to the new definition of acute myocardial infarction put forward by the American College of Cardiology and the European Society of Cardiology. Martina Vasatova, Tomas Buchler, in Advances in Clinical Chemistry, Abstract.
Biochemical markers of myocardial injury play an important role in the diagnosis of cardiovascular diseases. Measurement of cardiac biomarkers is one of the most important diagnostic tests in acute myocardial infarction (AMI), heart failure, and other cardiovascular disorders.
variation (CV A), within-subject biological variation (CV I), between-subject biological variation (CV G), index of individuality (II) and reference change values were calculated for all cardiac biomarkers.
Results CV I was highest for BNP (%, 95% CI to ) and lowest for hs-TnI (%, 95% CI to ). CV G exceeded the CV I. The first account of the use of a biochemical marker in the study of myocardial injury was published by La Due and colleagues in the journal Science in 85 They measured serum glutamate oxaloacetic transaminase activity from a few hours to up to 15 days in a group of patients immediately after an acute myocardial infarction (AMI).
They reported that enzyme activity increased above the. Myoglobin, although not a very specific marker, but it is the first marker released after the damage occurred to myocardial muscle cells. B-type natriuretic peptide (BNP), cardiac troponin I (cTnI), and CRP are released after myoglobin, but they are specific markers for coronary events.
The biological variation of IMA has been a population of 17 apparently healthy individuals (7 male, 10 female, aged years), the within subject coefficient of variation was % and the between subject coefficient of variation was %, calculated from weekly blood draws performed at the same time by the same phlebotomist for.
Standardization of Markers of Cardiac Damage Laboratory Medicine Practice Guidelines: analytical issues for biochemical markers of acute coronary syndromes. Clin Chem, 53 (4), injury/ischemia and markers of coronary plaque instability and disruption.
Finally, with the characterization of the cardiac natriuretic peptides, Laboratory Medicine is also assuming part in the assessment of cardiac function. Key words:biological markers, diagnosis, myocardial infarction, troponin.
Biological variation may differ in chronic disease states compared to health (18); there are few data on variability of biomarkers in CKD patients. An understanding of biological variation of markers is essential to interpretation of changes in response to disease events.
Biological variation ofcardiac markers: analytical and clinical considerations S M Ross and C G Fraser From the Directorate ofBiochemical Medicine, Ninewells Hospital and Medical School. Dundee DDI 9SY, UK SUMMARY. The analytical, within-subject and between-subject components of variation were estimated for serum total creatine kinase (TCK.
C-reactive protein. Initially considered a marker of inflammation, CRP is now considered a BM of several cardiac conditions. 15 CRP concentrations increase on the basis of genetics and non-Caucasian ethnicity.
16 However, daily serum levels are relatively steady with minimal diurnal variation. 17, 18 The development of robust assays such as high-sensitivity CRP (hs-CRP) has allowed for.The consensus among cardiology and emergency medicine (EM) physicians is that cardiac markers should be available within one hour of specimen collection, and optimally within 30 minutes or less (see Recommendat Table 2).
To meet this stringent requirement, several measures are necessary. The preface of “Biological variation: from principles to practice” begins with the statement, “There is significant renewed interest in strategies for setting quality specifications as well as for setting population-based and subject-specific reference values.” In the field where I specialize, i.e., cardiac markers, this is certainly true.
Quality specifications for cardiac troponin.