| Objective:To determine the diagnostic value of IMA, H-FABP and sGPVI in myocardial damage cases (AMI early stages and PCI complications), by comparing their sensitivity and specificity with the traditional cardiac bio-markers (cTnI, CK-MB and MYO). And then find out the relationship between their serum concentration and severity of coronary lesions and clinical situations.Method:32patients with AMI (STEMI, NSTEMI included) were enrolled as Group AMI. Their serum concentrations of IMA, H-FABP, GPVI, cTNI, CKMB and MYO were checked out in the time windows of0-3h,3-6h and6-12h after AMI onsets. And then the sensitivity and specificity of those bio-markers was found out by drawing ROC curves. The relationship between the concentration of those bio-markers and area of MI, pumping function, severity of coronary lesion and duration of chest pain was also observed.33patients with unstable angina were enrolled as Group UA. The correlation of their Gensini scores and serum concentration of IMA, H-FABP and GPVI was revealed by statistical analysis. The subgroup of UA was formed by those who were willing to take PCI therapy. Their serum concentration of IMA, H-FABP, GPVI, cTnI, CK-MB and MYO were checked before PCI and at the time points of1h,3h,6h,12h and24h after PCI. And then, the influence of PCI therapy on those bio-markers was also found out.Result:1. Significant statistical difference of IMA, H-FABP and sGPVI serum concentration was found between the AMI and UA Group and the Control Group (p<0.05), while no statistical difference among subgroups of AMI and UA Group was found.2. Positive correlations were found between IMA and cTn1(r=0.373, P=0.042), CK-MB (r=0.367, P=0.039)、MYO(r=0.549, P=0.001). Positive correlations were found between H-FABP and cTnI(r=0.476,p=0.006),CK-MB(r=0.391,p=0.027) and MYO(r=0.384, p=0.030).Positive correlations were found between GPVI and cTn1(r=0.380, P=0.032)、 CK-MB (r=0.435, P=0.013)、MYO (r=0.389, P=0.028).3. In the AMI Group, area under curves comparison results were:in0-3h Curves AUCIMA>AUCs V1>AUCH-f.ABr>AUCOTr>ALICCTn[>AUCcK-MH. in3-6h Curves AUC,l-FABi.>AUC,M,>AUCCTni>AUCsC1. vi>AUCck-mb>AUCmy, in6-12h CurvesAUCCTni>AUGlWAUCcK-M>AUC>AUCs01. n>AUC1VM.4. Diagnostic value of AMI:Sensitivity0-3h sGPVI (88.9%)>IMA (87.5%)>H-FABP (86.3%)>MYO (83.3%)>cTnI (67.5%)>CK-MB (38.3%);3-6h H-FABP (100%)=MYO (100%)>IMA(88.5%)>sGPVI(87.5%)>CK-MB(86.5%)>cTnI(86.1%);6-12h H-FABP (100%)=IMA (100%)=cTnI (100%)=CK-MB (100%)>MYO (83.3%)>sGP VI (66.7%). Specificity0-3h sGPVI (85.7%)=H-FABP (85.7%)>IMA (83.3%)>cTnI (81.6%)>CK-MB(72.9%)>MYO(71.4%);3-6hH-FABP(87.5%)>IMA(86.4%)>sGP VI (83.3%) R CK-MB (83.3%)>cTnI (81.2%)> MYO (62.5%);6-12h sGPVI (96.2%)>cTnI (92.3%)>H-FABP (81.8%)>CK-MB (76.9%)、MYO (76.9%)>IMA (46.2%).5. UA Group H-FABP, sGPVI and Gensini score had positive correlation (r=0.855, P=0.000),(r=0.566,P=0.001) with statistically significant, IMA and Gensini score had no correlation (r=0.18, P=0.341) with no statistically significant; Significant statistical difference of H-FABP and sGPVI serum concentration was found between the38-63score Group(136.3±12.92,158.83±15.27),63-132score Group(87.87±17.66,101.28±15.81) and9-28score Group(116.17±12.97,66.31±17.89) of Gensini score (P<0.05); Significant statistical difference of H-FABP and GPVI serum concentration was found between the cTnI Positive Group and cTnl Negative Group (P<0.05).6. Correlations were found between IMA, H-FABP, sGPVI, cTnI, CK-MB concentration and infarction area, heart pump failure, severity of coronary lesions, Chest pain (disease) time.7. PCI preoperative and postoperative:sGPVI concentration was no variation, no statistical difference of IMA, H-FABP, cTnI, CK-MB, MYO serum concentration was found between the postoperative and the preoperative of PCI (P>0.05).Conclusion:1. IMA, H-FABP and GPVI are ideal bio-markers in diagnosing early stage AMI, in both sensitivity and specificity, comparing with traditional biomarkers (cTnl, CK-MB and MYO).2. H-FABP and GPVI are highly positively correlated with the severity of coronary lesions, and may be taken for predicting severity of coronary lesions before PCI.3. Serum concentration of IMA. H-FABP、sGPVI are positively correlated with area of AMI and pumping failure, H-FABP、sGPVI may be as markers of risk stratification in UA.4. PCI can cause myocardial damage, Postoperative IMA, H-FABP, sGP Ⅵ concentration related to the PCI operation of myocardial injury, And as used as cTnI, CK-MB can be used as the index of complications of PCI postoperative... |
PDF Full Text Request