BACKGROUND:Early reperfusion can effectively treat acute myocardial infarction(AMI) and reduce the mortality signif icantly. This study aimed to compare the role of plasma microRNA-1(miR-1) and cardiac troponin T(cTnT...BACKGROUND:Early reperfusion can effectively treat acute myocardial infarction(AMI) and reduce the mortality signif icantly. This study aimed to compare the role of plasma microRNA-1(miR-1) and cardiac troponin T(cTnT) in early diagnosis of AMI patients.METHODS:From May 2011 to May 2012,plasma samples were collected from 56 AMI patients and 28 non-AMI controls. The expression of plasma miR-1 was measured by quantitative reverse transcription-polymerase chain reaction(qRT-PCR),and the level of plasma cTnT was measured using electrochemiluminescence-based methods on an Elecsys 2010 Immunoassay Analyzer. SPSS 16.0 was used for the statistical analysis of the results. Data were expressed as mean±standard deviation unless otherwise described. The differences about clinical characteristics between the AMI patients and controls were tested using Student's t test or Fisher's exact test. The Mann-Whitney U test was conducted to compare the expression of microRNAs between the AMI patients and controls. MicroRNAs expression between different intervals of the AMI patients was compared using Wilcoxon's signed-rank test. The receiver operating characteristic(ROC) curve was established to discriminate the AMI patients from the controls.RESULTS:In the present study,the expression of plasma miR-1 was signifi cantly increased in the AMI patients compared with the healthy controls(P<0.01). The plasma miR-1 in the AMI patients decreased to the normal level at 14 days(P>0.05). The expression of plasma miR-1 was not related to the clinical characteristics of the study population(P>0.05). ROC curve analyses demonstrated that miR-1 was specifi c and sensitive for the early diagnosis of AMI,but not superior to cTnT.CONCLUSION:Plasma miR-1 could be used in the early diagnosis of AMI,but it is similar to cTnT.展开更多
Background N-terminal pro-B-type natriuretic peptide （NT-proBNP） and high-sensitivity cardiac troponin T （hs-cTnT） are excellent biomarkers for detecting heart failure and subclinical myocardial injury.However,it ...Background N-terminal pro-B-type natriuretic peptide （NT-proBNP） and high-sensitivity cardiac troponin T （hs-cTnT） are excellent biomarkers for detecting heart failure and subclinical myocardial injury.However,it remains unclear whether subclinical myocardial injury is associated with NT-proBNP elevation in a community based population.Methods In a community based study,levels of hs-cTnT and of NT-proBNP were determined in 1 497 participants older than 45 years.The lower detection limit of the hs-cTnT assay used in the present study was 0.003 ng/ml.The association of hs-cTnT levels and NT-proBNP levels was analyzed.Results When the subjects with undetectable （〈0.003 ng/ml）,intermediate （0.003-0.014 ng/ml）,and elevated （≥0.014 ng/ml） levels of hs-cTnT were compared （r=0.175,P 〈0.001）,a strong association between the hs-cTnT levels and NT-proBNP levels was observed （β=-0.206,P 〈0.001; β=-0.118,P 〈0.001,respectively）.In multivariable analyses,older age and hs-cTnT were positively and independently associated with NT-proBNP levels （β=0.341,P 〈0.001; β=0.143,P 〈0.001,respectively）,and male gender and the levels of eGFR were inversely and independently associated with NT-proBNP levels.When the subjects with normal or elevated NT-proBNP were analyzed separately,the hs-cTnT level was not an independent predictor for the NT-proBNP level in the normal NT-proBNP group,whereas the hs-cTnT level was the only independent predictor for NT-proBNP level in the elevated NT-proBNP group （β=0.399,P 〈0.01）.Conclusions In this community based population,NT-proBNP elevation was common.In addition to female gender and older age,subclinical myocardial injury indicated by the hs-cTnT level was another important factor in NT-proBNP elevation.展开更多
Background:Biochemical analyses of N‑terminal pro‑brain natriuretic peptide(NT‑proBNP),cardiac troponin T(cTnT),and creatine kinase MB(CK‑MB)have been reported to be valuable for the auxiliary diagnosis of sudden card...Background:Biochemical analyses of N‑terminal pro‑brain natriuretic peptide(NT‑proBNP),cardiac troponin T(cTnT),and creatine kinase MB(CK‑MB)have been reported to be valuable for the auxiliary diagnosis of sudden cardiac death(SCD)in previous forensic studies.Aims and Objectives:The present study aimed to evaluate the diagnostic efficiency of combined analyses of NT‑proBNP,cTnT and CK‑MB in the pericardial fluid for forensic diagnosis of SCD caused by ischemic heart disease.Materials and Methods:Levels of NT‑proBNP,cTnT,and CK‑MB in the pericardial fluid of 132 medicolegal autopsy cases were obtained through electrochemiluminescence method.Results:NT‑proBNP,cTnT,and CK‑MB levels were significantly elevated in SCD cases(P<0.05).Receiver‑operating characteristics(ROC)analysis showed that NT‑proBNP,cTnT,and CK‑MB have diagnostic value for the diagnosis of SCD:NT‑proBNP,cutoff value of 2236 pg/ml;cTnT,cutoff value of 199.51 ng/ml;CK‑MB:cutoff value of 2742.5 ng/ml,and the combined analyses of these three biomarkers have better diagnostic efficiency than each single biomarker alone.Moreover,the causes of SCD were sub‑divided into acute ischemic heart disease,acute myocardial infarction(AMI),and recurrent myocardial infarction subgroups for further analysis,which revealed that the ratio of cTnT/CK‑MB could be used to distinguish AMI with the cutoff value of 0.1085 estimated by ROC analysis.Conclusion:These observations suggested that the postmortem biochemical analyses of NT‑proBNP,cTnT,and CK‑MB in the pericardial fluid may assist to diagnose SCD in forensic practice,and the combined analyses of multiple biomarkers have better diagnostic efficiency than each single biomarker alone.On the basis of the postmortem biochemical analyses of NT‑proBNP,cTnT and CK‑MB,combining the ratio of cTnT/CK‑MB could be used to distinguish AMI.展开更多
It is often challenging to diagnose acute myocardial infarction(AMI)in patients with elevated high-sensitivity cardiac troponin T(hs-cTnT)before observing a significant rise and/or fall in hs-cTnT.The current study ai...It is often challenging to diagnose acute myocardial infarction(AMI)in patients with elevated high-sensitivity cardiac troponin T(hs-cTnT)before observing a significant rise and/or fall in hs-cTnT.The current study aimed to identify an optimal cut-off to rule in AMI.A total of 76411 patients with elevated hs-cTnT were included.The predictive cut-off values for diagnosing ST-segment elevation myocardial infarction(STEMI)and non-STsegment elevation myocardial infarction(NSTEMI)were assessed using the area under the receiver operating characteristic curve(AUC).Among the patients,50466(66.0%)had non-cardiac diseases,25945(34.0%)had cardiac diseases,and 15502(20.3%)had AMI,including 816(1.1%)with STEMI and 14686(19.2%)with NSTEMI.The median hs-cTnT level was 3788.0 ng/L in STEMI patients and 67.2 ng/L in NSTEMI patients.The optimal cut-off for diagnosing STEMI was 251.9 ng/L,with a sensitivity of 90.7%,specificity of 86.5%,and an AUC of 0.942;the optimal cut-off for diagnosing NSTEMI was 130.5 ng/L,with a sensitivity of 40.9%,specificity of 83.8%,and an AUC of 0.638.Collectively,optimizing the cut-off values for diagnosing STEMI and NSTEMI to 251.9 ng/L and 130.5 ng/L,respectively,demonstrated high accuracy in a large cohort of Chinese patients with elevated hs-cTnT.展开更多
基金supported by grants from the National Natural Science Foundation of China(81071030)the Science and Technology Foundation of Guangdong Province(2011B080701006)
文摘BACKGROUND:Early reperfusion can effectively treat acute myocardial infarction(AMI) and reduce the mortality signif icantly. This study aimed to compare the role of plasma microRNA-1(miR-1) and cardiac troponin T(cTnT) in early diagnosis of AMI patients.METHODS:From May 2011 to May 2012,plasma samples were collected from 56 AMI patients and 28 non-AMI controls. The expression of plasma miR-1 was measured by quantitative reverse transcription-polymerase chain reaction(qRT-PCR),and the level of plasma cTnT was measured using electrochemiluminescence-based methods on an Elecsys 2010 Immunoassay Analyzer. SPSS 16.0 was used for the statistical analysis of the results. Data were expressed as mean±standard deviation unless otherwise described. The differences about clinical characteristics between the AMI patients and controls were tested using Student's t test or Fisher's exact test. The Mann-Whitney U test was conducted to compare the expression of microRNAs between the AMI patients and controls. MicroRNAs expression between different intervals of the AMI patients was compared using Wilcoxon's signed-rank test. The receiver operating characteristic(ROC) curve was established to discriminate the AMI patients from the controls.RESULTS:In the present study,the expression of plasma miR-1 was signifi cantly increased in the AMI patients compared with the healthy controls(P<0.01). The plasma miR-1 in the AMI patients decreased to the normal level at 14 days(P>0.05). The expression of plasma miR-1 was not related to the clinical characteristics of the study population(P>0.05). ROC curve analyses demonstrated that miR-1 was specifi c and sensitive for the early diagnosis of AMI,but not superior to cTnT.CONCLUSION:Plasma miR-1 could be used in the early diagnosis of AMI,but it is similar to cTnT.
基金This study was supported by grants from the National Basic Research Program of China，Nature Science Foundation of China
文摘Background N-terminal pro-B-type natriuretic peptide （NT-proBNP） and high-sensitivity cardiac troponin T （hs-cTnT） are excellent biomarkers for detecting heart failure and subclinical myocardial injury.However,it remains unclear whether subclinical myocardial injury is associated with NT-proBNP elevation in a community based population.Methods In a community based study,levels of hs-cTnT and of NT-proBNP were determined in 1 497 participants older than 45 years.The lower detection limit of the hs-cTnT assay used in the present study was 0.003 ng/ml.The association of hs-cTnT levels and NT-proBNP levels was analyzed.Results When the subjects with undetectable （〈0.003 ng/ml）,intermediate （0.003-0.014 ng/ml）,and elevated （≥0.014 ng/ml） levels of hs-cTnT were compared （r=0.175,P 〈0.001）,a strong association between the hs-cTnT levels and NT-proBNP levels was observed （β=-0.206,P 〈0.001; β=-0.118,P 〈0.001,respectively）.In multivariable analyses,older age and hs-cTnT were positively and independently associated with NT-proBNP levels （β=0.341,P 〈0.001; β=0.143,P 〈0.001,respectively）,and male gender and the levels of eGFR were inversely and independently associated with NT-proBNP levels.When the subjects with normal or elevated NT-proBNP were analyzed separately,the hs-cTnT level was not an independent predictor for the NT-proBNP level in the normal NT-proBNP group,whereas the hs-cTnT level was the only independent predictor for NT-proBNP level in the elevated NT-proBNP group （β=0.399,P 〈0.01）.Conclusions In this community based population,NT-proBNP elevation was common.In addition to female gender and older age,subclinical myocardial injury indicated by the hs-cTnT level was another important factor in NT-proBNP elevation.
基金funded by the National Natural Science Foundation of China(Grant No.82002001).
文摘Background:Biochemical analyses of N‑terminal pro‑brain natriuretic peptide(NT‑proBNP),cardiac troponin T(cTnT),and creatine kinase MB(CK‑MB)have been reported to be valuable for the auxiliary diagnosis of sudden cardiac death(SCD)in previous forensic studies.Aims and Objectives:The present study aimed to evaluate the diagnostic efficiency of combined analyses of NT‑proBNP,cTnT and CK‑MB in the pericardial fluid for forensic diagnosis of SCD caused by ischemic heart disease.Materials and Methods:Levels of NT‑proBNP,cTnT,and CK‑MB in the pericardial fluid of 132 medicolegal autopsy cases were obtained through electrochemiluminescence method.Results:NT‑proBNP,cTnT,and CK‑MB levels were significantly elevated in SCD cases(P<0.05).Receiver‑operating characteristics(ROC)analysis showed that NT‑proBNP,cTnT,and CK‑MB have diagnostic value for the diagnosis of SCD:NT‑proBNP,cutoff value of 2236 pg/ml;cTnT,cutoff value of 199.51 ng/ml;CK‑MB:cutoff value of 2742.5 ng/ml,and the combined analyses of these three biomarkers have better diagnostic efficiency than each single biomarker alone.Moreover,the causes of SCD were sub‑divided into acute ischemic heart disease,acute myocardial infarction(AMI),and recurrent myocardial infarction subgroups for further analysis,which revealed that the ratio of cTnT/CK‑MB could be used to distinguish AMI with the cutoff value of 0.1085 estimated by ROC analysis.Conclusion:These observations suggested that the postmortem biochemical analyses of NT‑proBNP,cTnT,and CK‑MB in the pericardial fluid may assist to diagnose SCD in forensic practice,and the combined analyses of multiple biomarkers have better diagnostic efficiency than each single biomarker alone.On the basis of the postmortem biochemical analyses of NT‑proBNP,cTnT and CK‑MB,combining the ratio of cTnT/CK‑MB could be used to distinguish AMI.
基金funded in part by the National Key R&D Program of China(Grant No.2022YFC2402404)the National Natural Science Foundation of China(Grant Nos.82170351 and 82370342)+1 种基金the Natural Science Foundation of Jiangsu Province(Grant Nos.BK20222002 and BK20231145)the Clinical Capacity Enhancement Project of Jiangsu Province Hospital(the First Affiliated Hospital of Nanjing Medical University)(Grant No.J SPH-MA-2022-3)。
文摘It is often challenging to diagnose acute myocardial infarction(AMI)in patients with elevated high-sensitivity cardiac troponin T(hs-cTnT)before observing a significant rise and/or fall in hs-cTnT.The current study aimed to identify an optimal cut-off to rule in AMI.A total of 76411 patients with elevated hs-cTnT were included.The predictive cut-off values for diagnosing ST-segment elevation myocardial infarction(STEMI)and non-STsegment elevation myocardial infarction(NSTEMI)were assessed using the area under the receiver operating characteristic curve(AUC).Among the patients,50466(66.0%)had non-cardiac diseases,25945(34.0%)had cardiac diseases,and 15502(20.3%)had AMI,including 816(1.1%)with STEMI and 14686(19.2%)with NSTEMI.The median hs-cTnT level was 3788.0 ng/L in STEMI patients and 67.2 ng/L in NSTEMI patients.The optimal cut-off for diagnosing STEMI was 251.9 ng/L,with a sensitivity of 90.7%,specificity of 86.5%,and an AUC of 0.942;the optimal cut-off for diagnosing NSTEMI was 130.5 ng/L,with a sensitivity of 40.9%,specificity of 83.8%,and an AUC of 0.638.Collectively,optimizing the cut-off values for diagnosing STEMI and NSTEMI to 251.9 ng/L and 130.5 ng/L,respectively,demonstrated high accuracy in a large cohort of Chinese patients with elevated hs-cTnT.
