Abstract | BACKGROUND: The estimation of infarct size by biochemical myocardial necrosis markers is used in current clinical practice, rather than the more expensive and not always available imaging techniques. However, for this purpose, the peak value of serum biomarkers can overestimate the necrotic area, especially after reperfusion. OBJECTIVE: METHODS: Sixty patients with a first acute myocardial infarction (55 STEMI and five NSTEMI) and normal function were enrolled. Among STEMI patients, 52 underwent reperfusion. cTnI and creatine kinase-myocardial band were assessed at admission and at 6, 12, 24, 48, 72 and 96 h (+/-1 h) from symptom onset. DE-CMR (Siemens Avanto 1.5T) was performed before discharge (4 +/- 2 days). Infarct size was determined by manual delineation of the areas of delayed enhancement. Infarct volume was calculated as the sum of each slice of infarct size area multiplied by thickness. RESULTS: Peak cTnI was 55 +/- 59 ng/ml (range 0.3-347). The area under the curve of cTnI was 1916 +/- 2224 ng/ml. The volume of infarcted myocardium assessed by DE-CMR was 27 +/- 25 ml (range 0-134). The single value of cTnI at 72 h after symptom onset provided the most accurate estimation of predischarge infarct volume (r = 0.84, 95% confidence interval 0.75-0.91) and was significantly more accurate than creatine kinase-myocardial band value assessed at any time during the same period (r = 0.42, 95% confidence interval 0.19-0.62; P < 0.002). CONCLUSION:
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Authors | Antonio Di Chiara, Erica Dall'Armellina, Luigi P Badano, Stefano Meduri, Norma Pezzutto, Paolo Maria Fioretti |
Journal | Journal of cardiovascular medicine (Hagerstown, Md.)
(J Cardiovasc Med (Hagerstown))
Vol. 11
Issue 8
Pg. 587-92
(Aug 2010)
ISSN: 1558-2035 [Electronic] United States |
PMID | 20588136
(Publication Type: Comparative Study, Journal Article)
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Chemical References |
- Biomarkers
- Contrast Media
- Troponin I
- Creatine Kinase, MB Form
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Topics |
- Aged
- Angioplasty, Balloon, Coronary
- Biomarkers
(blood)
- Contrast Media
- Creatine Kinase, MB Form
(blood)
- Female
- Humans
- Italy
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Myocardial Infarction
(blood, diagnosis, enzymology, pathology, therapy)
- Myocardium
(enzymology, pathology)
- Necrosis
- Predictive Value of Tests
- Thrombolytic Therapy
- Time Factors
- Treatment Outcome
- Troponin I
(blood)
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