Abstract | Uvod Akutni infarkt miokarda (AIM) kao najopasnija manifestacija ishemijske bolesti srca najčešće nastaje rupturom aterosklerotskog plaka na stijenci koronarne arterije. Kopeptin je predložen kao prognostički marker za različite bolesti i poremećaje u kojima bi mogao pomoći u ranom otkrivanju i dijagnostičkoj točnosti. Cilj istraživanja Cilj je ovog istraživanja ispitati dijagnostičku učinkovitost određivanja kopeptina u akutnom infarktu miokarda (AIM). Nacrt studije Nacrt studije čini presječno istraživanje (prospektivno istraživanje parova). Ispitanici i metode Ispitanici su (N = 73) bili podijeljeni u dvije skupine: ispitanici s NSTEMI AIM-om (N = 37) te kontrolni ispitanici (N = 36). Ispitanicima je uzeta anamneza te im je napravljen EKG. Koncentracije TnI-a izmjerene su kemiluminiscentnom imunoanalizom temeljenoj na LOCI tehnologiji na Dimension ExL s LM analizatorom (Siemens Healthcare Diagnostics Inc., Newark, USA). Mjerenje koncentracije CK i CKMB-a provedeno je na Beckman Coulter AU 680 analizatoru (Beckman Coulter Inc., Brea, USA) i to CK enzimatskom metodom (Beckman Coulter), a CKMB enzimatskom imunoinhibicijskom metodom (Beckman Coulter). Koncentracije kopeptina izmjerene su heterogenom enzimimunokemijskom metodom (ELISA) na analizatoru Labsystems IEMS Reader MF (LabsystemsOy, Helsinki, Finland). Rezultati su obrađeni statističkim programom (MedCalc Software, Mariakerke, Belgium). Rezultati Vrijednosti medijana za kopeptin i CK nisu se razlikovale među skupinama. Vrijednosti medijana CKMB-a i TnI-a bile su više kod pacijenata s NSTEMI AIM-om u odnosu na kontrolne ispitanike; CKMB: 17ng/L vs. 14ng/L (P = 0,025); TnI: 0,037ng/L vs. 0,009ng/L (P = <0,001). CKMB je u odnosu na kopeptin pokazao bolju specifičnost (88,9% vs. 25,0%), a kopeptin u odnosu na CKMB bolju osjetljivost (96,6% vs. 37,9%) u dijagnostici NSTEMI AIM-a. Zaključak Vrijednosti koncentracija kopeptina nisu serazlikovale među skupinamatako da se kopeptin nije pokazao zadovoljavajućim biljegom za isključivanje NSTEMI AIM-a rano od nastupa simptoma. |
Abstract (english) | Introduction Acute myocardial infarction is the most dangerous manifestation of ischemic heart disease and is usually caused by atherosclerotic plaque disruption in the coronary artery wall. Copeptin has been proposed as a prognostic marker in different illnesses and disorders where it may help in early detection and diagnostic accuracy. Objective The aim of this study is to examine the diagnostic efficacy of identifying copeptin in acute myocardial infarction (AMI). Study outline The study is organized as a cross-sectional research (prospective pairedresearch). Participants and Methods Participants (N=73) were divided into two groups: patients with NSTEMI AMI (N=37) and controls (N=36). Medical history and ECG were taken for all participants. TroponinI (TnI) concentrations were measured by chemiluminescence immunoassay based on LOCI technology on Dimension ExL with LM analyzer (Siemens Healthcare Diagnostics Inc., Newark, USA). CK and CKMB concentration were measured on the Beckman Coulter AU 680 analyzer (Beckman Coulter Inc., Brea, USA). CK was measured by enzymatic assay (Beckman Coulter) and CKMB by enzymatic immunoinhibitoryassay (Beckman Coulter). Copeptin concentrations were measured by enzyme-linked immunosorbentassay(ELISA) on the Labsystems IEMS Reader MF (LabsystemsOy, Helsinki, Finland) analyzer. The results were processed by a statistical program (MedCalc Software, Mariakerke, Belgium). Results The median values for the copeptin and CK did not differ between the groups. The median values of CKMB and troponin I were higher in patients with NSTEMI AMI than in control subjects; CK MB: 17 ng/L vs. 14 ng/L (P=0.025); TnI: 0.037 ng/L vs. 0.009 ng/L (P=0.001). CKMB showed a higher specificity compared to copeptin(88.9% versus 25.0%), while copeptinshowedhigher sensitivity compared to CK MB (96.6% versus 37.9%) in NSTEMI AMI diagnosis. Conclusion Copeptinconcentrations did not differ between the two observed groups. Thus, it can be concluded that copeptin did not show satisfactory score for NSTEMI AMI exclusionin early onset of the symptoms. |