Biomarkers Differentiate Types of Myocardial Infarction or Injury, Study Reveals

A recent study has revealed that 7 of 29 biomarkers have been identified as the most applicable discriminators between subtypes of myocardial infarction (MI) or myocardial injury. Furthermore, the regression models based on these biomarkers allow good discrimination.

Biomarkers Differentiate Types of Myocardial Infarction or Injury, Study Reveals
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What Is Myocardial Infarction?

Myocardial Infarction or MI, also known as heart attack is a health condition that occurs when one or more areas of the heart muscle does not get enough oxygen. This cardiovascular event takes place when the blood flow to the heart muscle is obstructed or blocked.

What Causes Myocardial Infarction?

A Myocardial Infarction or heart attack is usually caused by a buildup of plaque in the arteries or known as atherosclerosis. The plaque is made up of fat deposits, cholesterol, and other substances. When a plaque breaks or ruptures, a blood clot quickly forms. This blood clotting is the actual cause of the heart attack.

When the blood and oxygen supply is cut off, the muscle cells of the heart start to suffer damage and will eventually die. The irreversible damage starts within 30 minutes of arterial blockage. Outcome is the heart muscle gets affected by the lack of oxygen and no longer works normally as expected.

Two Types of Risk Factors for Myocardial Infarction

Inherited or genetic risk factors are risk factors an individual is born with that cannot be changed or altered; however, it can be improved with medical management and lifestyle changes.

Acquired risk factors are usually caused by activities that individual chooses to include in ones life that can be managed through lifestyle changes and clinical care and management.

Research aimed to evaluate the discriminative value of a 29-biomarker panel in an emergency department setting. The patients who presented to the Emergency Department (ED) with suspected myocardial infarction (MI) were enrolled. Final diagnosis in all participants was decided based on the 4th universal definition of myocardial infarction.

Experts have measured a panel of 29 biomarkers and performed a multivariate logistic regression analysis to evaluate the correlations of these biomarkers with the diagnosis of myocardial infarction or myocardial injury. A backward selection was utilized to select biomarkers. This model was verified using bootstrapping.

Overall, there were 748 patients with median age of 64 years were included in the research. Among the patients, 138 had myocardial infarction or MI – where 107 had type 1 MI and 31 patients had type 2 MI, and 221 had myocardial injury.

Multivariate model presented relevant discrimination between the type 1 and type 2 myocardial infarction by 4 biomarkers, namely: apolipoprotein A-11, N-terminal prohormone of brain natriuretic peptide, copeptin, and high-sensitivity cardiac troponin I. The internal validation of the model validated an area under the curve of 0.82.

Also, there were 6 biomarkers were chosen for discrimination between MI and myocardial injury, namely: adiponectin, N-terminal prohormone of brain natriuretic peptide, pulmonary and activation-regulated chemokine, transthyretin, copeptin, and high-sensitivity troponin I. Interval verification revealed an area under the curve of 0.84.

 

Source: J Am Coll Cardiol 2021;78:781-790

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