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.
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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