cardiology biomaker

1. IN ACUTE
MYOCARDI
AL
INFRACTIO
N

2. 1. MYOCARDIAL INFRACTION IS THE
MEDICAL TERM FOR AN EVENT
COMMONLY KNOWN AS HEART
ATTACK.
2. IT OCCURS WHEN BLOOD STOPS
FLOWING PROPERLY TO A PART OF
THE HEART AND THE HEART MUSCLE
IS INJURED DUE TO INSUFFICIENT
OXYGEN.
3. THERE IS BLOCKAGE IN CORONARY
ARTERIES DUE TO UNSTABLE BUILDUP
OF WBC , CHOLESTEROL AND FAT
Diagram of a myocardial infarction
(2) of the tip of the anterior wall of
the heart (an apical infarct) after
occlusion (1) of a branch of the left
coronary artery (LCA).

3.  1. SUDDEN CHEST PAIN
 2. SHORTNESS OF THE BREATH
 3.SWEATING
 4.NAUSEA
 5. VOMITING
 6. ABNORMAL HEART BEATS
 ANXIETY

5.  A PATIENT IS DIAGNOSED WITH MI IF 2
OR 3 OF THE FOLLOWING CRITERIA ARE
SATISFIED
 1. CHEST PAIN LASTING FOR MORE THAN
20 MINUTES
 2 . CHANGES IN SERIAL ECG TRACING
 3. RISE AND FALL OF SERUM CARDIAC
BIOMARKERS

6.  ischemia to myocardial muscles (with low O2 supply)
 anaerobic glycolysis
 increased accumulation of Lactate
 decrease in pH
 activate lysosomal enzymes
 disintegration of myocardial proteins
 cell death & necrosis
CLINICALmanifestations BIOMARKERS ECG CHANGES

7.  A BIOMARKER is
measurable and quantifiable
biological parameter which
serve as indices for health-and
physiology-related
assessments such as disease
risk, psychiatric disorder,
environmental exposure and
its effects, disease diagnosis,
metabolic processes,
substance abuse, pregnancy,
cell line development,
epidemiologic studies, etc

8.  1954 SGOT (AST)
 1955 LDH
 1960 CPK
 1972 CPK isoforms by Electrophoresis
 1975 CK - MB by immunoinhibition
 1975 Myoglobin
 1985 CK - MB Mass immunoassay
 1989 Troponin T
 1992 Troponin I
 Recently discover biomarker is Gb3 potentioly
related to survival of heart

9.  Diagnostically has;
1. High sensitivity (detection of MI positive cases)
2. High specificity (absent in non-myocardial injury) Rapidly release at a
detectible concentration
3. Correlate efficiently with the extent of MI
4. Persists in blood for valuable time (long 1/2 life)
 Analytically has;
1. High sensitivity (low detectable limit)
2. High specificity (less interferences)
3. Easy, inexpensive and rapidly tested ( short TAT)

10. Cardiac Enzyme Markers;
CK and LD
Cardiac protein Markers;
Troponins, FA Binding Protein and
Myoglobin
Prognostic & Risk Stratification markers;
hs CRP , MPO & homocysteine

11.  1.MUSELE CREATINE KINASE CATALAYSES THE
TRANSFER OF PHOSPHATE BETWEEN AND ATP
 2. CK IN SERUM IS UNSTABLE AS A RESULT OF
OXYDATION OF SULFHYDRYL GROUP
 3.IT IS RELATAVILY SPECIFIC WHEN SKELETAL
MUSCLE DAMAGE IS NOT PRESENT
 4. THE CKMB ISOFORM OF CK IS EXPRESSED IN
HEART MUSCLE
 5 SINCE IT HAS SHORT DURATION IT CAN NOT BE
USED FOR LATE DIAGNOSIS OF ACUTE MI BUT
CAN BE USED TO SUGGEST INFRACT EXTENTION
IF LEVEL RISE AGAIN