engleski

The Assessment of Minor Myocardial Damage in the Critically Ill Patients

The goal of this study was to determine the existence of minor myocardial damage (MMD) on the basis of new biochemical markers analysis ; cardiac troponin T (c-TnT), troponin I (c-TnI), CK-MB activity (CK-MBact), CK-MB mass (CK-MBmass), and conventional marker like total creatine kinase (CK), and 12 leads ECG monitoring in two groups of critically ill patients admitted to the intensive care unit (ICU). The investigated group (n=52) consisted of the patients with heart failure, unexplicable hypotension, chronic obstructive pulmonary disease in the acutisation, acute severe pancreatitis, sepsis, pulmonary embolism, diabetes with complications, liver cirrhosis and tachycardia >120/min who suffered chest discomfort without clear ECG signs of AMI. The control group consisted of patients (n=73) with acute gastrointestinal bleeding, poisoning, and miscellaneous conditions. Mean concentrations of c-TnT, c-TnI, total CK, CK-MBact, CK-MBmass were higher in the investigated group in relation to the control group, but with no statistical significance. The best positive correlation exists between CK-MBact and CK-MBmass (r=0.63). The highest specificity shows CK-MBact (92.3 %). Lower specificity show c-TnI (88.5%) and c-TnT (75.6 %). For all the analysed markers, the sensitivity was low. In respect to specificity CK-MBact represents the best biological marker for the assessment of MMD, following by c-TnI and c-TnT. c-TnI and c-TnT show moderate discrimination and accuracy in the assessment of MMD under the ROC curves surface (0.84 and 0.76 respectively), while the accuracy is very low for all other analyzed markers.

minor myocardial damage; critically ill; troponin

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