engleski

THE ROLE OF CARDIAC MARKERS IN ACUTE CORONARY SYNDROME

Background. The assessment of patients with acute chest pain and nondiagnostic electrocardiograms remain a continuing clinical problem. A number of patients presenting to the emergency department with chest pain are released after initial evaluation. Some of them returned with an AMI within 48 hours. Because of that, it is necessary to achieve higher diagnostic sensitivity and specificity within a few hours from the onset of chest pain. BNP and NT-proBNP are serum biomarkers that are released from the atria and ventricles of the heart in response to volume overload. They have been extensively studied in recent years, but the exact usefulness of them is yet to be determined. The aim was to assess BNP and NT- proBNP utility in acute coronary syndrome. Methods. Samples from 34 patients aged 43-80 coming to emergency department with chest pain were investigated. Biochemical markers measured in serum were: NT-proBNP (ROCHE, MODULAR E170), BNP (ABBOTT, AXSYM), TnI, myoglobin and CKMB- mass (DADE BEHRING, DIMENSION RxL). Clinical history, electrocardiography and echocardiography was also done. Results. All patients had confirmed diagnosis of AMI or unstable angina. There were no correlation between cardiac markers, except between CKMB- mass and myoglobin (r = 0.605 ; p<0.001). These could be explained by different releasing dynamic of markers and also by different period from the onset of pain and presenting to hospital. Diagnostic sensitivity was: NT-proBNP = 0.88 ; BNP = 0.38 ; CKMB-mass = 0.71 ; myoglobin = 0.53 ; TnI = 0.62. Conclusions. As a sensitive marker NT-proBNP seems to be helpful in emergency department.

acute coronary syndrome ; cardiac markers ; BNP

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