Yıl: 2022 Cilt: 20 Sayı: 3 Sayfa Aralığı: 115 - 123 Metin Dili: İngilizce DOI: 10.56615/tkbd.2022.14 İndeks Tarihi: 28-02-2023

The Prediction of the Prognosis After Acute Myocardial Infarction by MultiBiomarker Approach

Öz:
Aim: Early risk classification after acute myocardial infarction is very important for the prediction of complications. In this study, it was aimed to find the most sensitive panel in the prediction of prognosis after acute myocardial infarction by multi-biomarker approach. Materials and Methods: 120 patients who were diagnosed with the acute coronary syndrome were included. Patients’ heart failure and death outcomes that accrued after acute myocardial infarction were followed up. Heart failure and all causes of death were noted and the predictive values of the markers and new panels for these poor outcomes were examined. Results: In the prediction of heart failure after acute myocardial infarction, glucose’s area under the curve (AUC), was 0.714, hs-cTnT’s 0.779, and NT-proBNP’s 0.842 (p=0.035, p=0.002, p<0.001 respectively). In the panel created using hs-cTNT, NT-proBNP, copeptin, myoglobin, and glucose, the AUC reached 0.917. In mortality prediction, copeptin’s AUC was 0.696, myoglobin’s 0.713, and glucose’s 0.800 (p=0.045, p=0.003, p=<0.001 respectively). In the panel created using hs-cTNT, copeptin, myoglobin, and glucose, the AUC reached 0.865 in prediction of mortality. Conclusion: Biomarker combinations may increase the predictive values of biomarkers. It is demonstrated that the powerful prognostic panels were created using serum hs-cTNT, NT-proBNP, copeptin, myoglobin, and glucose levels in this study.
Anahtar Kelime: Troponin T Natriuretic Peptide Myoglobin Myocardial Infarction Prognosis

Çoklu Biyobelirteç Yaklaşımı ile Miyokard Enfarktüsü Sonrası Prognozun Öngörülmesi

Öz:
Amaç: Akut miyokard enfarktüsü sonras ı erken risk s ınıflandırması komplikasyonların öngörülmesinde çok önemlidir. Bu çalışmada, multi-biomarker yaklaşımı ile akut miyokard enfarktüsü sonrası prognozun öngörülmesinde en duyarlı paneli bulmak amaçlandı. Gereç ve Yöntem: Akut koroner sendrom tanısı almış 120 hasta dahil edildi. Akut myokard infaktüsü sonrası hastalarda geli şen kalp yetmezliği ve ölüm sonlan ımları takip edildi. Bu kötü prognozların öngörülmesinde belirteçlerin ve yeni panellerin prediktif değerleri incelendi. Bulgular: Akut myokard infarktüsü sonrası gelişen kalp yetmezli ği öngörüsünde glukozun ROC e ğrisi altında kalan alan ı 0.714, hs-cTnT'nin 0.779 ve NT-proBNP'nin 0.842 (s ırasıyla p=0.035, p=0.002, p<0.001) idi. hs-cTNT, NT-proBNP, kopeptin, miyoglobin ve glukoz kullanılarak oluşturulan panelde eğri altında kalan alan 0.917'ye ulaştı. Mortalite tahmininde kopeptinin ROC e ğrisi altında kalan alan ı 0.696, miyoglobinin 0.713 ve glukozun 0.800 (sırasıyla p=0.045, p=0.003, p=<0.001) idi. hs-cTNT, kopeptin, miyoglobin ve glukoz kullan ılarak olu şturulan panelde, mortalite tahmininde ROC e ğrisi alt ında kalan alan 0.865’e ulaştı. Sonuç: Biyobelirteç kombinasyonlar ı, biyobelirteçlerin prediktif de ğerlerini art ırabilir. Bu çal ışmada serum hs-cTNT, NT-proBNP, kopeptin, miyoglobin ve glukoz düzeyleri kullan ılarak güçlü prognostik panellerin oluşturulduğu gösterilmiştir.
Anahtar Kelime: Troponin T Natriüretik Peptid Miyoglobin Miyokardiyal Infarktüs Prognoz

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018; 39(2):119-77.
  • 2. WHO Fact sheet, https://www.who.int/en/newsroom/fact-sheets/detail/cardiovascular-diseases- (cvds) (updated 11 June 2021).
  • 3. Wang L, Jin Y. Noncoding RNAs as Biomarkers for Acute Coronary Syndrome. Biomed Res Int. 2020; 1;2020:3298696.
  • 4. Tobbia P, Brodie BR, Witzenbichler B, Metzger C, Guagliumi G, Yu J, et al. Adverse event rates following primary PCI for STEMI at US and non-US hospitals: three-year analysis from the HORIZONSAMI trial. EuroIntervention. 2013; 8(10):1134-42.
  • 5. Roe MT, Messenger JC, Weintraub WS, Cannon CP, Fonarow GC, Dai D, et al. Treatments, trends, and outcomes of acute myocardial infarction and percutaneous coronary intervention. J Am Coll Cardiol. 2010; 56(4):254–263.
  • 6. Fox KA, Dabbous OH, Goldberg RJ, Pieper KS, Eagle KA, Van de Werf F, et al. Prediction of risk of death and myocardial infarction in the six months after presentation with acute coronary syndromee: prospective multinational observational study (GRACE). BMJ. 2006; 333(7578):1091.
  • 7. Thygesen K, Alpert JS, White HD, Joint ESC/ACCF/ AHA/WHF. Task Force for the Redefinition of Myocardial Infarction. Universal definition of myocardial infarction. J Am Coll Cardiol. 2007; 50:2173–95.
  • 8. Afzali D, Erren M, Pavenstädt HJ, Vollert JO, Hertel S, Waltenberger J, et al. Impact of copeptin on diagnosis, risk stratification, and intermediate-term prognosis of acute coronary syndromees. Clin Res Cardiol. 2013; 102(10):755-63.
  • 9. Collet JP, Thiele H, Barbato E, Barthe´le´my O, Bauersachs J, Bhatt DL, et al. ESC Scientific Document Group. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2021; 42:1289-367.
  • 10. Gimenez MR, Twerenbold R, Reichlin T, Wildi K, Haaf P, Schaefer M, et al. Direct comparison of highsensitivity-cardiac troponin I vs. T for the early diagnosis of acute myocardial infarction. Eur Heart J. 2014; 35:2303-11.
  • 11. Haaf P, Reichlin T, Twerenbold R, Hoeller R, Gimenez MR, Zellweger C, et al. Risk stratification in patients with acute chest pain using three highsensitivity cardiac troponin assays. Eur Heart J. 2014; 35:365-75.
  • 12. Mueller C. Biomarkers and acute coronary syndromes: an update. Eur Heart J. 2014; 35:552-6.
  • 13. Reichlin T, Schindler C, Drexler B, Twerenbold R, Reiter M, Zellweger C, et al. One-hour rule-out and rule-in of acute myocardial infarction using highsensitivity cardiac troponin T. Arch Intern Med. 2012; 172:1211-8.
  • 14. Thygesen K, Mair J, Giannitsis E, Mueller C, Lindahl B, Blankenberg S, et al. How to use high-sensitivity cardiac troponins in acute cardiac care. Eur Heart J. 2012; 33:2252-7.
  • 15. Wang XY-, Zhang F, Zhang C, Zheng L-R, Yang J. The Biomarkers for Acute Myocardial Infarction and Heart Failure. Biomed Res Int. 2020; 17:2020: 2018035.
  • 16. Hillinger P, Twerenbold R, Jaeger C, Wildi K, Reichlin T, Gimenez MR, et al. Optimizing Early Rule-Out Strategies for Acute Myocardial Infarction: Utility of 1-Hour Copeptin. Clin Chem. 2015; 61(12):1466- 74.
  • 17. Maisel A, Mueller C, Neath SX, Christenson RH, Morgenthaler NG, McCord J, et al. Copeptin helps in the early detection of patients with acute myocardial infarction: primary results of the CHOPIN trial (Copeptin Helps in the early detection of Patients with acute myocardial INfarction). J Am Coll Cardiol. 2013; 62(2):150-60.
  • 18. Keller T, Tzikas S, Zeller T, Czyz E, Lillpopp L, Ojeda FM, et al. (2010) Copeptin improves early diagnosis of acute myocardial infarction. J Am Coll Cardiol. 2010; 55:2096-106.
  • 19. Mockel M, Searle J, Hamm C, Slagman A, Blankenberg S, Huber K, et al. Early discharge using single cardiac troponin and copeptin testing in patients with suspected acute coronary syndrome (ACS): a randomized, controlled clinical process study. Eur Heart J. 2015; 36:369-37.
  • 20. Reichlin T, Hochholzer W, Stelzig C, Laule K, FreidankH, Morgenthaler NG, et al. Incremental value of copeptin for rapid rule out of acute myocardial infarction. J Am Coll Cardiol. 2009; 54:60-8.
  • 21. Reichlin T, Twerenbold R, Maushart C, Reiter M, Moehring B, Schaub N, et al. Risk stratification in patients with unstable angina using absolute serial changes of 3 high-sensitive troponin assays. Am Heart J. 2013; 165:371-8.
  • 22. Eggers KM, Jernberg T, Lindahl B. Unstable angina in the era of cardiac troponin assays with improved sensitivity-A clinical dilemma. Am J Med. 2017; 130:1423-30.
  • 23. Libby P. Mechanisms of acute coronary syndromes and their implications for therapy. N Engl J Med. 2013; 368(21):2004-13.
  • 24. A de Lemos J, Morrow DA, Gibson CM, Murphy SA, Sabatine MS, Rifai N, et al. The prognostic value of serum myoglobin in patients with non-ST-segment elevation acute coronary syndromes. Results from the TIMI 11B and TACTICS-TIMI 18 studies. J Am Coll Cardiol. 2002; 40:238–44.
  • 25. Kontos MC, Garg R, Anderson FP, Roberts CS, Ornato JP, Tatum JL, et al. Ability of myoglobin to predict mortality in patients admitted for exclusion of myocardial infarction. Am J Emerg Med. 2007; 25:873–9.
  • 26. Wei CH and Litwin SE. Hyperglycemia and adverse outcomes in acute coronary syndromes: is serum glucose the provocateur or innocent bystander? Diabetes. 2014; 63(7):2209-12.
  • 27. Wahab NN, Cowden EA, Pearce NJ, Gardner MJ, Merry H, Cox JL, ICONS Investigators. Is blood glucose an independent predictor of mortality in acute myocardial infarction in the thrombolytic era? J Am Coll Cardiol. 2002; 40:1748-54.
  • 28. Stranders I, Diamant M, van Gelder RE, Spruijt J, Twisk JWR, Heine RJ, et al. Admission blood glucose level as risk indicator of death after myocardial infarction in patients with and without diabetes mellitus. Arch Intern Med. 2004; 164:982-8.
  • 29. Chan D and Ng LL. Biomarkers in acute myocardial infarction. BMC Med. 2010; 8:34-44.
  • 30. Ueland T, Aukrust P, Caidahl K. CCL21 and prognosis in acute coronary syndrome. Aging (Albany NY). 2019; 11: 9225–6.
  • 31. Wang L, Jin Y. Noncoding RNAs as Biomarkers for Acute Coronary Syndrome. Biomed Res Int. 2020;2020:3298696.
  • 32. Khan SQ, Dhillon OS, O'Brien RJ, Struck J, Quinn PA, Morgenthaler NG, et al. C-Terminal Provasopressin (Copeptin) as a Novel and Prognostic Marker in Acute Myocardial Infarction: Leicester Acute Myocardial Infarction Peptide (LAMP) Study. Circulation 2007; 115:2103-10.
  • 33. Potocki M, Reichlin T, Thalmann S, Zellweger C, Twerenbold R, Reiter M, et al. Diagnostic and prognostic impact of copeptin and high-senstivity cardiac troponin T in patients with pre-existing coronary arter disease and suspected acute myocardial infarction. Heart 2012; 98:558–65.
  • 34. Jaffery Z, Nowak R, Khoury N, Tokarski G, Lanfear DE, Jacobsen G, et al. Myoglobin and troponin I elevation predict 5-year mortality in patients with undifferentiated chest pain in the emergency department. Am Heart J. 2008;156:939–45.
  • 35. Yao J, Xie Y, Liu Y, Tang Y, Xu J. Prediction Factors of 6-Month Poor Prognosis in Acute Myocardial Infarction Patients. Front Cardiovasc Med. 2020; 13(7):130.
  • 36. Deedwania P, Kosiborod M, Barrett E, Ceriello A, Isley W, Mazzone T, et al. Hyperglycemia and acute coronary syndrome: a scientific statement from the American Heart Association Diabetes Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation. 2008; 117:1610-9.
  • 37. Goyal A, Mehta SR, Gerstein HC, Diaz R, Afzal R, Xavier D, et al. Glucose levels compared with diabetes history in the risk assessment of patients with acute myocardial infarction. Am Heart J. 2009; 157:763-70.
  • 38. Tansey MJ, Opie LH. Relation between plasma free fatty acids and arrhythmias within the first twelve hours of acute myocardial infarction. Lancet. 1983; 2:419-22.
  • 39. Kersten JR, Toller WG, Tessmer JP, Pagel PS, Warltier DC. Hyperglycemia reduces coronary collateral blood flow through a nitric oxidemediated mechanism. Am J Physiol Heart Circ Physiol. 2001; 281:2097-104.
  • 40. Ege M, Güray Ü, Güray Y, Yılmaz MB, Demirkan B, Şaşmaz A, et al. Relationship between TIMI frame count and admission glucose values in acute ST elevation myocardial infarction patients who underwent successful primary percutaneous intervention. Anadolu Kardiyol Derg. 2011; 11(3):213-7
  • 41. Fujino M, Ishihara M, Honda S, Kawakami S, Yamane T, Nagai T, et al. Impact of acute and chronic hyperglycemia on in hospital outcomes of patients with acute myocardial infarction. Am J Cardiol. 2014; 114 (12):1789-93.
  • 42. Lindahl B. Multimarker approach for diagnosis of acute myocardial infarction: better answers need better questions. Clin Chem. 2009; 55(1):9-11.
  • 43. Kelly D, Khan SQ, Thompson M, Cockerill G, Ng LL, Samani N, et al. Plasma tissue inhibitor of metalloproteinase-1 and matrix metalloproteinase9: novel indicators of left ventricular remodelling and prognosis after acute myocardial infarction. Eur Heart J. 2008; 29:2116-24.
  • 44. James SK, Lindahl B, Siegbahn A, Stridsberg M, Venge P, Armstrong P, et al. N-terminal pro-brain natriuretic peptide and other risk markers for the separate prediction of mortality and subsequent myocardial infarction in patients with unstable coronary artery disease: a Global Utilization of Strategies To Open occluded arteries (GUSTO)-IV substudy. Circulation. 2003; 108(3):275-81.
APA Kocaturk E, Birdane A, Cevik A, Colak E, Musmul A, Colak O (2022). The Prediction of the Prognosis After Acute Myocardial Infarction by MultiBiomarker Approach. , 115 - 123. 10.56615/tkbd.2022.14
Chicago Kocaturk Evin,Birdane Alparslan,Cevik Arif Alper,Colak Ertugrul,Musmul Ahmet,Colak Omer The Prediction of the Prognosis After Acute Myocardial Infarction by MultiBiomarker Approach. (2022): 115 - 123. 10.56615/tkbd.2022.14
MLA Kocaturk Evin,Birdane Alparslan,Cevik Arif Alper,Colak Ertugrul,Musmul Ahmet,Colak Omer The Prediction of the Prognosis After Acute Myocardial Infarction by MultiBiomarker Approach. , 2022, ss.115 - 123. 10.56615/tkbd.2022.14
AMA Kocaturk E,Birdane A,Cevik A,Colak E,Musmul A,Colak O The Prediction of the Prognosis After Acute Myocardial Infarction by MultiBiomarker Approach. . 2022; 115 - 123. 10.56615/tkbd.2022.14
Vancouver Kocaturk E,Birdane A,Cevik A,Colak E,Musmul A,Colak O The Prediction of the Prognosis After Acute Myocardial Infarction by MultiBiomarker Approach. . 2022; 115 - 123. 10.56615/tkbd.2022.14
IEEE Kocaturk E,Birdane A,Cevik A,Colak E,Musmul A,Colak O "The Prediction of the Prognosis After Acute Myocardial Infarction by MultiBiomarker Approach." , ss.115 - 123, 2022. 10.56615/tkbd.2022.14
ISNAD Kocaturk, Evin vd. "The Prediction of the Prognosis After Acute Myocardial Infarction by MultiBiomarker Approach". (2022), 115-123. https://doi.org/10.56615/tkbd.2022.14
APA Kocaturk E, Birdane A, Cevik A, Colak E, Musmul A, Colak O (2022). The Prediction of the Prognosis After Acute Myocardial Infarction by MultiBiomarker Approach. Türk Klinik Biyokimya Dergisi, 20(3), 115 - 123. 10.56615/tkbd.2022.14
Chicago Kocaturk Evin,Birdane Alparslan,Cevik Arif Alper,Colak Ertugrul,Musmul Ahmet,Colak Omer The Prediction of the Prognosis After Acute Myocardial Infarction by MultiBiomarker Approach. Türk Klinik Biyokimya Dergisi 20, no.3 (2022): 115 - 123. 10.56615/tkbd.2022.14
MLA Kocaturk Evin,Birdane Alparslan,Cevik Arif Alper,Colak Ertugrul,Musmul Ahmet,Colak Omer The Prediction of the Prognosis After Acute Myocardial Infarction by MultiBiomarker Approach. Türk Klinik Biyokimya Dergisi, vol.20, no.3, 2022, ss.115 - 123. 10.56615/tkbd.2022.14
AMA Kocaturk E,Birdane A,Cevik A,Colak E,Musmul A,Colak O The Prediction of the Prognosis After Acute Myocardial Infarction by MultiBiomarker Approach. Türk Klinik Biyokimya Dergisi. 2022; 20(3): 115 - 123. 10.56615/tkbd.2022.14
Vancouver Kocaturk E,Birdane A,Cevik A,Colak E,Musmul A,Colak O The Prediction of the Prognosis After Acute Myocardial Infarction by MultiBiomarker Approach. Türk Klinik Biyokimya Dergisi. 2022; 20(3): 115 - 123. 10.56615/tkbd.2022.14
IEEE Kocaturk E,Birdane A,Cevik A,Colak E,Musmul A,Colak O "The Prediction of the Prognosis After Acute Myocardial Infarction by MultiBiomarker Approach." Türk Klinik Biyokimya Dergisi, 20, ss.115 - 123, 2022. 10.56615/tkbd.2022.14
ISNAD Kocaturk, Evin vd. "The Prediction of the Prognosis After Acute Myocardial Infarction by MultiBiomarker Approach". Türk Klinik Biyokimya Dergisi 20/3 (2022), 115-123. https://doi.org/10.56615/tkbd.2022.14