1. Investigation of a multimarker approach to the initial assessment of patients with acute chest pain
- Author
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C.G. Owens, Peter Sharpe, Jane McEneny, Ian Menown, Conor J McCann, Ian S. Young, Bernie Smith, M.J. Moore, Jennifer Adgey, and Ben M. Glover
- Subjects
Chest Pain ,medicine.medical_specialty ,Acute coronary syndrome ,Multivariate analysis ,medicine.drug_class ,CD40 Ligand ,Myocardial Infarction ,Fatty Acid-Binding Proteins ,Risk Assessment ,Fibrin Fibrinogen Degradation Products ,Troponin T ,Troponin complex ,Glycogen Phosphorylase, Brain Form ,Predictive Value of Tests ,Internal medicine ,Natriuretic Peptide, Brain ,medicine ,Natriuretic peptide ,Acute chest pain ,Humans ,Pregnancy-Associated Plasma Protein-A ,Pharmacology (medical) ,Myocardial infarction ,Acute Coronary Syndrome ,Peroxidase ,business.industry ,Reproducibility of Results ,General Medicine ,medicine.disease ,Peptide Fragments ,Review article ,C-Reactive Protein ,Early Diagnosis ,Matrix Metalloproteinase 9 ,Heart-type fatty acid binding protein ,Multivariate Analysis ,Cardiology ,business ,Fatty Acid Binding Protein 3 ,Biomarkers - Abstract
Early identification of acute coronary syndrome (ACS) is important to guide therapy at a time when it is most likely to be of value. In addition, predicting future risk helps identify those most likely to benefit from ongoing therapy. Cardiac troponin T (cTnT) is useful for both purposes although cannot reliably rule out ACS until 12 hours after pain onset and does not fully define future risk. In this review article we summarize our previously published research, which assessed the value of myocyte injury, vascular inflammation, hemostatic, and neurohormonal markers in the early diagnosis of ACS and risk stratification of patients with ACS. In addition to cTnT, we measured heart fatty acid binding protein (H-FABP), glycogen phosphorylase-BB, high-sensitivity C-reactive protein, myeloperoxidase, matrix metalloproteinase 9, pregnancy-associated plasma protein-A, D-dimer, soluble CD40 ligand, and N-terminal pro-brain natriuretic peptide (NT-proBNP). Of the 664 patients enrolled, 415 met inclusion criteria for the early diagnosis of acute myocardial infarction (MI) analysis; 555 were included in the risk stratification analysis and were followed for 1 year from admission. In patients presenting
- Published
- 2009
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