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Introduction: Perinatal asphyxia is an important cause of admission to neonatal intensive care units (NICU) with multi organ dysfunction.Aim: Determine the change in functional echocardiographic parameters with CKMB and Troponin I and time. Methodology:The study, conducted at the Division of Pediatric Cardiology in M.D.M Hospital under the Department of Paediatrics, Dr. S. N. Medical College, Jodhpur, focused on perinatal asphyxia and hypoxic ischemic encephalopathy (HIE).Functional echocardiographic parameters were studied with time. Result: Both left atrial and aortic diameters did not significantly change over time. However, La/Ao showed a significant decrease over time. LVED and LVES remained relatively stable over the measured time intervals. EF and FS increased significantly over time, indicating improvement in cardiac function. Parameters such as LVMPI, mvcf, MAPSE, and TAPSE did not show significant changes over time. Mitral E/A ratio, mitral E/e' medial, mitral E/e' lateral, tricuspid E/A ratio, tricuspid E/e' medial, and tricuspid E/e' lateral also remained relatively stable over the measured time intervals. Conclusion: It shows a complex interplay between structural and functional aspects of cardiac performance over time. While certain parameters remained stable, others demonstrated dynamic changes, underscoring the importance of comprehensive echocardiographic assessment in evaluating cardiac function and guiding clinical management. [ABSTRACT FROM AUTHOR]

Background: Isoproterenol, a β-adrenergic agonist, may induce myocardial infarction when used in high dosage in rats. This study was conducted to evaluate the effect of the ethanol extract of Kleinhovia hospita leaves on cardiac biomarkers and myocardial structures of rats induced by isoproterenol. Methods: Male rats (n=30) were assigned as a normal controls or treatment groups. The treatment groups received pretreatments, either placebo or the extract at doses of 250, 500, or 750 mg/kg for 14 days, followed by two isoproterenol injections at 100 mg/kg. After 24 hours, blood samples were taken and the hearts dissected. The tested cardiac biomarkers were creatinine kinase myocardial band (CKMB) and lactate dehydrogenase (LDH). Heart histopathology analysis was performed followed by staining of samples with hematoxylin and eosin. Results: The isoproterenol injections significantly increased CKMB and LDH levels in the placebo group compared to those in normal controls. Pretreatment with the extract at doses of 500 and 750 mg/kg significantly reduced the serum CKMB and LDH levels compared to those of the placebo. The histopathological examinations showed the presence of diffused necrosis and severe inflammation in the placebo group. Pretreatment with the extract at 500 or 750 mg/kg significantly reduced the myocardial tissue damages in rats. Conclusion: The K. hospita extract at doses of 500 or 750 mg/kg significantly reduced the infarctions in the rats’ heart tissue, shown by significantly low levels of CKMB and LDH, and reduced necrotic lesions and inflammation in the rat heart tissue samples induced by isoproterenol pretreatment.

Background: Ischemia/reperfusion injury contributes to periprocedural myocardial injury (PMI) in patients undergoing percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). PMI can be estimated by the elevation of troponin (Tn) and creatine kinase-MB (CKMB) plasma levels, and it is associated with increased risk of cardiovascular events and mortality. Vitamin C might have a beneficial effect on PMI by improving endothelial function, improving myocardial perfusion, and by reducing oxidative stress generated during/after reperfusion. In several small animal models of cardiac stress, vitamin C reduced the increase in Tn and CKMB levels. The aim of this meta-analysis was to investigate whether vitamin C administration may have an effect on Tn and CKMB levels in patients undergoing PCI or CABG. Methods: We searched PubMed, Cochrane, Embase and Scopus databases for controlled clinical trials reporting on Tn and CKMB levels in adult patients who underwent PCI or CABG and received vitamin C. As secondary outcomes we collected data on biomarkers of oxidative stress in the included trials. In our meta-analysis, we used the relative scale and estimated the effect as the ratio of means. Results: We found seven controlled trials which included 872 patients. All included trials administered vitamin C intravenously, with a range from 1 to 16 g/day, and all initiated vitamin administration prior to the procedure. Vitamin C decreased peak Tn plasma levels in four trials on average by 43% (95% CI: 13 to 63%, p = 0.01) and peak CKMB plasma levels in five trials by 14% (95% CI: 8 to 21%, p < 0.001). Vitamin C also significantly decreased the biomarkers of oxidative stress. Conclusions: Vitamin C may decrease cardiac enzyme levels in patients undergoing elective PCI or CABG. This may be explained partially by its antioxidant effects. Our findings encourage further research on vitamin C administration during cardiac procedures and in other clinical contexts that increase the level of cardiac enzymes. Future studies should search for an optimal dosing regimen, taking baseline and follow-up plasma vitamin C levels into account. [ABSTRACT FROM AUTHOR]

Cardiac dysfunction can be prevented by addressing risk factors including unhealthy diet with other lifestyle modifications. The present study demonstrates the effect of diet mixed with sea and table salts on cardiac remodeling with respect to CKMB, renin, angiotensin II, interleukin-6 and 10. Animals divided into six groups. Normal control, Table salt (0.3%), Natural sea salt (0.3%), Doxorubicin-induced cardiac remodeling control (2 mg/kg), + Normal table salt (0.3%) and Doxorubicin + Natural sea salt (0.3%) . Serum analysis and histopathology of heart, liver and kidney was performed. Significant variation (P

Background: Isoproterenol, a β-adrenergic agonist, may induce myocardial infarction when used in high dosage in rats. This study was conducted to evaluate the effect of the ethanol extract of Kleinhovia hospita leaves on cardiac biomarkers and myocardial structures of rats induced by isoproterenol. Methods: Male rats (n=30) were assigned as a normal controls or treatment groups. The treatment groups received pretreatments, either placebo or the extract at doses of 250, 500, or 750 mg/kg for 14 days, followed by two isoproterenol injections at 100 mg/kg. After 24 hours, blood samples were taken and the hearts dissected. The tested cardiac biomarkers were creatinine kinase myocardial band (CKMB) and lactate dehydrogenase (LDH). Heart histopathology analysis was performed followed by staining of samples with hematoxylin and eosin. Results: The isoproterenol injections significantly increased CKMB and LDH levels in the placebo group compared to those in normal controls. Pretreatment with the extract at doses of 500 and 750 mg/kg significantly reduced the serum CKMB and LDH levels compared to those of the placebo. The histopathological examinations showed the presence of diffused necrosis and severe inflammation in the placebo group. Pretreatment with the extract at 500 or 750 mg/ kg significantly reduced the myocardial tissue damages in rats. Conclusion: The K. hospita extract at doses of 500 or 750 mg/kg significantly reduced the infarctions in the rats' heart tissue, shown by significantly low levels of CKMB and LDH, and reduced necrotic lesions and inflammation in the rat heart tissue samples induced by isoproterenol pretreatment. [ABSTRACT FROM AUTHOR]

The myocardial infarction (MI) types 4a and 5 guidelines recommend cardiac troponin (cTn) diagnostic decision limits of 5 and 10 times the 99th percentile, respectively. Different cTn kits elicit different responses, so the MI diagnosis is still challenging. The study aimed to establish the cutoff values and the accuracy of three different cTnI kits in the diagnosis of post-procedural MI. We analyzed 115 patients with multivessel stable chronic coronary artery disease; 26 underwent percutaneous coronary intervention, and 89 underwent coronary artery bypass graft. Delayed-enhancement magnetic resonance imaging was performed before and after each intervention for definitive MI diagnoses. Two contemporary and one high-sensitivity cTnI immunoassays were used. ROC curves determined the accuracy of each assay. Low accuracy was observed after applying the current guidelines recommendations. The three cTnI assays accuracies improved when adjusted by the new ROC cutoffs, reaching 82% for MI type 5 for all assays, and 78%, 88%, and 87% for MI type 4 for Siemens, Beckman, and Abbott, respectively. The ultrasensitive and contemporary tests' accuracy for MI types 4a and 5 diagnoses are equivalent when adjusted for these new cutoffs. The hs-cTnI assays had lower accuracy than contemporary tests for MI types 4a and 5 diagnoses. [ABSTRACT FROM AUTHOR]

Momordica charantia has various biological activities as antihyperglycemic, anti-inflammatory, and antioxidant. Thisstudy evaluated Momordica charantia fruit extract against the LDH and CKMB serum in rats induced with isoproterenol. We also evaluated the molecular docking of bioactive compounds in Momordica charantia fruit against the SIRT1 protein. Wistar male rats were divided into four groups: negative control (Na-CMC), positive control (Na-CMC and isoproterenol), and resveratrol group at 9 mg/kg b.wt, and Momordica charantia fruit extract at 300 mg/kg b.w with isoproterenol. The interaction between ligand and receptor was evaluated and calculated with molecular docking software. The ligands were docked using the AutoDock Tools - 1.5.7. The binding affinity was calculated using the binding free energy (kcal/mol). The results showed that Momordica charantia fruit extract at 300 mg/kg b.w could attenuate the LDH (49.37%) and CKMB (44.5%) increase in serum after isoproterenol-induced myocardial infarction in rats. Molecular docking of selected compounds from Momordica charantia fruit extract presents that momordicilin has great potential as a SIRT-1 activator with a binding energy of - 11.3 kcal/mol. These findings implicate that Momordica charantia fruit extract can be developed further as a potential cardioprotective drug. [ABSTRACT FROM AUTHOR]

Objective: To assess the rise in CKMB and Myoglobin levels and associated factors in non-cardiac patients of ischemic stroke presenting to the Emergency Department of a Tertiary Care Hospital. Study Design: Cross-sectional study. Place and Duration of Study: Department of Emergency Medicine, Pak Emirates Military Hospital (PEMH), Rawalpindi Pakistan, from Dec 2020 to May 2021. Methodology: A total of 150 patients with ischemic stroke diagnosed by the consultant Emergency physician or medical specialist based on clinical and neuro-radiological findings were included in this study. Serum CKMB and myoglobin levels were assessed along with other baseline investigations among the study participants. In addition, the relationship of age, gender, the severity of the stroke and the presence of non-cardiac comorbidities was assessed with the rise in CKMB and myoglobin levels among the target population. Results: Out of 200 patients with ischemic stroke included in the study, 114(67.0%) were males, while 86(43.0%) were females. 75(37.5%) patients had either raised CKMB or Myoglobin levels, while 125(62.5%) patients had both biomarkers within range. On the National Institutes of Health Stroke Scale, 110(55.0%) patients had mild, 55(22.5%) had mild to moderately severe, 25(12.5%) had severe, and 10(5.0%) had very severe symptoms. Statistical analysis revealed that increased stroke severity had a statistically significant relationship (p-value

Cardiac dysfunction can be prevented by addressing risk factors including unhealthy diet with other lifestyle modifications. The present study demonstrates the effect of diet mixed with sea and table salts on cardiac remodeling with respect to CKMB, renin, angiotensin II, interleukin-6 and 10. Animals divided into six groups. Normal control, Table salt (0.3%), Natural sea salt (0.3%), Doxorubicin-induced cardiac remodeling control (2 mg/kg), + Normal table salt (0.3%) and Doxorubicin + Natural sea salt (0.3%). Serum analysis and histopathology of heart, liver and kidney was performed. Significant variation (P <.05) observed in in CKMB for Natural sea salt group compared to Normal. Significant (P <.05) variation in renin for Normal table salt group compared to Normal. Variation in interleukin-6, 10, renin and angiotensin II give new insight in these parameters with marked variation in cellular architecture of the heart, liver and kidney. Observations suggest diet with natural sea salt demonstrated significant beneficial effect on cardiac dysfunction. [ABSTRACT FROM AUTHOR]

[Display omitted] • A novel bifunctional nucleic acid was designed for signal amplification in LFA detection. • Improving the sensitivity of LFA without time increasing or equipment dependent. • A signal amplification method for protein detection based on aptamer was reported. • The LOD of CKMB was 7.92 ng/mL, which was 20 times lower than previous study. At present, rapid and sensitive detection of disease biomarkers is still the focus of early clinical diagnosis. As a rapid response to point-of-care testing (POCT), lateral flow assay (LFA) has been given serious attention. Unfortunately, due to the sensitivity limitations, LFA, especially AuNPs-based LFA, was difficult to play an important role in the detection of trace biomarkers. The combination of different signal amplification methods increases the complexity of operation and use, or prolongs the detection time, which sacrifices the advantages of fast and convenient of LFA. Hence, a novel sandwich aptamer-based visual LFA based on bifunctional nucleic acid (bFNA-LFA) was proposed for rapid and sensitive detection of creatine kinase MB (CKMB) in this study. Based on hybridization chain reaction (HCR) and nucleic acid hybridization, a bifunctional nucleic acid with target recognition and signal amplification was prepared, which effectively improved the sensitivity of CKMB detection without increasing the reaction time and depending on the detecting equipment. Under optimal reaction conditions, the limit of detection of 7.92 ng/mL was observed, which was 20 times lower than that of sandwich aptamer-based AuNPs LFA in the previous study. The proposed bFNA-LFA assay expanded a new idea in improving the sensitivity of LFA, and provided a reference for the subsequent application of nucleic acid nanomaterials in the detection of protein biomarkers. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Surgery & Medicine (JOSAM) is the property of Journal of Surgery & Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and aims: Hemodialysis patients have an enhanced risk for cardiovascular events. Cardiac biomarkers provide useful information for stratifying their risk. However the prognosis value of creatine kinase MB isoenzyme (CKMB) has not yet been validated in this population. The aim of the present study is to determine the predictable value of CK-MB in hemodialysis. Methods: A cohort of 211 hemodialysis patients (58.3% male, median age 73 (60–80) years) were followed for 39 (19–56) months. Cardiac biomarkers including CKMB were recorded at baseline. Factors associated to CKMB and prognosis value of this biomarker was studied. Results: The median value of CKMB was 1 (1–2) ng/mL with no patient exceeding normal laboratory values. Previous heart disease, diabetes mellitus, peripheral vascular disease and systolic and diastolic dysfunction were associated with higher levels of CKMB. Ninety-four patients (44.5%) cardiovascular events were recorded. CKMB levels ≥2 ng/mL was independently associated to cardiovascular events during the follow up after adjusting. Adding CKMB to a model including several variables for predicting cardiovascular events, resulted in 17% improvement in risk discrimination (IDI) with a relative IDI of 9.9% (p = 0.04). Conclusions: CKMB is a good marker for stratifying cardiovascular risk in hemodialysis patients and adds prognosis information to other well known independent predictors for cardiovascular events.

The creatine kinase (CK) enzyme and its isoenzymes hold significant diagnostic value, appearing in distinct patterns across various tissues. The most common method for creatine kinase MB (CK-MB) estimation is based on immunoinhibition. However, this method can report falsely elevated CK-MB levels in various scenarios. Persistently elevated CK-MB levels or discrepancies between measured values and the patient's clinical condition warrant further investigation, such as total CK isoenzyme electrophoresis. This report presents a case where a patient was diagnosed with acute myocardial infarction and treated according to established guidelines. However, the presence of abdominal pain, in addition to persistently elevated CK-MB after the resolution of cardiac symptoms and a higher CK-MB to total CK ratio, suggested alternative pathologies. Thorough laboratory investigations, including quantitative CK isoenzyme electrophoresis and contrast-enhanced computed tomography (CECT) of the abdomen, followed by emergency operative intervention, led to a secondary diagnosis of acute small bowel infarction., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Ghosh et al.)

Background: Hemolysis is frequently reported in samples sent from emergency departments. In our study we aimed to compare the influence of invitro hemolysis on test results and hemolysis ratios of different blood drawing techniques (aspiration method and vacuum filling technique) used to draw blood from intravenous (IV) catheters in Emergency Department. Two techniques (aspiration vs. vacuum filling) used to draw blood into three different tubes (Sarstedt S-Monovette® 4.9 mL Serum Gel tube, BD 5 mL Vacutainer® Rapid Serum Tube (RST), and 5 mL Vacutainer® SST™II tube) and evaluated the effect of the hemolysis index of the sera on the tests analyzed. Methods: In the emergency department blood was drawn from 128 consecutive patients into Sarstedt S-Monovette ® 4.9 mL Serum Gel tubes using aspiration technique and also into BD 5 mL Vacutainer® Rapid Serum Tubes (RST) and 5 mL Vacutainer® SST™II tubes using vacuum filling technique. All the tests requested from the patients were analyzed on all tubes and the hemolysis index of all the tubes were also evaluated. Results: As a result, the percentage of hemolysis encountered in S-Monovette® vs. SST and S-Monovette® vs. RST was 4.41% vs. 14.71% and 0% vs. 18.97%, respectively (p < 0.001, p < 0.001). In addition to this, the mean values of the test results for each assay in S-Monovette® tubes showed a significant difference when compared to RST and SST (p < 0.01). CKMB and LDH test results found in the tubes filled using the aspiration techniques (SMonovette ®) were statistically significantly lower than the results gathered from the tubes filled using vacuum filling technique (Vacutainer® RST and Vacutainer® SST) (p < 0.001). Conclusions: The test results and HI taken from the aspiration method seemed to be more reliable despite the presence of hemolysis. [ABSTRACT FROM AUTHOR]

Background: Doxorubicin is a Anthracycline derivative and has proven efficacy in various malignancies. It is the most effective cytotoxic agent in current use. The clinical usefulness is limited due to its cardiac toxicity. Objectives: To study the preventive role of ethanolic extract fractions of Boerhaavia diffusa (BD) against doxorubicin (Dox) induced myocardial toxicity in albino rats. Methods: The ethanolic extract of whole plant of Boerhaavia diffusa was prepared by hot extraction method and further fractionated into Petroleum ether (PEBD), Chloroform (CLBD), Ethyl acetate (EABD) and Aqueous (AQBD) fractions by increasing in order of polarity. Cardiotoxicity was produced by cumulative administration of Dox (2.5 mg/kg, i.p. alternative day for two weeks). All four fractions (PEBD-20 mg/kg, CLBD-25 mg/kg, EABD-30 mg/kg and AQBD-25 mg/kg) and vitamin E as standard (100 mg/kg) were administered orally as pretreatment for two weeks followed by Dox on alternative days for two weeks. The general observations, biomarker enzymes like lactate dehydrogenase (LDH), Creatine kinase (CK-MB) and Troponin-I (cTnI), biochemical parameters such as aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were monitored after three weeks of last dose. Myocardial toxicity was also evaluated by histopathologic studies. Results: Repeated administration of Dox-induced cardiomyopathy characterized with an increased level of biomarkers and antioxidant deficit. Pretreatment with the EABD and Vit-E significantly protected myocardium from the toxic effects of Dox by reducing the elevated level of biomarker enzymes like LDH, CK-MB, biochemical parameters such as AST and ALT, absence of cTnI and restoring of disorganized myocardial tissue to normal. Conclusion: The biomarker, biochemical and histopathological data evidently substantiate the cardioprotective effect of EABD, which could be attributed to flavanoids present in the ethyl acetate fraction. [ABSTRACT FROM AUTHOR]

Aim: Not only the progressive increase in indications for percutaneous transluminal coronary angioplasty (PTCA) attracts the attention, but also the myocardial damage that may develop after this technique. In this paper, the significance of cardiac markers in detecting myocardial damage following PTCA is discussed. Methods: 47 randomly selected patients, who have undergone PTCA procedure for different reasons, had blood analysis of cTnI and CK-MB levels before and after the procedure between 6 and 12 hours. Chemiluminescent Enzyme Immunoassay method was applied for cTnI and kinetic immunoinhibition method was applied for CK-MB. Results: Significant increase was found in levels of cTnI (p

Background: Corn silk contains health promoting phytochemicals which could be applied in the treatment of cardiovascular diseases. Aim and objectives: This was designed to evaluate the effect of corn silk extract on lipid profile, CK-MB and LDH. Methods: Fifteen rabbits divided into three experimental groups of 5 rabbits each were studied. The control group(A) was not ingested with the extract throughout the period of study. Group B was ingested with the water extract for 3 weeks while group C was ingested with the mathanolic extract for 3 weeks. Plasma lipid profile, CK-MB and LDH were estimated in the rabbits biochemically by spectrophotometry. The rabbits were well kept and placed on normal diet throughout the period of study. Results: There was a significantly higher mean value of plasma Total Cholesterol Triglyceride in the control rabbits than those obtained in the test rabbits after one week of the administration of methanolic and aqueous extract of corn silk (p<0.05). There was a significantly lower mean value of plasma Total Cholesterol and Triglyceride in the control rabbits than those obtained in the test rabbits after two and three weeks of the administration of methanolic and aqueous extract of corn silk (p<0.05). There was a significantly lower mean value of plasma LDL- Cholesterol in the control rabbits than those obtained in the test rabbits after 2 and 3 weeks of the administration of methanolic and aqueous extract of corn silk (p<0.05). There was a significantly lower mean plasma CK-MB value in the test rabbits than the control rabbits after 3 weeks of administration of aqueous extract of corn silk (p<0.05). There was a significant decrease in Cholesterol and Triglyceride in the rabbits after one week of methanolic extract but prolong administration of the extract significantly increased the Cholesterol, Triglycerides and LDL-Cholesterol. The corn silk extract also has a lowering effect on CK-MB in rabbits administered with corn silk extract. Conclusion: Estimation of plasma CK-MB, Cholesterol, Triglyceride and LDL-Cholesterol in patient undergoing treatment with corn silk extract will be a useful indicies for effective management. [ABSTRACT FROM AUTHOR]

Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Neopterin has been considered as an important marker of cellular inflammation. The primary objective of the current study was to determine the role of neopterin in cardiovascular disease and its association with other well known cardiac markers. The study was composed of total 200 subjects (100 confirmed coronary artery disease (CAD) patients, 50 recently diagnosed, and 50 managed CAD patients) both men and women and 100 healthy control individuals of matching age and weight. Serum neopterin analysis was done using commercial available ELISA kits. Other cardiac markers viz. troponin, creatine kinase (CK), CK MB isoenzyme (CKMB), lactate dehydrogenase (LDH), fibrinogen, C-reactive protein (CRP), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) estimation was done by standard routine biochemical methods. Neopterin level was found to be remarkably enhanced by 150% and 513% in the recently diagnosed and managed CAD patients, respectively. CK level also showed a significant rise by 62% in the managed patients. However, recently diagnosed patients did not show any significant change. Moreover, cross correlation study showed statistically significant ( P < 0.01) change in neopterin and CK levels between recently and managed patients. In the other studied CAD markers such as CKMB, fibrinogen and LDH also showed a significant increase in both categories of patients. CRP level was also found to be significantly enhanced by 357% ( P < 0.01) and 341% ( P < 0.05) in recently diagnosed and managed patients respectively. Because of cost effectiveness, easy and quick analysis of neopterin in the serum sample, we propose neopterin as the prognostic as well as diagnostic biomarker of CAD before other markers could be tested especially in Saudi population. © 2015 IUBMB Life, 67(6):453-459, 2015 [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: To assess the rise in CKMB and Myoglobin levels and associated factors in noncardiac patients of ischemic stroke presenting to the Emergency Department of a Tertiary Care Hospital. Study Design: Cross-sectional study. Place and Duration of Study: Department of Emergency Medicine, Pak Emirates Military Hospital (PEMH), Rawalpindi Pakistan, from Dec 2020 to May 2021. Methodology: A total of 150 patients with ischemic stroke diagnosed by the consultant Emergency physician or medical specialist based on clinical and neuroradiological findings were included in this study. Serum CKMB and myoglobin levels were assessed along with other baseline investigations among the study participants. In addition, the relationship of age, gender, the severity of the stroke and the presence of noncardiac comorbidities was assessed with the rise in CKMB and myoglobin levels among the target population. Results: Out of 200 patients with ischemic stroke included in the study, 114(67.0%) were males, while 86(43.0%) were females. 75(37.5%) patients had either raised CKMB or Myoglobin levels, while 125(62.5%) patients had both biomarkers within range. On the National Institutes of Health Stroke Scale, 110(55.0%) patients had mild, 55(22.5%) had mild to moderately severe, 25(12.5%) had severe, and 10(5.0%) had very severe symptoms. Statistical analysis revealed that increased stroke severity had a statistically significant relationship (p-value<0.001) with raised CKMB/Myoglobin levels in the target population. Conclusion: Raised CKMB or myoglobin levels were found in many patients with acute ischemic stroke. The stroke severity was associated with raised levels of these biomarkers. [ABSTRACT FROM AUTHOR]

Com o objetivo de estudar a influência do exercício físico prolongado na indução de lesão miocárdica e na desqualificação de equinos em provas de enduro, colheram-se 87 amostras de sangue de equinos adultos Árabes e mestiços para determinação da concentração sérica da isoenzima MB (CKMB), da atividade sérica de creatina quinase (CK) e do índice CKMB/CK. Dividiram-se as amostras da seguinte forma: C (controle, n = 34): equinos em repouso, no dia anterior à competição; G1 (n = 24): equinos que finalizaram as competições; G2 (n = 14): equinos desqualificados durante as competições por causa metabólica e G3 (n = 15): equinos desqualificados durante as competições por claudicação. Os valores medianos obtidos de CKMB, para os grupos C, G1, G2 e G3, foram respectivamente 2,25; 2,95; 1,95 e 2,40 ng/mL; para a atividade de CK, os resultados foram 164,2; 1228,0; 840,0 e 581,0 U/L a 30°C; e para o índice CKMB/CK, os resultados foram 1,41; 0,21; 0,23 e 0,42%. Houve média correlação positiva entre distância percorrida e CKMB e CK, e negativa entre distância e índice CKMB/CK. O exercício físico de resistência não leva a aumento significante dos valores da isoenzima CKMB, mas sim da atividade sérica da enzima CK, indicando dano à musculatura esquelética. Animais desqualificados por causa metabólica parecem não apresentar envolvimento de lesão miocárdica na causa de desqualificação. Não foi possível verificar a presença de lesão cardíaca induzida pelo exercício em equinos de enduro e sua relação com causas metabólicas de desqualificação a partir da utilização de CKMB como único marcador cardíaco.

Doxorubicin (DOX) is an anthracycline antibiotic with a broad antitumor spectrum. However, the clinical use of DOX is limited because of its cardiotoxicity, a dose-dependent effect. Colloidal drug delivery systems, such as microemulsions (MEs), allow the incorporation of drugs, modifying the pharmacokinetic (PK) profile and toxic effects. In this study, we evaluated the PK profile and cardiotoxicity of a new DOX ME (DOX-ME). The PK profile of DOX-ME was determined and compared with that of the conventional DOX after single-dose administration (6 mg/kg, intravenous) in male Wistar rats ( n = 12 per group). The cardiotoxicity of DOX formulations was evaluated by serum creatine kinase MB (CKMB) activity in both animal groups before and after drug administration. The plasma DOX measurements were performed by high-performance liquid chromatography with fluorescence detection, and the CKMB levels were assayed using the CKMB Labtest® kit. The ME system showed a significant increase in plasma DOX concentrations and lower distribution volume when compared with conventional DOX. Serum CKMB activity increased after conventional DOX administration but was unchanged in the DOX-ME group. These results demonstrate modifications in drug access to susceptible sites using DOX-ME. DOX-ME displayed features that make it a promising system for future therapeutic application. © 2012 Wiley Periodicals, Inc. and the American Pharmacists Association J Pharm Sci 102:289-296, 2013 [ABSTRACT FROM AUTHOR]

Objectives. While long-term endurance exercise is known to increase cardiac biomarkers, only a few studies on short-term exercise and these markers have been reported. The aim of this study was to investigate the acute effects of a one-hour bicycle spinning on cardiac biomarkers in healthy individuals. Design. Serum levels of high-sensitive troponin T (TnT), creatinine kinase MB fraction (CK-MB), N-terminal pro-brain natriuretic peptide (NT-proBNP), creatinine kinase (CK) and myoglobin were measured at baseline, 1 and 24 hour after one hour of spinning exercise in ten healthy and fit (age 31.0 ± 6.6 years) individuals. Results. TnT doubled one hour post-exercise (All values ≤ 5 - 9.7 ± 6.0 ng/L, p < 0.001). Two individuals had TnT levels above upper reference limit, URL (20.7 and 20.2 ng/L, URL == 12 ng/L). Myoglobin levels increased 72% one hour post-exercise (38 ± 20 - 66 ± 41 mg/L, p < 0.02). TnT and myoglobin levels returned to baseline 24 hour post-exercise. Serum levels of CK-MB, NT-proBNP and CK were not significantly changed. Conclusions. A single-bout of one-hour bicycle spinning transiently increases TnT and myoglobin in healthy subjects. Some subjects even have TnT release above URL. Thus, recently performed exercise also of short duration should be taken into consideration in the evaluation of acute chest pain with release of cardiac TnT. [ABSTRACT FROM AUTHOR]

The present investigation deals with the determination of various serum enzymes known to be elevated during myocardial infarction (MI) and estimation of selected metals like Cu, Cr, Co, Fe, Pb, and Mg by flame atomic absorption spectrophotometry. The data obtained thereby were processed for the determination of correlation coefficient matrix among the cardiac enzymes and the serum metals. The study evidenced the accumulation of Pb during MI and reduction in the level of Fe. A significant negative correlation was observed between Cu and creatine kinase-MB. The data were also segregated into various groups to study the influence of age and gender on the levels of selected parameters. In both the genders, the age of the patients was found to be correlated significantly with various cardiac enzymes. In case of male patients, the most significant correlation was observed between age and blood sugar at random. The other significant correlations among the male patients included Cr-CPK, Cr-creatine kinase-MB, Fe-age, and others. In female patients, the pairs of studied parameters that exhibited significant correlations included age-lactic dehydrogenase, creatine phosphokinase isoenzyme-aspartate aminotransferase, lactic dehydrogenase-creatine phosphokinase isoenzymes, Pb-Fe, and Cu-Co in addition to others. [ABSTRACT FROM AUTHOR]

Aim: Not only the progressive increase in indications for percutaneous transluminal coronary angioplasty (PTCA) attracts the attention, but also the myocardial damage that may develop after this technique. In this paper, the significance of cardiac markers in detecting myocardial damage following PTCA is discussed. Methods: 47 randomly selected patients, who have undergone PTCA procedure for different reasons, had blood analysis of cTnI and CK-MB levels before and after the procedure between 6 and 12 hours. Chemiluminescent Enzyme Immunoassay method was applied for cTnI and kinetic immunoinhibition method was applied for CK-MB. Results: Significant increase was found in levels of cTnI (p<0.0001) and CK-MB (p<0.05) after PTCA. A meaningful increase was detected in levels of cTnI, when compared to CK-MB in percentage. When patients were subgrupped as SAP, USAP and post MI angina according to PTCA indications, no difference was found in the elevation of cTnI and CK-MB levels (p=0.69, p=0.43). Conclusion: Subclinical minor complications may occur during PTCA procedure, such as lateral branch occlusion, distal microembolism, transient vascular occlusion, etc. This may cause minor cardiac damage, which may lead to an increase in the levels of cardiac markers. Cardiac troponins, especially cTnI, are more sensitive than CK-MB for the diagnosis of cardiac damage. [ABSTRACT FROM AUTHOR]

: ObjectivesTo examine the proportion of patients admitted to CCU because of chest pain with a negative quantitative troponin t-test (Cardiac reader; Roche), who despite the negative test, would fulfil the new myocardial infarction criteria. A second aim was to evaluate the clinical utility of troponin I.: Design and methodsTroponin T (Cardiac reader; Roche) was measured 12 h after the last chest pain episode. If Troponin T was negative the subjects were included in the study. All included subjects were also examined with troponin I (Stratus CS; Dade Behring) and troponin T at the central laboratory (Elecsys 2010) at the same time. 187 patients were included. CKMB was also measured 6 h after the last chest pain (Stratus CS; Dade Behring).: ResultsFifth teen patients (8.0%) fulfilled the criteria of myocardial infarction, despite a negative Troponin T (Cardiac reader; Roche). CKMB measures did not add useful diagnostic information. The sensitivity and specificity were 100% and 95.3%, respectively for troponin I, when 0.2 μg/L was used as cut off level for myocardial infarction.: ConclusionIn this low risk group, eight percent of the patients with a negative Troponin T (Cardiac reader; Roche) fulfilled the new criteria of myocardial infarction. Troponin I (Stratus CS; Dade Behring) appeared to be a reliable method in this group. [Copyright &y& Elsevier]

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To examine the clinical course of patients with acute myocardial infarction complicated by 'extension', we studied prospectively 141 patients who had been diagnosed as having acute myocardial infarction. The serum CKMB level of these patients was determined at 8-h intervals during the first 5 days following admission. The patients were classified into 3 groups. (1) Group A (early extension): patients who showed CKMB re-elevation before the CKMB values reached normal levels (28%). (2) Group B (late extension): patients who showed CKMB re-elevation after the normalization of serum CKMB levels (21%). (3) Group C (control group): patients without CKMB relevation (51%). Patients in group A showed the most unfavourable clincial course with a greater rate of haemodynamic deterioration compared with patients in the B or C groups, and a higher rate of recurrent ischemic pain. We found no significant differences in these parameters between the B and C groups. We were unable to find any risk factor associated with the development of extension. The pattern of the serum CKMB curve may allow a separation of two different subgroups of patients with acute myocardial infarct extension: patients with early extenstion, who show a high prevalence of haemodynamic deterioration, and patients with late extension, characterized by small infarcts and a benign clinical course. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate research is to investigate degree of electrical burns, the type of elektrical current, labaratory findings and length of the stay the hospital in Selcuk University Meram Medical School Emergency Department. Materials and Methods: In this retrospective study, thirty-three patients who were exposed to electrical injuries and treated at the Emergency department of Selcuk University Meram Faculty of Medicine between January 2007 and January 2009 were reviewed. The relationship between clinical course, degree of electrical burns and changes of laboratory findings in patients who had electrical injuries were investigated. Analysis of data revealed a correlation between elevated leukocyte, CK-MB and CK serum levels with the degree of electrical burns. Serum leukocyte, CK-MB and CK serum levels were determined on the second day following admission. Results: Mean age of these patients was 24 years. Of the patients, 31 (93.4%) were male and two (6.6%) were female and mean length of stay in hospital was 7 days. Electricians and industrial workers constituted 49% of these patients. Fourteen (42.3%) patients were exposed to high voltage and 19 (57.7%) to low voltage. It was detected that the relation between length of stay in hospital with degree of electrical burns, leukocyte and CK-MB serum levels. Conclusion: There is a relation between length of stay in hospital with degree of electrical burns, leukocyte and CK-MB serum levels. Therefore, using of these laboratory findings may provide a prognostic value for the clinical outcome of these patients. [ABSTRACT FROM AUTHOR]

This study retrospectively examined a consecutive series of patient CKMB samples for a relationship between age (242 subjects, aged from 20 to 96 years old), serum CKMB activity and corresponding mass results analyzed for CKMB-specific activity (activity per molecule, unit/mg). Patients were categorized into six age groups. The means for specific activity of CKMB, standard error and 95% confidence intervals of each group were calculated. CKMB-specific activity in human serum increases with age regardless of gender or MI severity. As this greater propensity for increased CKMB activity may be due to alteration in part due to protein modification of post-MI release in the blood circulation, these findings add further weight for the current move to the use of troponins and other markers of myocardial injury. [Copyright &y& Elsevier]

The quality control sera commonly available in market does not provide the value of CKMB. The CKMB kit of Randox laboratories contains two lyophilized control sera. But the stability of the control serum after reconstitution with 2ml of distilled water is 5 days at 2–8 degree Celsius, 8hrs at 25 degree Celsius and 4 weeks at-20 degree Celsius when frozen once. Hence stability after reconstitution is not sufficient to fulfill the daily need of a laboratory. In quest of a good internal quality assessment (IQA) sample trial run has been performed at 37 degree Celsius using external quality assessment (EQA) samples obtained from Randox international quality assessment sample (RIQAS). The trial run was found to be successful. [ABSTRACT FROM AUTHOR]

Background: The current study evaluated level of serum asymmetric dimethylarginine (ADMA) and its association to cardiac biomarkers in thalassemia patients for early diagnosis of abnormality in myocardial infarction., Subjects and Methods: This study was conducted on 80 subjects divided into four groups each with 20 subjects. Group I: Control: healthy subjects. Group II: Myocardial infarction: Patients with elevated serum troponin T. Group III: thalassemia patients. Group IV: thalassemia with myocardial infarction patients: Included 20 thalassemia patients with Myocardial infarction. Serum samples were subjected for assay of creatine kinase (CK:MB), Lactate dehydrogenase, troponin I, ADMA, Serum MDA level was determined., Results: Data obtained showed that serum CKMB, LDH1, AST, Troponin T and ADMA levels were significant elevated in MI with or without Thalassemia compared with control groups. Serum MDA was statistically significantly elevated in MI with or without Thalassemia compared with control groups. The serum level of troponin T showed an area under curve (AUC) of 0.92, (sensitivity 91.0 % and specificity, 88%). Also, the ADMA supported the diagnostic profile, showing an AUC of 0.85 with (sensitivity, 92.0%; specificity, 91,9%)., Conclusion: Serum ADMA is sensitive marker for incidence of MI in thalassemia patients.

Background: Zinc is one of the most important microelements in the body and zinc homeostasis plays a critical role in maintaining cellular structure and function. Zinc dyshomeostasis can lead to many diseases, such as cardiovascular disease. Our aim was to investigate whether there is a relationship between zinc and cardiac markers, and the risk of acute myocardial infarction (AMI) by zinc quartiles., Methods: We enrolled a total of 529 patients and measured their serum zinc levels and cardiac markers. We performed further studies after dividing subjects into four groups according to their concentrations of zinc by quartile to clarify the relationship between zinc levels and risk of increased acute myocardial infarction prevalence rate., Results: We observed that there was a significant inverse linear relationship between zinc and Lg(creatine kinase) (p=0.011), Lg(creatine kinase-MB) (p=0.002) and Lg(cardiac troponin T) (p=0.045). In addition, the acute myocardial infarction prevalence rates were 28.8%, 24.8%, 20.5%, and 18.2% by patients with zinc quartiles, respectively. Multivariate logistic regression analysis showed that the odds ratio between the lowest and highest zinc quartile groups was 1.92 (1.019-3.604) (p<0.05)., Conclusions: The present study revealed a relationship between serum zinc levels in that zinc levels were significantly inversely correlated with serum creatine kinase (CK), creatine kinase-MB (CKMB) and cardiac troponin T (cTnT) levels. Furthermore, we found that the prevalence rate of acute myocardial infarction decreased with increasing zinc quartiles., (Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.)

Purpose: To analyse the impact of four different definitions of acute myocardial infarction (AMI) on number of events and all-cause mortality after AMI., Methods: We retrospectively examined number of AMI events and mortality according to four different definitions of AMI, among 1494 patients admitted to Haukeland University Hospital in Norway from March 2002 to February 2003. Eligible for analysis were 815 patients with a discharge diagnosis of an AMI, and 679 patients without any AMI discharge diagnosis but with elevated cardiac troponin I level during admission., Results: Applying the WHO 1979 definition resulted in 566 definite AMIs among the 1494 patients and was used as reference. According to the other definitions, there were 455 (-20%) definite AMIs by the original troponin 'rise and fall' version of the ESC/ACC 2000 definition, 729 (+29%) by the troponin 'rise or fall' interpretation of the ESC/ACC 2000 definition, 761 (+34%) by the AHA 2003 definition, and 743 (+31%) by the Universal 2007 definition (all p < 0.001). The 28-day, 1-year, 5-year, and 8-year mortality for definite AMI applying the WHO 1979 definition was 12, 19, 32, and 40%, whereas applying the Universal 2007 definition resulted in a mortality of 14, 21, 35, and 43%, respectively., Conclusions: The change of definitions of AMI during the last decades has had a significant impact on the number of AMI events and a moderate impact on the AMI mortality among hospitalized patients., (© The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.)

Antibody-based tests are the primary technology used for clinical measurement of cardiac biomarkers in peripheral circulation. This article focuses on the principles of immunometric methods that have been applied to cardiac biomarkers of widespread clinical utility (CKMB, Troponins, and B-type natriuretic proteins) and of more recent clinical testing (ST2, Galectin-2, and myosin binding protein C). How these principles are applied in the design of immunometric assays and how they influence assay performance in quantifying cardiac biomarkers in biologic fluids (serum or plasma) is discussed., (Copyright © 2014 Elsevier Inc. All rights reserved.)