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Ingenuous interpretation of elevated blood levels of macromolecular markers of myocardial injury: a recipe for confusion.

Abstract：

:Several assumptions about elevations of macromolecular markers of myocardial injury in blood require critical consideration. The dichotomy of modest, persistent elevations of troponins I and T as prognostic factors in patients with unstable angina and absent elevations of isoenzymes of creatine kinase is presently unexplained. Factors influencing the appearance of macromolecular markers of myocardial injury in blood are considered, including the need to estimate baseline values, to consider elevations as deviations from baseline rather than simply points within a distribution of baseline values in normal subjects, to recognize operative biochemical and physiologic determinants of marker release from injured myocytes and washout and to take into account the influence of apoptosis. Elucidation and consideration of mechanisms underlying the appearance of specific macromolecular markers in blood appear likely to improve diagnosis and explain the prognostic power of the troponins in patients with unstable angina. Detection of proteolytic breakdown products of troponins in blood is likely to explain the modest, persistent elevations seen in some patients with unstable angina and their prognostic implications.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Sobel BE,LeWinter MM

doi

10.1016/s0735-1097(00)00516-7

subject

Has Abstract

pub_date

2000-04-01 00:00:00

pages

1355-8

issue

5

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(00)00516-7

journal_volume

35

pub_type

杂志文章,评审

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