Normal Cardiac Troponin T Serum Concentrations Identify Non-Car-Diac Origin Of Ck-Mb Isoenzyme
Mahidol University Annual Research Abstracts 82 Faculty of Medicine Siriraj Hospital Accurate measurements of low-density lipoprotein (LDL) cholesterol are essential in the management of patients with atherosclerotic cardiovascular disease.
Since the conventional method of calculating LDL cholesterol by the Friedewald equation has several methodological limitations, the use of a novel and simple method for estimation of non-high-density lipoprotein (non-HDL) cholesterol concentration was recently proposed as a tool for assessing cardiovascular risk. In the present study, the associations of non-HDL cholesterol with apolipoprotein B-containing lipoproteins [LDL and lipoprotein (a)] and other lipid parameters were examined in 103 middle-aged apparently healthy individuals. The results revealed a strong correlation between levels of non-HDL cholesterol and those of total cholesterol (r = 0.942), LDL cholesterol (r = 0.
943) and total cholesterol : HDL cholesterol ratio (r = 0.744). Similarly high correlation coefficients were obtained from individuals with triglyceride levels of more than 140 mg/dl (n = 35). In contrast to LDL cholesterol, non-HDL cholesterol also showed significant correlations with triglycerides and HDL cholesterol in the total study population.
Levels of lipoprotein (a), on the other hand, did not exhibit association with any of the lipid and lipoprotein variables measured in this study. In conclusion, non-HDL cholesterol may provide a surrogate for calculated LDL cholesterol in assessing the risk of cardiovascular disease, particularly in individuals with high triglyceride levels. (Siriraj Hosp Gaz 2000 ; 52 : 793-99) NORMAL CARDIAC TROPONIN T SERUM CONCENTRATIONS IDENTIFY NON-CAR-DIAC ORIGIN OF CK-MB ISOENZYME : CASE REPORT (NO. 204) Kosit Sribhen, Sudcharee Kiartivich Department of Clinical Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Key words : Troponin T, CK-MB A case of patient with prolonged substernal chest pain and constant increased activities of creatine kinase (CK) MB isoenzyme serially determined for many days without a typical rise and fall was reported. This unusual pattern of CK-MB has led to determinations of cardiac troponin T (cTnT) concentration in the same blood specimens, all of which were in the normal range. The presumptive diagnosis of a significant myocardial damage could thus be ruled out. The presented case should demonstrate the usefulness of the sensitive and specific cTnT as a reliable marker for the biochemical differential diagnosis of patients presenting with acute chest pain.
(Thai Heart J 2000 ; 13(1): 21-24.) LIPOPROTEIN PROFILE AND MYOCARDIAL MARKER PROTEINS LEVEL IN THALASSEMIC PATIENTS (NO. 205) Kosit Sribhen1, Nisarat Opartkiattikul1, Sudcharee Kiartivich1, Pensri Pootrakul2, Suphachai Chaithiraphan3 1Department of Clinical Pathology, 2Thalassemia Research Center, Institute of Sciences and Technology for Research and Development, 3Her Majestys Cardiac Centre, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand. Key words : Lipoprotein, Myocardia markers, Thalassemia Biochemical assessment of cardiac damage in thalassemic patients has thus far rarely been reported.
In the present study, determination of lipoprotein profile as well as measurement of the enzymatic activity of creatine kinase (CK), its isoenzyme CK-MB and cardiac specific contractile protein troponin T (cTnT) concentration were performed on 18 patients with hemoglobin H (HbH) and 25 with beta-thalassemia/hemoglobin E (b-thal/HbE) disease using automated analyzers. The results have revealed a moderate to marked degree of hypocholesterolemia in both patient groups, with mean total cholesterol levels of 117 and 104 mg/dl in HbH and b-thal/HbE disease, respectively. In addition, patients in the latter group constantly exhibited low levels (mean concentration = 18 mg/dl) of high density lipoprotein (HDL) cholesterol. Whereas reduced activity of CK was a constant finding in b-thal/HbE subjects, detectable serum concentrations of cTnT were observed in the majority of these patients, with 2 of them showing slightly increased values above the upper reference limit of 0.
10 ng/ml indicative of minor myocardial injury. In conclusion, b-thal/HbE disease was biochemically characterized by significantly reduced serum levels of HDL cholesterol and detectable cTnT concentrations, the pathophysiological association of which deserves further clinical investigations. (Thai Heart J 2000; 13(2) : 43-49.) CHLAMYDIA PNEUMONIAE ANTIBODIES AND ANGIOGRAPHICALLY DEMONSTRATED CO- RONARY ARTERY DISEASE IN THAILAND (NO.
206) Wattana Leowattana1, Kiertijai Bhuripanyo2, Sudcharee Kiartivich1, Nithi Mahanonda2, Sasikant Pokum1 1Department of Clinical Pathology, 2Her Majestys Cardiac Center, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand. Key words: Chlamydia Pneumoniae antibodies, CAD, Coronary Angiography Recent reports have suggested an association between Chlamydia pneumoniae and coronary artery disease. This study investigated the relationship between the presence of immunoglobulin G (IgG), immunoglobulin A (IgA) of C. pneumoniae in angiographically diagnosed coronary disease.
Patients enrolled were 243 (178 male, 65 female, mean age 6110 years) with angiographically proven at least one significant coronary artery stenosis. Fifty-eight patients (33 male, 25 female, mean age 5711 years) with no angiographic evidence of coronary lesions were used as the normal coronary angiogram group. Control subjects (95 male, 92 female, mean age 5817 years) were used as normal healthy persons who had no history of coronary artery disease. C.
pneumoniae IgG and IgA antibodies were measured by ELISA method. We found that 179 out of 243 (73.7%) coronary artery disease (CAD) patients were positive for IgG and 132 out of 243 (54.3%) were positive for IgA.
In 58 normal coronary angiogram patients, 23 (39.7%) cases
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