Abstract
BackgroundNo information is available on the optimal sampling time to catch the highest increase for biomarkers whose elevation after ST-elevation myocardial infarction (STEMI) is prognostic for adverse events. This study aimed to investigate release kinetics and peak times of cardiac troponin I (cTnI), C-reactive protein (CRP), B-type natriuretic peptide (BNP), chromogranin A (CgA) and cystatin C (CyC) in STEMI patients undergoing primary percutaneous coronary intervention (PPCI). MethodsBlood concentrations of cTnI, CRP, BNP, CgA and CyC were measured before and 6h, 24h, and 48h after PPCI in 84 STEMI patients. The averaged trajectory of marker kinetics was estimated by multivariable regression models adjusted for patient characteristics and orthogonal polynomials were used to describe related releases. ResultsFrom the estimated kinetics cTnI peaked at 10h from symptoms, BNP at 28h and CRP within 30h. CyC concentrations did not change, whereas CgA concentrations increased from 6 to 48h after PPCI. The amount of BNP release was found to be affected by the interaction between gender and age: females<75years had BNP concentrations fourfold higher than males. ConclusionsAccording to different release kinetics a single blood sampling for measuring all biomarkers is not recommended.
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