RESUMEN
OBJECTIVE: To determine the role of heart fatty acid-binding protein in early detection of non-ST-elevation myocardial infarction and its comparison with two other cardiac markers. METHODS: The cross-sectional study was conducted at Abbasi Shaheed Hospital, Karachi, from June 2012 to June 2014, and comprised patients presenting at the emergency department within two hours of chest pain and who were subsequently referred to the cardiology department with a provisional diagnosis of either unstable angina or non-ST-elevation myocardial infarction. Relevant history was taken on a specific proforma and electrocardiogram as well as routine investigations were done in the emergency department. Blood samples from the subjects were tested for the diagnosis of myocardial infarction through detection of heart fatty acid-binding protein, Troponin-I and Creatine kinase-myocardial band. Sensitivity and specificity of the three markers were calculated keeping coronary angiography as the gold standard. Data was analysed using SPSS 17. RESULTS: Out of 250 patients, 153(61.2%) were males. The overall mean age was 54.45±13.92 years. Sensitivity and specificity of heart fatty acid-binding protein were 80.6% and 78.5% (p<0.05), for Troponin-I, 37.7% and 75% (p>0.05), and for Creatine Kinase-myocardial band, 29.5% and 67.8% (p>0.05). CONCLUSIONS: Heart fatty acid-binding protein was found to be a good diagnostic tool for the detection of non-ST-elevation myocardial infarction.
Asunto(s)
Infarto del Miocardio , Infarto del Miocardio sin Elevación del ST , Adulto , Anciano , Biomarcadores , Forma MB de la Creatina-Quinasa , Estudios Transversales , Proteína 3 de Unión a Ácidos Grasos , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/diagnóstico , Sensibilidad y EspecificidadRESUMEN
OBJECTIVE: To determine association between patient's symptoms and incidence of arrhythmia on 24-hour electrocardiographic Holter monitoring. STUDY DESIGN: A cross-sectional descriptive study. PLACE AND DURATION OF STUDY: The Cardiology Department, Liaquat National Hospital, Karachi, from January to June 2007. METHODOLOGY: Patients above 15 years of age, of either gender, referred for Holter monitoring with symptoms of palpitations, dizziness and syncope were evaluated for arrhythmia. The symptoms were documented by the patients in their symptom diaries (historical logs) during Holter monitoring. Patients who had permanent pacemaker implants were excluded. Descriptive statistics were used to calculate the frequencies and percentages of different symptoms, different arrhythmias were noted on Holter monitoring and the age of patients was noted. Chi-square test was applied to calculate p-values with significant at value less than 0.05. RESULTS: The mean age of patients was 53.71 +/- 15.52 years. There were 54% females and 46% males. Eighty two percent had documented arrhythmias on their Holter monitoring reports. The complaints for which patients were referred included dizziness in 24%, palpitations in 61% and syncope in 15%. On analysis of the historical logs of patients only 64% had symptoms during Holter monitoring and 23% had concurrence of their symptoms with an arrhythmia. Patients who had sinus exit block (p=0.02) and sinus arrest (p=0.002) had significant association with arrhythmia. Twenty percent patients with dizziness, 50% patients with palpitations and 12% of patients who presented with syncope had documented arrhythmias. CONCLUSION: Twenty four hour Holter monitoring is an important investigation for evaluation of patients with palpitation, dizziness and syncope. Arrhythmias were detected frequently in both symptomatic and asymptomatic patients. One must be careful to avoid attributing a symptom to an arrhythmia until a close temporal relationship is demonstrated.