| Objective:The concentration of cMyBP-C(cardiac myosin binding protein-c,cMyBP-C)in venous blood of patients with acute myocardial infarction(AMI)was measured to explore the potential of the protein as a new marker of myocardial infarction.Methods:From September 2018 to December 2018,120 patients with chest pain as the first symptoms within 24 hours were collected from the chest pain outpatient of Yan'an Hospital affiliated to Kunming Medical University.There were 40 patients with acute myocardial infarction(22 males and 18 females,average age of 59.60±10.46 years),20 cases in angina pectoris group(11 males and 9 females,average age 65.15±8.47 years)and 60 non-cardiac chest pain groups(33 males and 27 females,average age 60.34±8.24 years).30 healthy volunteers were selected as control group(19 males,11 females,average age 51.13±6.69 years).All patients with chest pain were treated with elbow venous blood immediately after admission and blood again at 3 hours after admission.The concentrations of cMyBP-C and cTnI were measured by ELISA and chemiluminescence respectively in the healthy control group.The experimental data were analyzed by SPSS 22.0.Results:1?The concentrations of cMyBP-C and cTnI:(1)The concentrations of cMyBP-C:the concentrations of cMyBP-C in acute myocardial infarction group,angina pectoris group and non-cardiogenic chest pain group were(228.99± 109.53)ng/ml,(91.98±19.07)ng/ml,(100.62±38.59)ng/ml,and(90.98±21.60)ng/ml.There were significant differences in the concentrations of cMyBP-C between the four groups,P<0.01.The concentration of cMyBP-C in acute myocardial infarction group was higher than that in control group,P<0.01.There was no significant difference in cMyBP-C concentration between angina pectoris group,non-cardiogenic chest pain group and control group,P>0.05.(2)The concentrations of cTnI:the concentrations of cTnl in acute myocardial infarction group,angina pectoris group and non-cardiogenic chest pain group were(1.25 ±1.23)ng/ml,(0.024 ±0.020)ng/ml,(0.024±0.015)ng/ml and(0.02±0.01)ng/ml.There were significant differences among the four groups,P<0.01.The concentration of cTnI in acute myocardial infarction group was higher than that in control group,P<0.01.There was no significant difference between angina pectoris group,non-cardiogenic chest pain group and control group,P>0.05.2?The correlation analysis between the concentrations of cMyBP-C and cTnI:there was a positive correlation between the concentrations of cMyBP-C and cTnI co(correlation coefficient R=0.892,linear regression equation:y=91.842x+99.694).3?ROC curve analysis of cMyBP-C:for the diagnosis of acute myocardial infarction whose onset time was less than 24 hours,cMyBP-C had high accuracy in the diagnosis of acute myocardial infarction(AUC under cMyBP-C curve was 0.954).By calculating Youden index,the optimal threshold concentration for differential diagnosis of acute myocardial infarction by cMyBP-C was 121.35 ng/ml,the sensitivity was 92.5%,and the specificity was 90.0%.4?The results of each subgroup:(1)Comparison of cMyBP-C,cTnI concentration before and after emergency PCI:35 of 40 patients with acute myocardial infarction underwent emergency PCI after admission.The concentration of cMyBP-C before and after operation was(228.68± 101.44 ng/ml?99.02±37.84 ng/ml,P<0.01),and the concentration of cMyBP-C decreased significantly after operation.The concentration of cTnI before and after operation was(1.28 ± 1.20 ng/ml,31.13±21.42 ng/ml,P<0.01),and the concentration of ctni increased after operation.(2)Comparison of cMyBP-C,cTnI concentration in patients with acute myocardial infarction with onset time less than 4 hours:a total of 9 patients with acute myocardial infarction with onset time less than 4 hours were enrolled in the acute myocardial infarction group.The concentration of cMyBP-C measured immediately after admission in 9 cases was significantly higher than that in the control group(130.23±28.26 ng/ml,90.98±21.60 ng/ml,P<0.01).However,there was no significant difference in cTnI concentrations between the two groups(0.03±0.01 ng/ml,0.02 ±0.01 ng/ml,P>0.05).(3)The concentration of cMyBP-C,cTnl in each subgroup of non-cardiogenic chest pain group:? The concentration of cMyBP-C in aortic sandwich group was(141.218±68.439 ng/ml),which was higher than the control group(P<0.01).The concentration of cMyBP-C in acute pancreatitis group was(104.004±18.519 ng/ml),pulmonary embolism group was(117.545±73.446 ng/ml),pneumonia group was(85.761 ±1.480 ng/ml),esophagus group was(82.827±8.786 ng/ml),bronchitis group was(91.815±10.078 ng/ml),lung cancer group was(88.350±16.778 ng/ml),cardio neurosis group was(87.882±11.584 ng/ml),pneumothorax group was(78.478±10.684 ng/ml),pleurisy group was(91.845±8.519 ng/ml).There was no significant difference in the concentration of cMyBP-C between the above nine groups and the control group(P>0.05).?The concentration of cTnl in aortic sandwich group was(0.036 10.026 ng/ml),which was higher than that in the control group(P<0.01).The concentration of cTnl in acute pancreatitis group was(0.028±0.009 ng/ml),pulmonary embolism group was(0.033±0.023 ng/ml),peumonia group was(0.017±0.006 ng/ml),esophagus inflammation group was(0.016±0.009 ng/ml),bronchitis group was(0.026±0.005 ng/ml),lung cancer group was(0.015±0.007 ng/ml),cardiac neurosis group-was(0.021±0.008 ng/ml),pneumothorax group was(0.020±0.014 ng/ml),pleurisy group was(0.012±0.004 ng/ml).There was no significant difference in the concentration of cTnl between the above nine groups and the control group(P>0.05).Conclusions:1.cMyBP-C increased significantly after acute myocardial infarction,and its elevated level was positively correlated with cTnl,and cMyBP-C increased within 4 hours after myocardial necrosis,which was earlier than that of cTnI.2.The optimal threshold concentration for differential diagnosis of acute myocardial injury was 121.35 ng/ml,the sensitivity was 92.5%,and the specificity was 90.0%.The accuracy of diagnosis of acute myocardial injury was high.3.The concentration of cMyBP-C in patients with acute myocardial infarction after emergency PCI was significantly lower than that before operation.cMyBP-C can be used as an early index to evaluate the condition and effect of PCI.4.cMyBP-C was similar to cTnI in myocardial injury and even necrosis caused by other diseases.cMyBP-C was more sensitive to minimal myocardial injury and myocardial necrosis. |
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