Acute Myocardial Infarction Risk Factors and Correlation of its Markers with Serum Lipids

Myocardial Infarction (MI) is a term which is used for defining the necrosis in the heart muscle due to the lack of the oxygen need of myocardium which cannot be supplied by the coronaries. It is characterized by chest pains or discomfort which may travel into the shoulder, arm, back, neck or jaw [1,2]. Acute myocardial infarction (AMI) is considered more appropriately part of a spectrum referred to as acute coronary syndromes, which also includes unstable angina and non-ST-elevation. Patients with ischemic discomfort may or may not have ST-segment elevation. Most of those with ST-segment elevation will develop Q waves. Those without ST elevations will ultimately be diagnosed with unstable angina based on the presence of cardiac enzymes. Approximately 90% of myocardial infarction results from an acute thrombus that obstructs an atherosclerotic coronary artery [3]. The highest risk of fatality occurs within the initial hours of onset of AMI. Thus, early diagnosis of cardiac ischemia is critical for the effective management of patients with AMI. Improper diagnosis of patients with chest pain often leads to inappropriate admission of patients without AMI and vice versa. In addition to clinical history, physical examination, accurate electrocardiogram findings and assessment of cardiac biomarkers have an important role in the early diagnosis of acute ischemia. The analysis of cardiac biomarkers has become the frontline diagnostic tools for AMI, and has greatly enabled the clinicians in the rapid diagnosis and prompt treatment planning, thereby reducing the mortality rate to a great extent [4]. There are some cardiac markers that can be used in the diagnosis of myocardial infarction among them include, aspartate transaminase, alanine transaminase, troponin I, creatine kinase, etc. Creatine kinase (isoenzymes CK-MB) is the enzyme used as a definitive serum marker for the diagnosis or exclusion of acute myocardial infarction [2,5]. Lactate dehydrogenase, creatine kinase and their isoenzymes exhibited better cardiac specificity. After the discovery that cardiac troponins I and T have the desired specificity, they have replaced the cytosolic enzymes in the role of diagnosing myocardial ischemia and infarction. The use of the troponins provided new knowledge that led to revision and redefinition of ischemic myocardial injury as well as the introduction of biochemicals for estimation of the probability of future ischemic myocardial events. These markers, known as cardiac risk markers, evolved from the diagnostic markers such as CK-MB or troponins, but markers of inflammation also belong to these groups of diagnostic chemicals [6]. The markers that are well suited for the early diagnosis of AMI within the time interval 0-6 hours after symptom onset are myoglobin, H-FABP and CK-MB Volume 3 Issue 4 2017