Latest Research on Cardiac Biomarkers : Nov 2020

Biosensors for cardiac biomarkers detection: A review

The cardiovascular disease (CVD) is considered as a major threat to global health. Therefore, there is a growing demand for a range of portable, rapid and low cost biosensing devices for the detection of CVD. Biosensors can play an important role in the early diagnosis of CVD without having to rely on hospital visits where expensive and time-consuming laboratory tests are recommended. Over the last decade, many biosensors have been developed to detect a wide range of cardiac marker to reduce the costs for healthcare. One of the major challenges is to find a way of predicting the risk that an individual can suffer from CVD. There has been considerable interest in finding diagnostic and prognostic biomarkers that can be detected in blood and predict CVD risk. Of these, C-reactive protein (CRP) is the best known biomarker followed by cardiac troponin I or T (cTnI/T), myoglobin, lipoprotein-associated phospholipase A(2), interlukin-6 (IL-6), interlukin-1 (IL-1), low-density lipoprotein (LDL), myeloperoxidase (MPO) and tumor necrosis factor alpha (TNF-α) has been used to predict cardiovascular events. This review provides an overview of the available biosensor platforms for the detection of various CVD markers and considerations of future prospects for the technology are addressed. [1]


Cardiac biomarkers and the case for point-of-care testing

Cardiovascular disease (CVD) is the single greatest cause of adult mortality in the western world and, consequently, places a massive burden on healthcare services and the economy. Lifestyles, lack of clearly defined risk assessment criteria, consistently high incidences of misdiagnosis and inappropriate referrals, all contribute significantly to this problem. It also correlates directly with inefficient or non-accessible early detection systems. Over the last decade much research has focused on the identification of cardiac biomarkers that can be used for the detection of cardiac distress and that add value to current risk stratification criteria. An exposition of some of the most consistently cited biomarkers is provided and their current status and potential value as early CVD risk predictors, more accurate diagnostic markers of acute myocardial damage and as reliable prognostic indicators, is evaluated. The particular importance of early prediction and the integral role that point-of-care (POC) testing is expected to play in the future of cardiac care is critically discussed. [2]

Cardiac biomarkers: a contemporary status report

The field of cardiac biomarkers has grown by leaps and bounds in the past two decades. In this review we try to summarize the explosion of emerging knowledge and address the roles of some of the biomarkers that have either proven or potential utility. We detail some of the markers of ischemia, hemodynamic markers of heart failure, inflammatory markers, and the novel and innovative approach of combining these for a multimarker strategy. At the end of this review we highlight some of the biomarker-guided approaches and strategies that might lead to better and more-effective care of patients. [3]


Evaluation of Cardiac Biomarkers in Detection of Cardiomyopathy Induced by Cardiotoxic Chemotherapeutic Agents

Background: Doxorubicin is a potent chemotherapeutic drug. The clinical usefulness of doxorubicin has been limited largely by the risk of cardiomyopathy and life-threatening heart failure. Therefore early identification of cardiotoxicity represents a primary goal for cardiologist and oncologist, considering the definition of personalized anticancer therapeutic strategies or intervention. The use of endomyocardial biopsy for detection of myocardial damage and monitoring of cardiac functions is troublesome in clinical practice.
Aim: So, evaluation of different cardiac biomarkers was performed to specifically detect myocardial injury and to predict ventricular dysfunction.

Methods: Fifty two adult AL patients (mean age 48.9±11.8 years, 25 males) treated with 2–6 cycles of chemotherapy (CT) containing cardiotoxic chemotherapeutic drugs were studied. Cardiac evaluation was performed at baseline, after first and last chemotherapy with cardiotoxic drugs and 6 months after chemotherapy.

Results: Mean baseline NT-proBNP (N-terminal pro brain natriuretic peptide) concentration was 109.3±42.7 pg/ml (slightly elevated in 6 patients). After first and last chemotherapy, NT-proBNP elevations to 317.8±147.6 pg/ml and 302.3±123.9 pg/ml were observed, respectively. Six months after CT, mean NT-proBNP concentration was 412.5±184.2 pg/ml (elevated in 32 patients). Changes in NT-proBNP were significant in comparison with the baseline values (p < 0.001). Six months after chemotherapy, four patients with marked NT-proBNP elevations during chemotherapy developed treatment-related cardiomyopathy with symptoms of heart failure. NT-proBNP correlated with systolic and diastolic LV dysfunction on echocardiography (r = 0.638; p < 0.01) and (r = 0.412; p < 0.01). hs-cTnT concentrations were negative (<10 pg/ml) during chemotherapy in all patients. Six months after chemotherapy, delayed hs-cTnT positivity occurred in 6 patients. CK-MB mass remained within the reference range in all patients.

Conclusion: The present study suggests that NT-proBNP in blood is better indicator for the detection of doxorubicin induced cardiotoxicity during the treatment and the follow-up than hs-cTnT, cTnI and CK-MB. [4]

Effect of Magnesium Sulphate on Cardiac Biomarkers in Pre-eclamptic Patients in Selected Tertiary Hospitals in Osun State South Western Nigeria

Aims: This study investigated the effect of Magnesium Sulphate (MgSO4) on cardiac biomarkers in the management of pre-eclampsia in selected tertiary hospitals in Osun State, Nigeria. This was with a view to provide scientific report for the use of MgSO4 in the management of pre-eclampsia, and also to investigate likely adverse effects of MgSO4 on the biological functions of the heart.

Study Design: One-factor, two controls – six test groups quasi – experimental design.

Place and Duration of Study: Department of Biochemistry, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria, between November 2013 and July 2014.

Methodology: A total of two hundred and sixty (260) subjects were recruited for the study, and were grouped into normotensive pregnant women at 2nd and 3rd trimesters (n=20/trimester), pre-eclamptic women not on MgSO4 at 2nd and 3rd trimesters (n=10/trimester) and pre-eclamptic women on MgSO4 at 2nd and 3rd trimesters (n=60/trimester). Also normotensive pregnant women at post-partum (n=20) and pre-eclamptic women on MgSO4 at post-partum (n=60). Blood samples (10 mL venous blood) were collected, centrifuged and stored as plasma before subjection to biochemical analysis. Blood plasma was analyzed for cardiac biomarker using standard Enzyme Linked Immunosorbent Assay (ELISA) and Spectrophotometric methods.

Results: Results revealed that cardiac biomarkers (plasma troponin, c-reactive protein and creatine) were significantly decreased in pre-eclamptic women on MgSO4 at both 2nd and 3rd trimesters compared to their counterparts not on MgSO4, while creatine-kinase, lactate dehydrogenase aspartate aminotransferase, and myoglobin showed non-significant reduction in same comparison. Moreover, with exception of lactate dehydrogenase that showed non-significant reduction, all cardiac biomarkers at 3-6 days post-partum decreased significantly compared to Pre-eclamptic Women on MgSO4 at 3rd trimester.

Conclusion: The results obtained from this work revealed that MgSO4 exhibits safe and protective roles devoid of any adverse effects on the hearts of pre-eclamptic women. This study further agrees with the existing usage of Magnesium Sulphate as an anti-convulsant in the management of pre-eclampsia. [5]

Reference

[1] Qureshi, A., Gurbuz, Y. and Niazi, J.H., 2012. Biosensors for cardiac biomarkers detection: A review. Sensors and Actuators B: Chemical, 171, pp.62-76.

[2] McDonnell, B., Hearty, S., Leonard, P. and O’Kennedy, R., 2009. Cardiac biomarkers and the case for point-of-care testing. Clinical biochemistry, 42(7-8), pp.549-561.

[3] Maisel, A.S., Bhalla, V. and Braunwald, E., 2006. Cardiac biomarkers: a contemporary status report. Nature Clinical Practice Cardiovascular Medicine, 3(1), pp.24-34.

[4] Datta, S., Pal, M., Ghosh, K., Mitra, R. and Kumar Pradhan, A. (2015) “Evaluation of Cardiac Biomarkers in Detection of Cardiomyopathy Induced by Cardiotoxic Chemotherapeutic Agents”, Journal of Cancer and Tumor International, 2(4), pp. 196-205. doi: 10.9734/JCTI/2015/19169.

[5] Olajide Awofadeju, S., Oloruntobi Imoru, J. and Fisayo Asaolu, M. (2016) “Effect of Magnesium Sulphate on Cardiac Biomarkers in Pre-eclamptic Patients in Selected Tertiary Hospitals in Osun State South Western Nigeria”, Cardiology and Angiology: An International Journal, 5(1), pp. 1-11. doi: 10.9734/CA/2016/24537.

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