Serum Uric Acid Could Differentiate Acute Myocardial Infarction and Unstable Angina Pectoris in Hyperuricemic Acute Coronary Syndrome Patients.

INTRODUCTION: Serum uric acid (SUA) is the final product of purine metabolism in humans. AIM: The present study aimed to identify a potential association between serum UA and cardiac troponin I (cTnI) levels and to find out whether uric acid could differentiate patients presenting with the acute myocardial infarction (AMI) and unstable angina pectoris (UAP) in hyperuricemic and normouricemic acute coronary syndrome (ACS) patients. METHODS: Eighty ACS patients, aged 50-83 years, were enrolled in the study, 40 of them presenting with AMI and 40 with UAP. Frequency of patients with serum uric level over threshold for hyperuricemia was investigated and two groups of patients were formed such as hyperuricemic and normouricemic groups (A and B groups, respectively) independently of type of ACS. Those groups of patients were also subjected to cTnI measurement. RESULTS: Levels of SUA are associated with the type of ACS in the hyperuricemic ACS patients (AMI versus UAP, 499(458-590), 425(400-447) mmol/L, p=0.007, respectively). Uric acid correlated significantly with cTnI, moderate positively in the group A (rho=0.358, p=0.038) and moderate negatively in the group B (r=-0.309, p=0.037) of ACS patients. Multiple logistic regression analysis revealed that cTnI and age were independently associated with the SUA levels in the group A of ACS patients. CONCLUSIONS: Serum uric acid differentiates AIM and UAP patients in hyperuricemic group of acute coronary syndrome. Therefore it can be used as nonspecific parameter for evaluation of the myocardial lesion extent only in hyperuricemic ACS patients. This is supported by finding that cTnI along with age predicts SUA level in hyperuricemic ACS patients.

Cytogenetic Abnormalities Found in Patients with Reproductive Problems.

INTRODUCTION: One of the important causes of male infertility is aberration at the chromosomes. AIM: The main purpose of this study was to determine the frequency and types of chromosomal aberration in infertile/sterile men whose samples were analyzed in the Center for Cytogenetics of Faculty of Medicine University of Sarajevo in the last four years. METHODS: A total of 353 infertile/sterile men, between the ages of 22-55 years, referred for cytogenetic analysis to the Center for Genetics of Faculty of Medicine during the period 2013-2016. Karyotyping was performed on peripheral blood lymphocytes by using the Giemsa trypsin banding (GTG) technique. RESULTS: The structural and numerical chromosomal aberration in infertility/ sterility of men found with the incidence of 6% (20/353). Out of the 20 patients with abnormal cytogenetic diagnosis, structural chromosome abnormalities were observed in 17 (85%) patients and 3 (15%) with numerical aberrations. The type of aberrations mostly found were Robertsonian and reciprocal translocations (35%, 35%, respectively). CONCLUSIONS: The incidence of chromosomal abnormalities in infertile/sterile males suggests that the cytogenetics analysis is an important in male infertility, especially if it will be used for the purpose of assisted reproduction techniques.

Association of Parental Age and the Type of Down Syndrome on the Territory of Bosnia and Herzegovina.

BACKGROUND: Advanced paternal and/or maternal age is a classic risk factor for Down syndrome. The aim of the study was to investigate the frequency of Down syndrome types in children and its association with maternal and paternal age in Bosnia and Herzegovina. SUBJECTS AND METHODS: The cross sectional, observational study included 127 children, 49 girls and 78 boys, aged 1-180 months suspected to have Down syndrome, admitted to the Centre for Genetics, Faculty of Medicine University of Sarajevo, for cytogenetic analysis and differential diagnosis of Down syndrome during the period from January 2010 to May 2015. Standard method of 72 hours cultivation of peripheral blood lymphocytes has been applied. The accepted level of statistical significance was p<0.05. STUDY RESULTS: The most common type of Down syndrome was standard trisomy (86.6%), comparing to translocation and mosaicism (7.1%; 6.3%, respectively). The highest frequency of Down syndrome cases was in mother and father's group from 30-39 years old (57; 57 children, respectively) compared to mother and father's groups with younger than 30 (44; 29, respectively) and 40 and older (26; 41, respectively). The significant difference was found in maternal age between translocation and mosaicism groups (p=0.036). Difference between parental years and type of Down syndrome was significant when Standard trisomy 21 and translocation (p=0.045), as well as mosaicism and translocation (p=0.036), were compared. CONCLUSION: The most common type of Down syndrome was standard trisomy 21, with highest occurrence in parents from 30 to 39 years old. Parents were the youngest in translocation group. Obtained results suggest that multidisciplinary approach to identifying the trigger for trisomy appearance and the influence of maternal age is required.

Dilemma: Correlation Between Serum Level of Hepcidin and IL-6 in Anemic Myeloma Patients.

INTRODUCTION: Anemia occurs in 60% to 80 % of patients with newly diagnosed myeloma multiplex (MM). The cause of anemia in MM is probably multi factorial and involved among the others hepcidin and some cytokines, especially interleukine-6. Anemia in MM is one of the risk factor used in Durie-Salmon classification for staging and prognostic score. Treatment options are set according to this score with most significant impact on survival. AIM: To estimate baseline level of serum hepcidin, IL-6 and iron metabolism markers in anemic MM patients, possible role of hepcidin and its interaction with IL-6. METHODS: 27 patients with newly diagnosed MM were enrolled in this observational, prospective study and age, gender matched 60 healthy controls. Erythrocyte count, hemoglobin, serum hepcidin, interleukin-6, iron, ferritin and transferrin were measured. RESULTS: Anemia was diagnosed in 70% of MM patients. Serum hepcidin was significantly higher in MM group (55.5 ng/mL) than in control 5.9 ng/mL (p=0000). In myeloma patients serum IL-6 was 3.59 pg/mL, anemic 3.80 pg/mL, non-anemic 0.33 pg/mL, without significant difference. It was not found significant correlation between hepcidin and IL-6 in anemic myeloma patients. CONCLUSION: High level of hepcidin probably causes anemia in MM but its high expression is not due only to IL-6.

Renalase Gene rs2576178 Polymorphism in Hemodialysis Patients: Study in Bosnia and Herzegovina.

INTRODUCTION: Renalase is a protein secreted in kidneys and considered as a blood pressure modulator. High rates of hypertension and its regulation in patients on hemodialysis demands search for potential cause and treatment. The aim of this study was to determine the genotype and allele frequencies of renalase gene rs2576178 polymorphism in population from Bosnia and Herzegovina. Also, the objective of present study was to find the possible association between renalase gene rs2576178 polymorphism and hypertension in patients on hemodialysis. MATERIAL AND METHODS: The genotype of renalase gene rs2576178 polymorphism was determined in 137 participants (100 patients on hemodialysis and 37 controls), using polymerase chain reaction (PCR) and subsequent cleavage with MspI restriction endonuclease. Genotype and allele frequencies were assessed for Hardy-Weinberg equilibrium using a Chi-squared test. The value of P<0.05 was considered as statistically significant. RESULTS: Comparison of genotype distribution and allele frequency in participants on hemodialysis with and without hypertension, and healthy control showed no statistical difference. CONCLUSION: The results of the study suggest that renalase gene rs2576178 polymorphism is not a factor that influences blood pressure in patients on hemodialysis.

Influence of Malondialdehyde and Matrix Metalloproteinase-9 on Progression of Carotid Atherosclerosis in Chronic Renal Disease with Cardiometabolic Syndrome.

Objective was to assess whether the concentration of malondialdehyde (MDA) as a marker of lipid peroxidation and serum concentration of matrix metalloproteinase-9 (MMP-9) are involved in the process of atherosclerosis in chronic kidney disease (CKD) patients nondialysis-dependent and those on peritoneal dialysis (PD), both with signs of cardiometabolic syndrome (CMS). Thirty CKD and 22 PD patients were included in a study. All observed patients were divided into three subgroups depending on the degree of atherosclerotic changes in the carotid arteries (CA). Severity of atherosclerotic changes in the CA was evaluated by ultrasonography. We confirmed significantly lower level of serum MDA throughout all the stages of atherosclerosis in PD patients compared with observed CKD patients (P < 0.05) and increased serum concentration of MDA and MMP-9 with the progression of severity atherosclerotic changes in both groups of patients. The multiple regression analysis revealed that MDA and MMP-9 are significant predictors of changes in IMT-CA CKD patients (P < 0.05) and plaque score on CA in these patients (P < 0.05). The results suggest that MDA and MMP-9 could be mediators of CKD-related vascular remodeling in CMS.

Heat-related biomarkers: Focus on the correlation of troponin I and 70 kDa heat shock protein.

Heat-related biomarkers: Focus on the correlation of troponin I and 70 kDa heat shock protein Abstract Introduction: There is intensive research related to the forensic importance of biomarkers that would be the standard for postmortem damage to cardiomyocytes and the mechanism of the resulting damage. The aim of the research was to examinate the forensic-medical significance of serum levels of biomarkers as detectors of terminal hyperthermic damage to the myocardium. MATERIAL AND METHOD: 40 laboratory animals were divided into groups: the first group was the control (n = 8) exposed to a physiological temperature of 37 °C, the second group was divided into two subgroups: antemortem (n = 8) and postmortem (n = 8), which included a exposure temperature of 41 °C and the third group was divided into two subgroups: antemortem (n = 8) and postmortem (n = 8), which included a exposure temperature of 44 °C. The concentration of cardiac TnI and Hsp70 was resoluted in serum by immunochemical enzyme-labeled immunoabsorption method. RESULTS: A positive correlation was found between the temperature measured at the time of death and the serum values of cTnI (p = 0.02), in G41, and Hsp70 values did not significantly correlate with the core temperature in this group, p > 0.005. A positive correlation was significant between the concentration of Hsp 70 and the body temperature of rats in the group of rats with a fatal outcome was determined, p = 0.03. CONCLUSION: Changes in the concentration of cTnI and Hsp70 in rat serum may indicate hyperthermic damage to the myocardium in the Wistar rat model of heat stroke.

CRP/HDL-C and Monocyte/HDL-C ratios as Predictors of Metabolic Syndrome in Patients With Type 2 Diabetes Mellitus.

Background: Metabolic syndrome (MetS) denotes a cluster of co-occurring medical conditions associated with regulating hyperglycemia and acute cardiovascular events and complications. The escalating frequency of MetS among individuals afflicted with type 2 diabetes mellitus (T2DM) underscores its burgeoning significance as a critical public health concern and a complex clinical conundrum. Timely identification is imperative to avert the expedited progression of diabetic complications. Objective: To investigate the role of CRP/HDL-C and Monocyte/HDL ratios in predicting MetS in T2DM individuals. Methods: The study was designed as a two-year prospective study and included 80 T2DM patients divided into MetS and non-MetS groups based on MetS development over two years. The patients' serums were analyzed for complete blood count parameters, lipid profile, and C-reactive protein (CRP). Based on the laboratory test results, Monocyte/HDL-C and CRP/HDL-C ratios were calculated and analyzed. The receiver operating characteristic (ROC) curve and their corresponding areas under the curve (AUC) were used to determine prognostic accuracy. Results: Monocyte/HDL-C ratio and CRP/HDL-C ratio were significantly higher in MetS-T2DM2 than in nonMetS-T2DM (p=0.003 and p=0.029, respectively). The results of ROC curve analysis have shown that the CRP/HDL-C ratio (AUC of 0.695) and Monocytes/HDL-C ratio (AUC of 0.645) can serve as good predictors of MetS in T2DM patients. Conclusion: This study confirms the reliability of the Monocytes/HDL-C and CRP/HDL-C ratios as novel, simple, low-cost, and valuable predictors of MetS development in T2DM.

Fasting state requirements for blood sampling: a survey of patients in Cantonal Hospital Zenica, Bosnia and Herzegovina.

Aim To explore patient's awareness and appliance of the fasting state requirements for blood sampling. Methods This observational survey was performed at the Department of Medical Biochemistry and Immunology Diagnostics, Cantonal Hospital Zenica, from June to July 2019. An anonymous questionnaire was conducted on 200 consecutive outpatients older than 18, who were admitted to the laboratory for routine blood testing. Results A total of 134 (67%) patients were informed that they needed to be at fasting to perform laboratory tests. Patients were mostly informed by a requesting physician or a nurse, 68 (50.8%), and by other patients, members of the family and friends, 58 (43.3%); only seven (5.2%) patients were informed in the laboratory. A total of 75 (37.5%) patients arrived to the laboratory properly prepared. Conclusion Most patients were not well informed about fasting state requirements for blood sampling and consequently they were not adequately prepared for laboratory tests. Laboratory should establish updated fasting recommendations available to patients and healthcare professionals, and conduct continuing education of patients and health care staff.

Could the neutrophil-to-lymphocyte ratio serve as a marker in the diagnosis and prediction of acute appendicitis complications in children?

INTRODUCTION: Acute appendicitis (AA) is the most common surgical condition of the abdomen in children. The aim of this study was to analyse the possible use of the neutrophil-to-lymphocyte ratio (NLR) in the diagnosis and prediction of AA complications in children. MATERIAL AND METHODS: We included 170 AA patients under 15 years of age, who were divided into the following groups: Group 1 - non-operated patients with AA, and Group 2 - patients who underwent appendectomy. Based on pathologic grades of AA, Group 2 was subdivided into: Group A - phlegmonous, Group B - gangrenous, and Group C - perforated AA. NLR was calculated as the absolute neutrophil count divided by the absolute lymphocyte count. RESULTS: In Group 2 NLR was significantly higher than in Group 1 (5.5 (1.9-9.9) vs. 2.3 (1.2-3.7); p < 0.001). A significant difference in NLR was found between Group C and Group A (p < 0.001), and as well as between Group B and Group A (p = 0.001). The determined optimal cut-off value of NLR in differentiating Group 1 vs. Group 2 was ≥ 3.48 (p < 0.001). In differentiating Group A from Group C the optimal cut-off value of NLR was ≥ 5.61 (p < 0.001). Furthermore, optimal cut-off value of NLR in differentiating Group A from Group B was ≥ 5.45 (p = 0.001). CONCLUSIONS: The obtained results suggest that NLR could be used as a simple and reliable test in the diagnosis and prediction of AA complications in children. However, to draw definite conclusions on the predictive power of NLR as a marker of AA large multicentric studies are required.

The importance of plasma ferritin values in blood donors for the evaluation of body iron store in a five-month period.

Aim To present haemoglobin and ferritin parameters in donors to highlight the importance of serum ferritin testing for the purpose of evaluating iron depots in order to make recommendations for preserving a population of blood donors. Method A prospective study was conducted on 80 blood donors divided in two groups: group I (regular donors, n =40) and group II (irregular donors, n=40). Haemoglobin and ferritin were measured twice every 45 days, before two consecutive blood donations. Results By measuring haemoglobin and ferritin values before donation in both groups, a decrease of initial ferritin value in Group I relative to Group II was observed (without statistical significance). A significant decrease was found between repeated measurements for both parameters in both groups, indicating equal intensity of the decline in value regardless of a donor status. Measurement of ferritin before and after donation revealed statistically significant loss of ferritin in all examinees (p=0.011). The decline in haemoglobin after donation, although significant, did not fall below the reference value for donation in either women or men. Conclusion Results indicate the need for periodic monitoring of the plasma value of ferritin in voluntary donors who donate blood more than twice a year and the possible oral supplementation with iron.

The prevalence of pre-analytical errors in the laboratory of the Cantonal Hospital Zenica in Bosnia and Herzegovina.

Aim To identify rates of most common pre-analytical errors and to document possible (different) error rates between inpatients and outpatients. Methods This retrospective study was conducted at the Department of Medical Biochemistry and Immunology Diagnostics, Cantonal Hospital Zenica, from December 2016 until March 2017. Data on rejected blood samples in the laboratory information system were analysed. Results During the 3-month period 35,343 patient blood samples (25,545 inpatients and 9,798 outpatients) were received in the laboratory. The study identified 602 (1.70%) rejected samples because of pre-analytical errors, mostly due to haemolysis, 292 (48.50%), and clotted samples, 240 (39.87%). The remaining 70 (11.63%) samples were rejected because of inappropriate sample volume, inappropriate container and identification errors (7.81%, 2.16% and 1.66%, respectively). The proportion of inpatient rejected samples was 8.7-fold higher than in the outpatient samples. The proportion of inpatient rejected samples because of haemolysis, clotted samples, inappropriate sample volume and inappropriate containers were higher than in the outpatient samples (20.5-, 12.1-, 2.3- and 1.3-fold higher, respectively); proportion of rejected samples because of identification errors was 8.0-fold higher in the outpatient (collection sites outside the hospital) than in the inpatient samples. Conclusion Higher pre-analytical sample error rates were connected with inpatient samples, while higher identification error rates were connected with outpatient samples. Establishment of periodic stuff training and introduction of information technology could reduce pre-analytical errors.

The Triglyceride/HDL Ratio and Triglyceride Glucose Index as Predictors of Glycemic Control in Patients with Diabetes Mellitus Type 2.

INTRODUCTION: Poor glycemic control, assessed by higher glycated hemoglobin (HbA1c) levels, is associated with greater risk of diabetic complications. AIM: The aim of this study was to assess the association of triglyceride - to - HDL cholesterol (TG/HDL-C) ratio and triglyceride glucose (TyG) index with HbA1c and to evaluate their potential role as predictors of glycemic control in patients with diabetes mellitus type 2 (DM2). PATIENTS AND METHODS: This cross-sectional study was conducted in Health Center Banovici and included a total of 113 patients with DM2 classified according to their HbA1c values in two groups: DM2 HbA1c <7% - DM2 patients with good glycemic control (n=39) and DM2 HbA1c ≥7% - DM2 patients with poor glycemic control (n=74). Anthropometric, biochemical parameters and blood pressure values were measured, while TG/HDL-C ratio and TyG index were calculated. RESULTS: TG/HDL-C ratio and TyG index were significantly higher in DM2 HbA1c≥7% compared to DM2 HbA1c<7% group (p=0.003 and p<0.001; respectively). Both TG/HDL-C ratio and TyG index were positively associated with HbA1c levels (Rho=0.29; p=0.002; Rho=0.37; p<0.001; respectively). In linear regression analysis TG/HDL-C ratio and BMI, and also TyG index and BMI were significantly independently associated with HbA1c even after controlling for age, gender, diabetes duration and smoking. When we stratified patients according to BMI values, independent association between TG/HDL-C ratio and HbA1c remained significant only in normal weight subjects (OR 0.21; 95%CI: 0.05-0.37; ß=0.65; p=0.017), while independent association between TyG index and HbA1c remained significant only in overweight and obese subjects (OR 0.063; 95%CI: 0.01- 0.12; ß=0.24; p =0.027). CONCLUSION: TG/HDL-C ratio might be a useful predictor of glycemic control in normal weight, and TyG index in overweight and obese patients with DM2.

Polymorphism in methylentetra-hydrofolate reductase gene: important role in diseases.

It has been recognized that some people have a genetic variant which leads to elevated levels of homocysteine and impairs ability to process folate. This condition was recognized as independent risk factor of coronary heart disease. Recently, connection between this termolabile mutation of the methylenetetrahydrofolate reductase and numerous conditions and diseases has been established. Aim of this review is to draw attention to this interesting area in medicine. Additionally, well defined study about presence and frequency of gene polymorphism in our region will provide proper diagnosis and achieve possible delay of development of diseases with vitamin supplementation.

High-density lipoprotein cholesterol, apolipoprotein E and atherogenic index of plasma are associated with risk of chronic kidney disease.

Aim To investigate the association of parameters of lipid profile and estimated glomerular filtration rate (eGFR) p<60 ml/min/1.73m2 calculated by the Modification of Diet in Renal Disease (MDRD) in non-dialysis kidney patients. Methods The observational, case-control study enrolled patients (n=117) recruited from the Nephrological Counselling Centre of the University Clinical Centre Sarajevo and divided into two groups: group 1 eGFR (15-59 mL/min/1.73 m2 ), and group 2 (control) eGFR ≥ 60 mL/min/1.73 m2 . Concentration of lipids, lipoproteins and apolipoproteins was measured, and atherogenic index of plasma (AIP; log(TG/HDLc)) was calculated. Results High density lipoprotein cholesterol (HDLc) and apolipoprotein E (APOE) concentrations in serum were reduced [(1.02 (0.94-1.29) vs 1.15 (1.1-1.4) mmol/L; p=0.009 and 0.035 (0.026-0.04) vs 0.041 (0.034-0.05) g/L; p=0.002, respectively)], while AIP was higher in group 1 than in group 2 (0.19±0.03 vs 0.09±0.04; p=0.013). Values less than 1.09 mmol/L and 0.038 g/L for HDLc and APOE, or higher than 0.165 for AIP (p< 0.05) were associated with the eGFR below 60 ml/min/1.73 m2. The age [OR = 1.1; 95% CI (1.05-1.17)] and AIP [OR = 8.7; 95% CI (1.18- 65.0)] were independent positive predictors, while APOE was a negative predictor of eGFR reduction rate (OR=0.01; 95% CI (0.001-0.033; p<0.001). Conclusion Changes in parameters such as HDLc, APOE and AIP are associated with CKD. The study results imply the need of the AIP calculation as routine laboratory work due to its role along with the age and APOE in the prediction of renal function decline.

Influence of C-reactive protein on the occurrence and assessing of albuminuria severity in diabetics.

Aim To asses relation of serum high sensitive C-reactive protein (hsCRP) level with albumin concentration in daily urine in patients with diabetes mellitus type 2 (T2DM). Methods The prospective study included 69 patients with T2DM, both sexes (24 males, 45 females), aged 30-82 years. They were divided into two groups: patients with T2DM and normoalbuminuria(T2DM-NA; n=40) and patients with T2DM and microalbuminuria (T2DM-MA; n=29). Patients were hospitalized at the Department of Internal Medicine, Cantonal Hospital Zenica, in the period January-April 2014. Immunonephelometry measurement of hsCRP was performed on the Nephelometer Analyzer BN II (Siemens, Germany). Results Frequency of patients in T2DM-NA and T2DM-MA groups was not significantly different in relation to sex and age. There was significant difference in relation to duration of diabetes ( p=0.001). Average glucose and HbA1c levels were significantly higher in T2DM-NA group comparing to T2DM-MA group (p=0.008 and p=0.047, respectively). Serum creatinine (p=0.011),urea (p=0.009) and hsCRP (p=0.005) were significantly higher in T2DM-MA group compared to T2DM-NA group. Urinary albumin showed significantly positive correlation with the hsCRP (rho=0.286; p=0.017), urea (rho=0.503) and creatinine (rho=0.438) (p < 0.0005). A one unit (mg/L) increase in hsCRP concentration was associated with 11.5% increase of odds of microalbuminuria OR=1.115; 95% CI 1.014-1.225; p=0.025). Conclusion Significantly higher values of serum hsCRP in patients with type 2 diabetes mellitus and microalbuminuria in comparison to those with normoalbuminuria as well as the correlation of values of inflammatory marker with urinary albumin implicate a low grade inflammation in the progression of diabetic nephropathy.

Comparison of trazodone, diazepame and dibenzepine influences on rat brain beta-endorphins content.

The aim of our study was to establish the extent of influence of different psychotropic drugs to brain Beta-endorphins in experimental animals. The study was performed on albino Wistar rats (weight 250 g), treated with different psychoactive drugs. RIA technique was employed for quantification of brain beta-endorphins. Brain beta-endorphins were higher in experiment group treated with trazodone (929 pg/g +/- 44,43; X+/-SD), and dibenzepine (906,63 pg/g +/- 74,06), yet with lower brain content in rats treated with diazepam (841,55 pg/g +/- 68,47), compared to brain beta-endorphins content of control group treated with saline solution (0,95% NaCl) (873,5 pg/g +/- 44,89). Significant differences were obtained comparing brain beta-endorphins of trazodone vs. diazepam treated animals, with diazepam group having lower values (p<0,02). This study showed differences in changes of rat brain beta-endorphins contents when different psychoactive drugs are used. Therefore, we consider that beta-endorphins could be used for evaluation of effects of psychoactive drugs, as a useful parameter in therapy with these psycho-pharmaceuticals.

Beta-endorphins as possible markers for therapeutic drug monitoring.

This study was performed in order to investigate possible role of brain beta-endorphins as markers of antidepressive drugs therapy monitoring. Experiment was done using amitriptyline and trazodone as antidepressants. For quantification of brain beta-endorphins we used RIA technique. Our results showed significant decrease of brain beta-endorphins concentration in drug-pretreated animals, vs. those in of control group treated with 0,95% NaCl. The lower values were obtained in trazodone pre-treated animals. This study shows that use of psychoactive drugs have influence on brain beta-endorphins concentration. beta-endorphins could be of great importance, used as markers for evaluation of patient treatment.

Troponin T and histological characteristics of rat myocardial infarction induced by isoproterenol.

In our investigation,we used short-time model of myocardial infarction of rats induced by high dose of isoproterenol (ISP). We investigated cardiac troponin T blood level (cTnT) and histological characteristics of rat myocardium. ISP, single, intraperitoneal dose 250 mg/kg was given to male, adult, Wistar rats (n=12). Rats were distributed depending on their body weight in subgroups: ISP I (BW 260-280g) and ISP II (BW 250-400g).Control group (n=9) was treated with intraperitoneal dose of 0,95% NaCl. Cardiac TnT was measured by electrochemiluminiscence (ECLA) sandwich immunoassay in rat serum 4 hours after ISP application. Rats' hearts were dissected and examined by qualitative histological method (HE). Statistical significance was set at 0,05. There was significant difference in cTnT of ISP II (p=0,0001) vs. control and ISP I (p<0,05) vs. control. Significant difference was between ISP I and ISP II subgroups (p<0.001). The accent of histological changes of myocardium was on nuclei of cell. Cells showed acidophilic changes and nuclei disappearance as signs of coagulative necrosis development. Extensivity of histological changes were different between ISP I and ISP II subgroup. Used dose of ISP induced development of myocardial necrosis in rats. Subendocardial portion of myocardium was more vulnerability than subepicardial portion. Rats of ISP II had more extensive histological changes than these in ISP I. Administered doses of ISP enabled cTnT utilization as a marker of myocardial necrosis.

Comparison of creatine kinase activity and myoglobin blood level in acute myocardial infarction patients.

The aim of this prospective study was to evaluate and compare the relative increase of serum myoglobin level and total creatine kinase (CK) activity in acute myocardial infarction (AMI) patients (n=36). We measured serial changes in total CK activity and myoglobin serum level in three-time periods (6-9 hours, 24 hours and 6-7 days) from chest pains onset. Myoglobin peaked during the first 6-9 hours but total CK reached its peak activity after 24 hours from AMI symptoms onset. Results of this study showed that as non-specific cardiac marker myoglobin had better sensitivity and earlier rise in serum than total CK activity in AMI patients. Rapid kinetic of myoglobin level is important for its utility as marker for re-infarction diagnosis. Early myoglobin increase in serum is important for early triage of AMI patients and early "ruling out" of AMI diagnosis if there is no evidence of its elevation in circulation.