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1.
Nat Commun ; 14(1): 8339, 2023 Dec 14.
Artículo en Inglés | MEDLINE | ID: mdl-38097584

RESUMEN

Genome duplication is essential for the proliferation of cellular life and this process is generally initiated by dedicated replication proteins at chromosome origins. In bacteria, DNA replication is initiated by the ubiquitous DnaA protein, which assembles into an oligomeric complex at the chromosome origin (oriC) that engages both double-stranded DNA (dsDNA) and single-stranded DNA (ssDNA) to promote DNA duplex opening. However, the mechanism of DnaA specifically opening a replication origin was unknown. Here we show that Bacillus subtilis DnaAATP assembles into a continuous oligomer at the site of DNA melting, extending from a dsDNA anchor to engage a single DNA strand. Within this complex, two nucleobases of each ssDNA binding motif (DnaA-trio) are captured within a dinucleotide binding pocket created by adjacent DnaA proteins. These results provide a molecular basis for DnaA specifically engaging the conserved sequence elements within the bacterial chromosome origin basal unwinding system (BUS).


Asunto(s)
Replicación del ADN , Proteínas de Unión al ADN , Proteínas de Unión al ADN/metabolismo , Proteínas Bacterianas/metabolismo , Origen de Réplica , Bacterias/genética , ADN , ADN de Cadena Simple/genética , ADN Bacteriano/metabolismo , Cromosomas Bacterianos/genética , Cromosomas Bacterianos/metabolismo
2.
Biomol NMR Assign ; 14(2): 221-225, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32535836

RESUMEN

The CaMK subfamily of Ser/Thr kinases are regulated by calmodulin interactions with their C-terminal regions. They are exemplified by Ca2+/calmodulin dependent protein kinase 1δ which is known as CaMK1D, CaMKIδ or CKLiK. CaMK1D mediates intracellular signalling downstream of Ca2+ influx and thereby exhibits amplifications of Ca2+signals and polymorphisms that have been implicated in breast cancer and diabetes. Here we report the backbone 1H, 13C, 15N assignments of the 38 kDa human CaMK1D protein in its free state, including both the canonical bi-lobed kinase fold as well as the autoinhibitory and calmodulin binding domains.


Asunto(s)
Biocatálisis , Proteína Quinasa Tipo 1 Dependiente de Calcio Calmodulina/química , Resonancia Magnética Nuclear Biomolecular , Secuencia de Aminoácidos , Humanos , Dominios Proteicos , Estructura Secundaria de Proteína
3.
Methods Mol Biol ; 1732: 1-14, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29480465

RESUMEN

Determination of the crystal structure of AMP-activated protein kinase (AMPK) is fundamental to understanding its biological function and role in a number of diseases related to energy metabolism including type 2 diabetes, obesity, and cancer. We describe methods for the expression and purification of a human full-length active AMPK complex that is suitable for biochemical and structural analyses, followed by methods for its crystallization in complex with small molecule activators. Quality control of the purified protein by functional and biophysical analysis was an essential part of the process enabling the achievement of crystals of the full-length protein capable of being used for high-resolution structure determination by X-ray diffraction. X-ray structures have been determined of both phosphorylated and non-phosphorylated forms of full-length human AMPK α1ß1γ1.


Asunto(s)
Proteínas Quinasas Activadas por AMP/química , Cromatografía en Gel/métodos , Cristalografía por Rayos X/métodos , Proteínas Quinasas Activadas por AMP/aislamiento & purificación , Sitios de Unión , Cromatografía en Gel/instrumentación , Cristalografía por Rayos X/instrumentación , Fosforilación , Estructura Cuaternaria de Proteína , Subunidades de Proteína/química , Subunidades de Proteína/aislamiento & purificación , Proteínas Recombinantes/química , Proteínas Recombinantes/aislamiento & purificación
4.
Biochem J ; 474(17): 3059-3073, 2017 08 22.
Artículo en Inglés | MEDLINE | ID: mdl-28694351

RESUMEN

AMP-activated protein kinase (AMPK) plays a major role in regulating metabolism and has attracted significant attention as a therapeutic target for treating metabolic disorders. AMPK activity is stimulated more than 100-fold by phosphorylation of threonine 172 (Thr172). Binding of AMP to the γ subunit allosterically activates the kinase. Additionally, many small molecules, e.g. 991, have been identified that bind between the kinase domain and the carbohydrate-binding module of the ß subunit, stabilising their interaction and leading to activation. It was reported recently that non-phosphorylated Thr172 AMPK is activated by AMP and A769662. We present here the crystal structure of non-phosphorylated Thr172 AMPK in complex with AMP and 991. This structure reveals that the activation loop, as well as the complex overall, is similar to the Thr172 phosphorylated complex. We find that in the presence of AMP and 991 non-phosphorylated Thr172, AMPK is much less active than the Thr172 phosphorylated enzyme. In human cells, the basal level of Thr172 phosphorylation is very low (∼1%), but is increased 10-fold by treatment with 2-deoxyglucose. In cells lacking the major Thr172 kinases, LKB1 and CaMKKß, Thr172 phosphorylation is almost completely abolished, and AMPK activity is virtually undetectable. Our data show that AMP and 991 binding to non-phosphorylated Thr172 AMPK can induce an ordered, active-like, conformation of the activation loop explaining how AMPK activity can be measured in vitro without Thr172 phosphorylation. However, in a cellular context, phosphorylation of Thr172 is critical for significant activation of AMPK.


Asunto(s)
Proteínas Quinasas Activadas por AMP/metabolismo , Quinasa de la Proteína Quinasa Dependiente de Calcio-Calmodulina/metabolismo , Proteínas Serina-Treonina Quinasas/metabolismo , Células A549 , Quinasas de la Proteína-Quinasa Activada por el AMP , Proteínas Quinasas Activadas por AMP/genética , Compuestos de Bifenilo , Quinasa de la Proteína Quinasa Dependiente de Calcio-Calmodulina/genética , Activación Enzimática/efectos de los fármacos , Activación Enzimática/genética , Células HEK293 , Humanos , Fosforilación/efectos de los fármacos , Fosforilación/genética , Proteínas Serina-Treonina Quinasas/genética , Pironas/farmacología , Tiofenos/farmacología
6.
Biochim Biophys Acta ; 1828(11): 2583-91, 2013 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-23871992

RESUMEN

G-protein coupled receptors (GPCRs) are integral membrane cell surface receptors with key roles in mediating the cellular responses to a wide range of biologically relevant molecules including hormones, neurotransmitters and importantly the majority of currently available drugs. The first high-resolution, X-ray crystallographic structure of a GPCR, that of rhodopsin, was obtained in 2000. It took a further seven years for the next structure, that of the ß2 adrenergic receptor. Remarkably, at the time of writing, there have been an astonishing 18 further independent high-resolution GPCR structures published in the last five years (overall total of 68 structures in different conformations or bound to different ligands). Of particular note is the recent structure of the ß2 adrenergic receptor in complex with its cognate heterotrimeric G-protein revealing for the first time molecular details of the interaction between a GPCR and the complete G-protein. Together these structures have provided unprecedented detail into the mechanism of action of these incredibly important proteins. This review describes several key methodological advances that have made such extraordinarily fast progress possible.


Asunto(s)
Receptores Acoplados a Proteínas G/metabolismo , Cristalización , Cristalografía por Rayos X , Fragmentos de Inmunoglobulinas/metabolismo , Modelos Moleculares , Mutagénesis , Receptores Acoplados a Proteínas G/química , Receptores Acoplados a Proteínas G/genética
7.
Br J Pharmacol ; 169(5): 988-98, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23489072

RESUMEN

BACKGROUND AND PURPOSE: Thermostabilization by mutagenesis is one method which has facilitated the determination of high-resolution structures of the adenosine A2A receptor (A(2A)R). Sets of mutations were identified, which both thermostabilized the receptor and resulted in preferential agonist (Rag23 mutant) or antagonist (Rant5 and Rant21) binding forms as assessed by radioligand binding analysis. While the ligand-binding profiles of these mutants are known, the effects these mutations have on receptor activation and downstream signalling are less well characterized. EXPERIMENTAL APPROACH: Here we have investigated the effects of the thermostabilizing mutations on receptor activation using a yeast cell growth assay. The assay employs an engineered Saccharomyces cerevisiae, MMY24, which couples receptor activation to cell growth. KEY RESULTS: Analysis of the receptor activation profile revealed that the wild-type (WT) A(2A)R had considerable constitutive activity. In contrast, the Rag23, Rant5 and Rant21 thermostabilized mutants all exhibited no constitutive activity. While the preferentially antagonist-binding mutants Rant5 and Rant21 showed a complete lack of agonist-induced activity, the Rag23 mutant showed high levels of agonist-induced receptor activity. Further analysis using a mutant intermediate between Rag23 and WT indicated that the loss of constitutive activity observed in the agonist responsive mutants was not due to reduced G-protein coupling. CONCLUSIONS AND IMPLICATIONS: The loss of constitutive activity may be an important feature of these thermostabilized GPCRs. In addition, the constitutively active and agonist-induced active conformations of the A(2A)R are distinct.


Asunto(s)
Receptor de Adenosina A2A/genética , Receptor de Adenosina A2A/metabolismo , Adenosina/farmacología , Agonistas del Receptor de Adenosina A2/farmacología , Adenosina-5'-(N-etilcarboxamida)/farmacología , Humanos , Mutación , Receptor de Adenosina A2A/química , Saccharomyces cerevisiae/genética , Saccharomyces cerevisiae/metabolismo , Temperatura
8.
Br J Nurs ; 20(6): 373-82, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21471896

RESUMEN

The role of health practitioners in attempting to reverse homeostatic imbalances essentially makes them external agents of homeostatic control-they are replacing the assessment, controlling and effector mechanisms that operate during health (homeostasis), but have failed in ill-health (homeostatic imbalances). Myocardial infarction (MI) is the homeostatic imbalance examined in this article, which aims to apply the analogy between the components of homeostatic theory and the components of the nursing process (Clancy and McVicar, 2011b) to the condition. After reading the article, nurses should be able to understand that: the components of homeostasis are associated with health, and the failure of one or more of these components results in illness; illness arises from a cellular, hence chemical, homeostatic imbalance(s); MI results from a cellular imbalance leading to a restriction in blood flow to the myocardium, and is identified by signs and symptoms (i.e. other homeostatic imbalances) related to the ischaemia; when caring for people with MI, coronary care nurses are acting as external agents of homeostatic control.


Asunto(s)
Hemodinámica/fisiología , Homeostasis/fisiología , Contracción Miocárdica/fisiología , Infarto del Miocardio , Femenino , Humanos , Persona de Mediana Edad , Infarto del Miocardio/enfermería , Infarto del Miocardio/fisiopatología , Infarto del Miocardio/terapia
9.
Bioorg Med Chem Lett ; 20(19): 5695-700, 2010 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-20801653

RESUMEN

A novel series of P2-P4 macrocyclic HCV NS3/4A protease inhibitors with α-amino cyclic boronates as warheads at the P1 site was designed and synthesized. When compared to their linear analogs, these macrocyclic inhibitors exhibited a remarkable improvement in cell-based replicon activities, with compounds 9a and 9e reaching sub-micromolar potency in replicon assay. The SAR around α-amino cyclic boronates clearly established the influence of ring size, chirality and of the substitution pattern. Furthermore, X-ray structure of the co-crystal of inhibitor 9a and NS3 protease revealed that Ser-139 in the enzyme active site traps boron in the warhead region of 9a, thus establishing its mode of action.


Asunto(s)
Compuestos de Boro/química , Ácidos Borónicos/química , Compuestos Macrocíclicos/química , Inhibidores de Proteasas/química , Proteínas no Estructurales Virales/antagonistas & inhibidores , Sitios de Unión , Compuestos de Boro/síntesis química , Compuestos de Boro/farmacología , Dominio Catalítico , Cristalografía por Rayos X , Hepacivirus/efectos de los fármacos , Compuestos Macrocíclicos/síntesis química , Compuestos Macrocíclicos/farmacología , Inhibidores de Proteasas/síntesis química , Inhibidores de Proteasas/farmacología , Estructura Terciaria de Proteína , Relación Estructura-Actividad , Proteínas no Estructurales Virales/metabolismo
10.
Bioorg Med Chem Lett ; 20(12): 3550-6, 2010 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-20493689

RESUMEN

We have designed and synthesized a novel series of alpha-amino cyclic boronates and incorporated them successfully in several acyclic templates at the P1 position. These compounds are inhibitors of the HCV NS3 serine protease, and structural studies show that they inhibit the NS3 protease by trapping the Ser-139 hydroxyl group in the active site. Synthetic methodologies and SARs of this series of compounds are described.


Asunto(s)
Ácidos Borónicos/síntesis química , Hepacivirus/efectos de los fármacos , Proteínas no Estructurales Virales/antagonistas & inhibidores , Ácidos Borónicos/farmacología , Ácidos Borónicos/uso terapéutico , Dominio Catalítico , Diseño de Fármacos , Hepacivirus/enzimología , Estructura Molecular , Serina/química , Relación Estructura-Actividad
11.
Bioorg Med Chem Lett ; 19(13): 3664-8, 2009 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-19428244

RESUMEN

Inhibition of the aspartyl protease BACE-1 has the potential to deliver a disease-modifying therapy for Alzheimer's disease. We have recently disclosed a series of transition-state mimetic BACE-1 inhibitors showing nanomolar potency in cell-based assays. Amongst them, GSK188909 (compound 2) had favorable pharmacokinetics and was the first orally bioavailable inhibitor reported to demonstrate brain amyloid lowering in an animal model. In this Letter, we describe the reasons that led us to favor a second generation of inhibitors for further in vivo studies.


Asunto(s)
Ácido Aspártico Endopeptidasas/antagonistas & inhibidores , Inhibidores de Proteasas/química , Tiazinas/química , Administración Oral , Enfermedad de Alzheimer/tratamiento farmacológico , Péptidos beta-Amiloides/metabolismo , Animales , Ácido Aspártico Endopeptidasas/metabolismo , Sitios de Unión , Simulación por Computador , Etilaminas/síntesis química , Etilaminas/química , Etilaminas/farmacología , Humanos , Ratones , Inhibidores de Proteasas/farmacocinética , Ratas , Relación Estructura-Actividad , Tiazinas/síntesis química , Tiazinas/farmacocinética
12.
Bioorg Med Chem Lett ; 19(13): 3669-73, 2009 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-19477642

RESUMEN

Our first generation of hydroxyethylamine transition-state mimetic BACE-1 inhibitors allowed us to validate BACE-1 as a key target for Alzheimer's disease by demonstrating amyloid lowering in an animal model, albeit at rather high doses. Finding a molecule from this series which was active at lower oral doses proved elusive and demonstrated the need to find a novel series of inhibitors with improved pharmacokinetics. This Letter describes the discovery of such inhibitors.


Asunto(s)
Ácido Aspártico Endopeptidasas/antagonistas & inhibidores , Etilaminas/química , Inhibidores de Proteasas/química , Administración Oral , Enfermedad de Alzheimer/tratamiento farmacológico , Péptidos beta-Amiloides/metabolismo , Animales , Ácido Aspártico Endopeptidasas/metabolismo , Sitios de Unión , Simulación por Computador , Cristalografía por Rayos X , Etilaminas/síntesis química , Etilaminas/farmacología , Humanos , Ratones , Inhibidores de Proteasas/síntesis química , Inhibidores de Proteasas/farmacología , Ratas , Relación Estructura-Actividad , Tiazinas/química , Tiazinas/farmacología
13.
Bioorg Med Chem Lett ; 19(13): 3674-8, 2009 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-19406640

RESUMEN

Our first generation of hydroxyethylamine BACE-1 inhibitors proved unlikely to provide molecules that would lower amyloid in an animal model at low oral doses. This observation led us to the discovery of a second generation of inhibitors having nanomolar activity in a cell-based assay and with the potential for improved pharmacokinetic profiles. In this Letter, we describe our successful strategy for the optimization of oral bioavailability and also give insights into the design of compounds with the potential for improved brain penetration.


Asunto(s)
Ácido Aspártico Endopeptidasas/antagonistas & inhibidores , Etilaminas/química , Inhibidores de Proteasas/química , Miembro 1 de la Subfamilia B de Casetes de Unión a ATP/genética , Miembro 1 de la Subfamilia B de Casetes de Unión a ATP/metabolismo , Péptidos beta-Amiloides/metabolismo , Animales , Ácido Aspártico Endopeptidasas/metabolismo , Disponibilidad Biológica , Perros , Etilaminas/síntesis química , Etilaminas/farmacocinética , Ratones , Ratones Noqueados , Inhibidores de Proteasas/síntesis química , Inhibidores de Proteasas/farmacocinética , Ratas , Relación Estructura-Actividad
14.
Bioorg Med Chem Lett ; 17(10): 2927-30, 2007 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-17420122

RESUMEN

The synthetic entry to new classes of dual fXa/thrombin and selective thrombin inhibitors with significant oral bioavailability is described. This was achieved through minor modifications to the sulfonamide group in our potent and selective fXa inhibitor (E)-2-(5-chlorothien-2-yl)-N-{(3S)-1-[(1S)-1-methyl-2-(morpholin-4-yl)-2-oxoethyl]-2-oxopyrrolidin-3-yl}ethenesulfonamide and these observed activity changes have been rationalised using structural studies.


Asunto(s)
Inhibidores del Factor Xa , Fibrinolíticos/farmacología , Morfolinas/farmacología , Sulfonamidas/farmacología , Trombina/antagonistas & inhibidores , Animales , Perros , Fibrinolíticos/síntesis química , Fibrinolíticos/química , Modelos Moleculares , Estructura Molecular , Morfolinas/síntesis química , Ratas , Relación Estructura-Actividad , Sulfonamidas/síntesis química
15.
Bioorg Med Chem Lett ; 17(10): 2931-4, 2007 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-17336062

RESUMEN

Structure-based design (SBD) is a challenging endeavour since even localised SAR can hardly ever be explained by the variation of just one dominating factor. Here, we present a rare example where structural information combined with ab initio calculations clearly indicate that the observed difference in biological activity is dominated by conformational effects. The learnings discussed are successfully put to the test and have the potential to be of general use as a qualitative guide in SBD efforts.


Asunto(s)
Diseño de Fármacos , Sulfonamidas/química , Conformación Molecular , Relación Estructura-Actividad , Sulfonamidas/farmacología
16.
J Bacteriol ; 187(19): 6691-700, 2005 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-16166531

RESUMEN

We have characterized the induction kinetics of approximately 1,700 proteins during entry into and survival in carbon-starved stationary phase by Mycobacterium smegmatis. Strikingly, among the patterns of expression observed were a group of proteins that were expressed in exponential-phase cultures and severely repressed in 48-h stationary-phase cultures (Spr or stationary-phase-repressed proteins) but were synthesized again at high levels in > or =128-day stationary-phase cultures (Spr(128) proteins). A number of Spr(128) proteins were identified, and they included the heat shock protein DnaK, the tricarboxylic acid cycle enzyme succinyl coenzyme A synthase, a FixA-like flavoprotein, a single-stranded DNA binding protein, and elongation factor Tu (EF-Tu). The identification of EF-Tu as an Spr(128) protein is significant, as ribosomal components are known to be expressed in a growth rate-dependent way. We interpreted these data in terms of a model whereby stationary-phase mycobacteria comprise populations of cells that differ in both their growth status and gene expression patterns. To investigate this further, we constructed gene fusions between the rpsL gene promoter (which heads the Mycobacterium smegmatis operon encoding the tuf gene encoding EF-Tu) or the rrnA promoter gene and an unstable variant of green fluorescent protein. While the majority of cells in old stationary-phase cultures had low levels of fluorescence and so rpsL expression, a small but consistently observed population of approximately 1 in 1,000 cells was highly fluorescent. This indicates that a small fraction of the cells was expressing rpsL at high levels, and we argue that this represents the growing subpopulation of cells in stationary-phase cultures.


Asunto(s)
Proteínas Bacterianas/genética , Proteínas Bacterianas/metabolismo , Mycobacterium smegmatis/genética , Mycobacterium smegmatis/metabolismo , Proteómica , Carbono/metabolismo , Electroforesis en Gel Bidimensional , Citometría de Flujo , Regulación Bacteriana de la Expresión Génica , Mycobacterium smegmatis/crecimiento & desarrollo , Proteínas Recombinantes de Fusión/genética , Proteínas Recombinantes de Fusión/metabolismo
17.
Nurs Times ; 100(6): 42-4, 2004.
Artículo en Inglés | MEDLINE | ID: mdl-15000028

RESUMEN

Atrial fibrillation (AF) is one of the most common arrhythmias encountered in the adult population. It can be an isolated event or a chronic lifelong rhythm disturbance. The common causes of AF and the presenting electrocardiogram characteristics are outlined. The risks to the patient in AF, the role of the nurse, and treatment options are also discussed.


Asunto(s)
Fibrilación Atrial/terapia , Adulto , Algoritmos , Antiarrítmicos , Fibrilación Atrial/diagnóstico , Fibrilación Atrial/etiología , Árboles de Decisión , Cardioversión Eléctrica , Electrocardiografía , Humanos , Rol de la Enfermera , Marcapaso Artificial , Medición de Riesgo , Factores de Riesgo
18.
Nurs Times ; 99(36): 26-7, 2003.
Artículo en Inglés | MEDLINE | ID: mdl-14533429

RESUMEN

As pacemaker technology comes closer to mimicking the heart's own pacing system, patients in need of such devices can hope to live increasingly normal and productive lives. This article outlines common types of cardiac pacing and indications for pacemaker insertion. Nursing considerations are outlined both during and following the insertion of a pacemaker.


Asunto(s)
Estimulación Cardíaca Artificial/enfermería , Marcapaso Artificial , Estimulación Cardíaca Artificial/métodos , Electrocardiografía , Humanos , Monitoreo Fisiológico/enfermería , Marcapaso Artificial/clasificación , Selección de Paciente , Atención Perioperativa/enfermería
19.
Mol Microbiol ; 49(5): 1191-200, 2003 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-12940980

RESUMEN

Two-component signal transduction (TCST) pathways are regulatory systems that are highly homologous throughout the bacterial kingdom. Their established role in virulence and absence in vertebrates has made TCST an attractive target for therapeutic intervention. However, such systems have yet to yield success in the development of novel antibiotics. CheY serves as a prototype for the analysis of response regulator function. The protein structure exhibits several conformations by both X-ray and nuclear magnetic resonance (NMR) analyses. Knowledge of which structures are relevant in vivo would be valuable in a rational drug design project. Our aim was to probe the in vivo conformation and ligand binding of CheY in Escherichia coli under resting conditions by in-cell NMR methods. CheY was selectively labelled with 15N by the control of growth and expression conditions. NMR spectra obtained in vivo demonstrated that the Mg2+ complex was the predominant form even though cells were resuspended in metal-free buffers and the intracellular free Mg2+ was low. In-cell NMR also confirmed the uptake and in vivo binding mode to CheY of small-molecular-weight compounds identified in vitro. This paper reports the first observation of the structure and interactions with a potential drug of a regulator protein in its native host in vivo using NMR spectroscopy.


Asunto(s)
Proteínas Bacterianas , Escherichia coli/química , Proteínas de la Membrana/química , Proteínas de la Membrana/metabolismo , Conformación Proteica , Cationes Bivalentes/metabolismo , Quimiotaxis , Escherichia coli/metabolismo , Proteínas de Escherichia coli/química , Proteínas de Escherichia coli/metabolismo , Ligandos , Magnesio/metabolismo , Proteínas Quimiotácticas Aceptoras de Metilo , Modelos Moleculares , Isótopos de Nitrógeno , Resonancia Magnética Nuclear Biomolecular , Unión Proteica , Transducción de Señal
20.
Nurs Times ; 99(26): 24-5, 2003.
Artículo en Inglés | MEDLINE | ID: mdl-12875110

RESUMEN

An electrocardiogram (ECG) and clinical features alone are used to diagnose almost 75 per cent of patients presenting with an acute myocardial infarction (MI). In these cases elevated cardiac enzyme levels merely confirm the diagnosis. However, when the clinical picture is less characteristic and the ECG is normal or has nonspecific changes, verification may rely on the detection of enzyme elevation. This article outlines the common biochemical markers used to assess for myocardial damage and the implications for nursing practice.


Asunto(s)
Biomarcadores/sangre , Cardiopatías/diagnóstico , Cardiopatías/metabolismo , Aspartato Aminotransferasas/sangre , Creatina Quinasa/sangre , Electrocardiografía , Cardiopatías/enfermería , Humanos , L-Lactato Deshidrogenasa/sangre , Mioglobina/sangre , Rol de la Enfermera , Valor Predictivo de las Pruebas , Factores de Tiempo , Troponina I/sangre , Troponina T/sangre
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