Recently, the general idea of the acute coronary syndrome(ACS) that includes
acute myocardial infarction and unstable angina has been established. ACC/AHA
guidelines in 1996 and 1999 had emphasized the importance of the initial
diagnosis and the early treatment in acute myocardial infarction. We presented
about the recent advances in "injured myocardial marker" around
the ACS in this paper.
The sensitivity and specificity for detecting myocardial injury by troponin T and I(TnT and TnI) were superior compared with those in creatinine kinase(CK) and CK-MB. Easy rapid detection system by using whole blood was useful in the diagnosis a high risk cases in ACS. Measurement of TnT and TnI are recommended the use in the emergency room.
A guideline for a diagnosis of acute myocardial infarction had a revision(ACC/ESC)
on 2000. Biochemical markers of TnT & TnI were recommended as the first
step for defining the myocardial injury. Unstable angina pectoris with
a minimal myocardial injury(rise in CK under two times) was defined acute
myocardial infarction. As for the measurement of the myocardial injury,
rapid detection and accuracy & specificity may enhance the value of
modality. In future, inflammation marker such as the high sensitivity CRP
and an activated platelet may be thought to become important.
[Rinsho Byori 50 : 1140〜1145, 2002]
*1Department of Laboratory Medicine, Iwate Medical University, Morioka 020-8505
【Key Words】acute coronary syndrome(急性冠症候群)，heart-type fatty acid-binding protein：H-FABP(心臓型脂肪酸結合蛋白)，Troponin T：TnT，Troponin I：TnI，plaque rupture(プラーク破綻)
*1〜3岩手医科大学臨床検査医学(〒020-8505 盛岡市内丸19-1)
(臨床病理50巻11号に掲載予定でしたが，都合により本号に掲載させていただきます)
E-mail :knakai@iwate-med.ac.jp