Echocardiographic estimation of infarct size by using cardiac biomarkers (troponin I, CK and CK-MB)‎ and some hematological changes in patients With STEMI

Abstract EN

Background : Severity of infarction in ST segment elevation MI (STEMI) is clinically important so early determination of infarct size by using non- invasive, non-coasty imaging modalities is a key to assessing the future risk of patients and instructive for optimization of therapeutic strategies.

Aims of the study : 1-To evaluate the efficacy of echocardiographic examination in estimation of extension and severity of infarction in ST segment elevation MI (STEMI) and its relationship with cardiac biomarkers and some heamatological changes.

2-To find out the relationship between these biomarkers and post STEMI complications.

Materials & Methods : The study lasted from 23th / 0ctober / 2012 to 28th / May / 2013 in AL-Zahraa teaching hospital in Kerbala city There are 92 (56 ± 13 years old) patients and 86 (50 ± 12 years old) healthy controls are taken in this study.

ECG and echocardiographic study of wall motion abnormality had been done for each one as well as serum cardiac biomarkers as cardiac troponin I (cTRI), Creatine kinase (CK) and creatine kinase myocardial band (CKMB) also hematological ayalysis (WBC, ESR & platelet count).

The patients are classified into 3 groups (G1, G2 &G3) according to wall motion score index (WMSI) : G1 WMSI ( > 2) MI ; G2 WMSI (1.7-2) and G3 WMSI ( < 1.7) to estimate the extension of myocardial injury .

Results : Cardiac biomarkers study, serum cTRI ; CK and CK-MB showed that there was high significant increment in relation to severity of infarction (p < 0.01) assessed by WMSI.

Our result revealed that there was strong relationship between both serum cTRI and CK-MB concentration and acute complications developed in ST-elevation MI statistically reaching (P < 0.01) and (p < 0.05) respectively.

Hematological showed highly significant (p < 0.01) increase in the levels of platelet count according to the severity of infarction (G1, G2 and G3) while the total white blood cells (WBC)count and erythrocyte sedimentation rate (ESR) showed significant (p < 0.01) increment in group 1 and group 3 only.

Conclusion: In patients with STEMI echocardiographic examination of left ventricle wall motion abnormalities and calculate WMSI reveal good estimation of severity and extension of infarction which is assessed by increment of cardiac biomarkers .presence of acute complications as arrhythmias which is associated with increase in serum biomarker concentration give us a clue about adverse prognosis of MI.