Dissertação
Avaliação da ligação da albumina humana ao níquel e sua potencial aplicação na detecção da isquemia cardíaca
Fecha
2010-07-16Registro en:
SILVA, Sandra Huber da. EVALUATION OF A NICKEL-ALBUMIN BINDING AND ITS POTENTIAL
APPLICATION ON THE DETECTION OF CARDIAC ISCHEMIA. 2010. 95 f. Dissertação (Mestrado em Farmacologia) - Universidade Federal de Santa Maria, Santa Maria, 2010.
Autor
Silva, Sandra Huber da
Institución
Resumen
Acute coronary syndrome (ACS) is characterized by the occurrence of a set of signs and
symptoms that are related to myocardial ischemia. Unstable angina (UA) and acute
myocardial infarction with ST segment elevation (AMI-SST) and without ST segment
elevation (AMI-SSST) comprise this syndrome. It stands out among the diseases that affect
the cardiovascular system due to its high prevalence and its impact on mortality in the general
population. Its formation occurs due to rupture or erosion of atheromatous plaque, producing
progressive tissue ischemia. This ischemia may progress to necrosis of the cardiomyocytes
and changes could be detected by laboratory biomarkers. The gold standard biomarkers for
the diagnosis of myocardial necrosis are the cardiac troponins I (cTnI) or T (cTnT), which
have nearly absolute myocardial specificity and clinical sensitivity, reflecting microscopic
areas of myocardial necrosis. However, markers used for the detection of myocardial
ischemia during the pre-infarction are potentially the most interesting because they offer the
opportunity for early intervention to prevent progression of the infarction. Thus, a biomarker
to detect myocardial ischemia in the absence of necrosis would add substantially to the
current clinical tools. The main objectives of this study were: (a) to evaluate the binding of
albumin to nickel in patients with suspected ACS and develop a laboratory method based on
this property capable of detecting cardiac ischemia, (b) develop a test protocol on the binding
of albumin to nickel adapted to the automated Cobas Mira, (c) to investigate the diagnostic
features of this method in the diagnosis of ACS, and (d) compare the test results of albumin
binding to nickel with the albumin cobalt- binding to investigate whether the type of metal
used in the test interferes with the diagnostic features of the method. Patients with myocardial
ischemia showed a reduction in the capacity of binding albumin to nickel. A test, which was
adapted for the automated Cobas Mira, was developed to detect this change. The binding test
of albumin to nickel showed a potential role in excluding the diagnosis of AMI and was
effective in the diagnosis of ACS because of its significant negative and positive predictive
values, respectively. The test using nickel showed a slightly higher skill in the diagnosis of
ACS than the test using cobalt. Thus, we could conclude that the type of metal (nickel or
cobalt) influences the characteristics of the diagnostic test.