Research Article: Biochemical markers as diagnostic/prognostic indicators for ischemic disease

Date Published: June , 2018

Publisher: Makerere Medical School

Author(s): MA Alkireidmi, FA Al-Abbasi, MG Mehanna, Said S Moselhy.

http://doi.org/10.4314/ahs.v18i2.13

Abstract

The use of a biomarker was extremely useful in clinical emergencies such as stroke to aid in triage and early management of cases. The diagnostic accuracy of laboratory biomarkers is run to approve the identification of easy, cheap and fast tests associated with cerebral ischemia and intracranial hemorrhage. The present study was designed to screen serum enolase activity, activities of CK-BB, LDH and lipid profile in patients with ischemic or related diseases as good diagnostic/ prognostic indicator for ischemic diseases.

Sixty male subjects in the age range of (45 ±2years) were divided into four groups each with 15 participants: Group (I) normal . Group (II) patients recently diagnosed as ischemic disease; Group (III) hypertensive patients and Group (IV); diabetic patients enolase activity (p<0.001) and CK-BB (p<0.01) in ischemic and hypertensive patients compared with control and diabetic groups. LDH level was significantly elevated in ischemic, hypertensive and diabetic patients compared with controls (p<0.001). The cut -off value for serum enolase was 62.5 nmol/l showing 90% sensitivity and 93% specificity for differentiation of ischemic disease. Positive correlations were observed between serum enolase (r = 0.56), and CK-BB (r = 0.53). Serum enolase can be considered as a more sensitive and specific marker and used as a sensitive diagnostic or prognostic marker for ischemic related diseases.

Partial Text

Transient ischemic attacks (TIA) are episodes in which a person has signs or symptoms of a stroke (e.g. numbness; inability to speak) that last for a short time1, but without any sign of stroke on brain scans such as MRI or CT. Symptoms of a TIA usually last between a few minutes and a few hours. A person may have one or many TIAs. People recover completely from the symptoms of a TIA. TIA is a warning sign that a person is at high risk for a stroke; immediate treatment can decrease or eliminate this risk2.

This study was approved by the ethics committee of the King Abdul-Aziz University Hospital. A written informed consent was obtained from all participants prior to enrollment into the study. Sixty adult males volunteers were included in the present study, age ranging between 40–55 years. The subjects were divided into four groups each with 15: Group (I) normal subjects not suffering from any systemic diseases; Group (II) including patients recently diagnosed as ischemic disease; Group (III) including hypertensive patients (BP ≥ 140/90) and Group (IV) including patients with type II diabetes, fasting HAB1C>10%.

Results obtained in figure 1 show that, there was a significant elevation in the level of serum total cholesterol in ischemic, hypertensive and diabetic groups compared with the control group (p <0.001, <0.01 and <0.05) respectively. The elevation in hypertension was more than in diabetes. Serum HDL-c level was significantly lower in ischemic, hypertension and diabetic groups compared with the normal group (p <0.001, <0.01 and <0.05) respectively. Serum LDL-c level was significantly increased in ischemic, hypertension and diabetic compared with the control group (p <0.001, <0.01 and <0.05) respectively. While there was no significant difference in the level of LDL-c between the ischemic, hypertension and the diabetic groups. The blood-brain barrier is compromised in patients with stroke. Neuron-specific markers, such as neuron specific enolase (NSE) in the circulation may allow the pathophysiology and prognosis of patients with cerebrovascular diseases to be evaluated11–16. The present study was designed to measure NSE in serum of patients with ischemic stroke and patients with related diseases as a diagnostic tool for early prediction of ischemic stroke. The diagnostic accuracy of laboratory biomarkers is run to approve the identification of easy, cheap and fast test associated with cerebral ischemia and intracranial hemorrhage. Serum enolase can be considered as a more sensitive and specific marker and used as a sensitive diagnostic or prognostic marker for ischemic related diseases.   Source: http://doi.org/10.4314/ahs.v18i2.13

 

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