IA Hutagalung, I Patellongi, R Pakasi, M Arif, AA Mappahya, Hardjoeno .


In many patients presenting with chest pain symptoms at the emergency room, cardiac markers are measured not only to detect acute
myocardial infarction (AMI) but to exclude them too. Presently, the only biochemical markers used for diagnosis of MI are creatine kinase
myocardial band (CKMB) and troponin T (cTnT) as the markers of myocardial necrosis. Other biochemical markers have been sought to
find marker which can reflect the important, upstream processes in the pathophysiology of MI that therefore might give an earlier signal
of ongoing MI. These markers are myeloperoxidase (MPO) and matrix metalloproteinase-9 (MMP-9) as markers of plaque destabilization.
The aim of this study was to analyze the CKMB, MPO, MMP-9 activityies and troponin T level in MI. A cross sectional study had been
done at the Cardiovascular Centre Unit and Internal Ward of Dr. Wahidin Sudirohusodo Hospital during April up to August 2010 period.
The laboratory tests were done at the Clinical Pathology Laboratory of Dr. Wahidin Sudirohusodo Hospital, Makassar and the Research
and Esoteric Unit of Prodia Clinical Laboratory, Jakarta. Ffifty-three patients with AMI had been examined. The results showed that the
means of CKMB, cTnT, MPO and MMP-9 were 52.4 U/L, 2.0 ng/mL, 217.9 ng/mL and 920.3 ng/mL, respectively. MMP-9 had positively
value (69.8%) higher than cTnT (60.4%), MPO (58.5%) and CKMB (45.3%). Troponin T and MMP-9 were higher in patients with high
CKMB. The higher level of CKMB will be the higher MPO, MMP-9 and cTnT. There were strong correlation between MPO and MMP-9, also
between CKMB and Troponin T. Troponin T and CKMB were lower in inferior wall infarction compared with anterolateral/anteroseptal wall
infarction. The most sensitive biochemical marker in patients with AMI is the MMP-9. The MMP-9 usage is suggested to assist the diagnosis
of AMI. It is suggested a further study to establish the specificity of MMP-9 in all patients suffering with chest pain.


Myocardial infarction, biochemical markers, CKMB, troponin T, MPO, MMP-9

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