Troponin is an important biomarker of acute coronary syndrome.Especially highsensitivity cardiac troponin in recent years played an important role for the early diagnosis and prognosis of myocardial infarction.Recommendations for the use of high-sensitivity cardiac troponin have been issued in some guidelines.But the clinical doctors and laboratory workers still have many problems in practice.Some problems in high-sensitivity cardiac troponin assay and the clinical application were introduced here.Suggestions were also put up from international organizations,including unified high-sensitivity cardiac troponin name,unit,establish healthy population,selection guidelines to identify the 99th percentile value.

Galectin-3 (gal-3),a member of the galectin family,is directly associated with cardiac fibrosis and cardiac remodeling.Recently it has been approved by the US Food and Drug Administration as a prognostic aid in patients with heart failure (HF).Gal-3 is associated with age,kidney function and B-type natriuretic peptide (BNP).Compared with the diagnostic utility of BNP,the long-term prognosis value of gal-3 is higher than the value of diagnosis.Higher concentration of Gal-3,a marker of cardiac fibrosis,is associated with increased risk for incident CHF and mortality.

Objective: To investigate the effect of Shenfu injection on postoperation of mitral and aortic valve combined replacement surgery.Methods:46 cases, elective patients with mitral and aortic valve combined replacement in September 2008 to December 2009,were randomly assigned into two groups, the observation group 24 patients with the control group 22 patients. The Shenfu Injection, 50ml with 5% glucose injection 250ml,was used on postoperative day and 1-5day after that in the observation group. Other treatments were in the same with the control group patients. Monitoring pre and postoperative left ventricular end systolic diameter (LVSD),left ventricular end diastolic diameter (LVDD),left ventricular ejection fraction (LVEF),biochemicalmarkers of myocardial injury, dopamine dosage and the time of ventilator-assisted breathing. Results: The levels of reducing of left ventricular end systolic diameter and increasing of left ventricular ejection fraction in the observation group were higher than those in the control group(P

MicroRNA (miRNA),a type of 22-25nt non-coding RNA,plays an important role in proliferation and apoptosis of the cardiomyocyte,as well as the pathogenesis of some common cardiovascular diseases.Recently,researches on circulating miRNA in cardiovascular disease draw more attentions.This review will focus on the application value of miRNA in cardiovascular disease,the characteristics of miRNA and its detection technology will be described as well.

Corin is a newly identified membrance protease which responsible for converting pro-B-type natriuretic peptide to biologically active B-type natriuretic peptide.B-type natriuretic peptide play an important role in regulating blood pressure and cardiac function.It is a biological marker of heart failure.So Corin plays a role in reducing blood volume, blood pressure, regulating body fluid balance, and improving cardiac function.Corin may be used as a biomarker for heart failure or other cardiovascular disease.Recent studies have found that Corin is associated with the occurrence and development of cardiovascular diseases, such as heart failure and acute coronary syndrome.The article mainly expound the biological characteristics of Corin, testing methods and its clinical application in cardiovascular disease status.

Objective To evaluate the values of the combined eGFR and qualitative determination of urine albumine on in both during and 3 years after hospitalization prognosis of after PCI.Methods One thousand and five PCI patients were divided into 4 groups by level of eGFR and qualitative determination of urine albumine.A group:eGFR ＜ 60 ml/min,urine albumine negative ( n =34 ) ; B group:eGFR ＜ 60 ml/min,urine albumine positive ( n =34) ; C group:eGFR ≥60 ml/min,urine albumine negative ( n =797 ) ; D group:eGFR ≥60 ml/min,urine albumine positive (n =140).The levels of serum creatinine and urine albumine of PCI patient were measured,and then compare body mass index,smoking,hypertension,hyperlipaemia,diabetes mellitus,previous MI,perioporative PCI and etc.All patients were followed up from 30 d to 3 years.The prognostic facters of PCI patients were analyzed by COX proportional hazards models.Kaplan-Meier survival analysis was used to compare survival curves between the four groups stratified by level of eGFR.The log rank statistic was used to test for differences between groups.Results By multivariate COX regression adjustment for body mass index,smoking,hypertension,hyperlipaemia,diabetes mellitus,previous MI,perioperative PCI,the relative risk (RR) of albuminuria for cardiac events was 2.006 ( 95％ CI:1.020 - 3.947,P ＜ 0.05 ),perioperative PCI 3.375 ( 95％ CI:2.106 - 5.410,P ＜0.05 ).The cardiac events rate of B group with PCI after 1,2 and 3 year was 20.59％,2.94％,2.94％respectively,have statistical significant(x2 =8.774,P ＜ 0.05 ).The cardiac events rate of the first year in A,B,C,D groups was 5.89％,20.59％,4.01％,2.86％ respectively.The different cardiac events rate among four groups had statistical significant(x2 =22.050,P ＜0.01 ).B group cardiac events rate of the first year was significant higher than C,D group,which had statistical significant (x2 =20.020,14.520,P ＜0.01 ).The survival rate of 3 year follow-up after PCI was 91.2％,73.5％,91.6％,93.6％ respectively in four group,the different survival rate among four groups have statistical significant(x2 =16.750,P ＜0.01 ).Conclusion For the identification and treatment of high incidence of cardiac events in patients undergoing PCI,eGFR and qualitative determination of urine albumine are simple and effect tools.

Objective To explore the clinical value of the different components of glycosylated hemoglobin in pa-tients with coronary artery disease (CAD). Methods A total of 217 patients were divided into 3 groups:CAD group (groupⅠ, n=60), CAD patients without acute coronary syndrome (ACS) and with diabetes mellitus group (groupⅡ, n=60) and ACS patients with diabetes mellitus group (groupⅢ, n=97). Fifty-eight healthy volunteers in the same time period were selected as control group. The values of fructose glycosylated hemoglobin (HbA1a), lactose glycosylated hemoglobin (HbA1b), glucose glycosylated hemoglobin (HbA1c), hemoglobin P3 component (HbP3), hemoglobin A0 component (HbA0), unstable glycosyl-ated hemoglobin (LA1c/CHb1) and alkali-resistant hemoglobin (HbF) were measured. These parameters were compared be-tween 4 groups. Logistic regression was used to analyze factors that influencing CAD and CAD with diabetes mellitus. The re-ceiver operating characteristic (ROC) curve was used to analyze the diagnostic efficiency of these factors. Results There were significant differences in titers of HbA1b, HbA1c, HbP3 and HbA0 between groupⅠ, groupⅡ, groupⅢand control group (P＜0.01, or P＜0.05). There were no significant differences in levels of glycosylated hemoglobin parameters between groupⅡand groupⅢ(P>0.05). Logistic regression and ROC curve analysis showed that HbA1c and HbP3 were indepen-dent effects of CAD, and there were some diagnostic efficiency of CAD. The diagnostic efficiency of ROC curve was consis-tent in HbA1c and HbP3 between group Ⅱ and group Ⅲ. Conclusion Levels of HbA1b, HbA1c, HbP3 and HbA0 are closely related to CAD and CAD with diabetes mellitus. HbA1c and HbP3 are independent effects of CAD and, there are some diagnostic efficiency in CAD.

Objective To evaluate the performances of high-sensitivity cardiac troponin I ( cTnI ) on VITRO ECIQ with enhanced chemiluminescence method .Methods This verification study validated the limited of detection,function sensitivity,imprecision,linearity of the high-sensitivity cardic troponin used VITROS ECIQ according to the document EP-17A, EP-6A,EP-15A published by Clinical and Laboratory Standards Institute (CLSI) and determined 99th percentiles.All 652 patients with chest pain on immediate admission in TEDA International Cardiovascular Hospital during January to November 2013 were enrolled in this study.Including 323 cases of acute ST segment elevation myocardial infarction and non ST segment elevation myocardial infarction patients as the case group , exclude 329 cases of other diagnosis ,303 cases of apparent normal people as control group .The receiver operating characteristic curve was used to evaluated the sensitivity and the specificity of cTnI . Non-normal distribution of quantitative data were used nonparametric test Mann-Whitney U, With P<0.05 for the difference was statistically significant .Results The LoB was 0.006 5 ng/ml and the LoD was 0.015 5 ng/ml;the FS was 0.016 76 ng/ml;repeatability CV
was 1.73 % -2.33 %, reproducibility CV was 4.93% -9.96%.The imprecision were lower than that declared by assay producer.The linearity was 0.015 5-78.4 ng/ml(R2 =0.999 9); the 99th percentile reference value was 0.017 ng/ml.The area under the curve ( AUC) of cTnI was 0.986,95%CI 0.973 -0.994,with the cut-off value as 0.017 ng/ml, the diagnostic sensitivity and specificity in CIN were 90.09%and 99.34%.Compared between STEMI and NSTEMI groups after admission , the levels of cTnI had no significantly difference , Z were -0.485, P >0.05;compared between STEMI and control groups after admission, the levels of cTnI had significantly difference , Z were -19.567,P<0.001;compared between NSTEMI and control groups after admission , the levels of cTnI had significantly difference , Z were-14.598,P<0.001.Conclusions High-sensitivity cardiac troponin I detection by VITROS ECIQ with enhanced chemiluminescence method has good performances of sensitivity , linearity, specificity, which meet the clinical needs.

Objective To evaluate the postoperative prognosis of the modification of diet in renal disease formula (MDRD) in coronary artery bypass graft surgery (CABG) in hospital or 4 years after hospitalization. Methods Two hundred and seventy-two CABG patients were divided into 3 groups according to the levels of estimated glomerular filtration rate (eGFR) including 35 cases in eGFR < 60 ml/min group, 119 cases in 60 ≤ eGFR < 90 mL/min group and 118 cases in eGFR ≥90 ml/min group. The prognostic factors of CABG patients were analyzed by COX proportional hazards models. Kaplan-Meier survival analysis was used to compare survival curves among the three groups stratified by eGFR levels. The Log-rank statistic was used for comparing between groups. Results By multivariate COX regression adjustment for body mass index, smoking, hypertension, hyperlipaemia, diabetes mellitus, previous MI, perioperative PCI and etc. , the relative risk (RR) of the increasing age for cardiac events was 1.077(95% CI 1.002-1.158,P =0.044). RR of left ventricular ejection fraction (LVEF) was 0.005(95% CI 0.000-0.456,P =0.022). RR of eGFR was 0.968(95% CI 0.948-0.988,P =0.002). The survival rate in the first, second, third and fourth year were same in every group. The survival rate of group with eGFR < 60 ml/min, 60 ≤ eGFR < 90 ml/min and eGFR≥ 90 mL/min was 76.4%, 93.1%, and 96.6%. The survival rates among three groups were statistically significant. In the survival curve of 4 year follow-up after CABG, the survival rate of group with eGFR < 60 mL/min was lower than that of 60 ≤ eGFR < 90 ml/min group and eGFR ≥ 90 ml/min group. Conclusions The preoperative eGFR is an independent risk factor in evaluating cardiac events in hospital and after hospitalization. It has a higher prognosis value in patients undergoing CABG.

Objective To explore the clinical application value of neutrophil gelatinase-associated lipocalin(NGAL)which were tested by immunity transmission turbidity in early kidney injury after elective percutaneous coronary intervention.Methods A case-control study was conducted.All 201 stable angina pectoris and acute coronary syndrome patients undergone percutaneous coronary intervention in TEDA International Cardiovascular Hospital,during April to August 2013,were enrolled in this study.Before and 2 h,4 h,8 h,24 h,48 h after the operation,the plasma creatinine of the patient samples were tested by enzymic method.Before and 2 h,4 h,8 h,24 h after the operation,the plasma NGAL was tested by immunity transmission turbidity method.Before and 8 h,24 h after the operation,the urinary NGAL was tested by immunoturdimetric method.The data were compared between contrast induced nephrpathy (CIN) and non-CIN groups.For normal distribution of quantitative data,t test were used and for non-normal distribution of quantitative data,nonparametric rank and inspection were used.Results CIN occurred in 8 of 201 enrolled patients,the incidence was 3.98％.Receiver operating characteristic curve (ROC) analysis confirmed the diagnostic accuracy of the plasma NGAL in CIN,and the area under the curve(AUC) of 2 h plasma NGAL was 0.928,95％ CI 0.800-0.985,with the cut-off value NGAL as 109 ng/ml,the diagnostic sensitivity and specificity for CIN were 87.5％ and 100％ ;the AUC of 8 h plasma NGAL was 0.945,95％ CI 0.824-0.992,with the cut-off value NGAL as 96 ng/ml,the diagnostic sensitivity and specificity for CIN were 87.5％ and 87.5％ ;the AUC of 8 h urinary NGAL was 0.969,95％ CI 0.859-0.999,with the cutoff value NGAL as 91 ng/ml,the diagnostic sensitivity and specificity for CIN were 87.5％ and 100％.Conclusions The change of plasma and urinary NGAL is earlier to that of serum creatinine for the early diagnosis of CIN.It can be used as the predictor of early renal damage after elective coronary artery interventional.