No abstract available.
C-Reactive Protein* ; Emergencies* ; Emergency Service, Hospital* ; Troponin T* ; Troponin*

No abstract available.
C-Reactive Protein* ; Emergencies* ; Emergency Service, Hospital* ; Troponin T* ; Troponin*

In order to construct and express human cardiac troponin C-linker-troponin I(P) [ cTnC-linker-TnI(P)] fusion protein, detect its activity and prepare lyophilized protein, we searched the CDs of human cTnC and cTnI from GenBank, synthesized cTnC and cTnI(30-110aa) into cloning vector by a short DNA sequence coding for 15 neutral amino acid residues. pCold I-cTnC-linker-TnI(P) was constructed and transformed into E. coli BL21(DE3). Then, cTnC-linker-TnI(P) fusion protein was induced by isopropyl-β-D-thiogalactopyranoside (IPTG). Soluable expression of cTnC-linker-TnI(P) in prokaryotic system was successfully obtained. The fusion protein was purified by Ni²⁺ Sepharose 6 Fast Flow affinity chromatography with over 95% purity and prepared into lyophilized protein. The activity of purified cTnC-linker-TnI(P) and its lyophilized protein were detected by Wondfo Finecare™ cTnI Test. Lyophilized protein of cTnC-linker-TnI(P) was stable for 10 or more days at 37 °C and 4 or more months at 25 °C and 4 °C. The expression system established in this research is feasible and efficient. Lyophilized protein is stable enough to be provided as biological raw materials for further research.
Escherichia coli ; Freeze Drying ; Humans ; Recombinant Fusion Proteins ; biosynthesis ; Troponin C ; biosynthesis ; Troponin I ; biosynthesis

BACKGROUND AND OBJECTIVES: There is growing evidence that inflammation plays an important role in atherosclerosis and in the elevation of cardiac troponin I (cTnI) after coronary intervention. The aim of this study was to evaluate the relationship between inflammatory markers and the elevation of cTnI after coronary intervention in patients with stable angina. SUBJECTS AND METHODS: Twenty-three patients who underwent successful percutaneous transluminal coronary angioplasty with stent were examined as the subjects. Serial blood samples were obtained for High Sensitivity C-reactive protein (hs-CRP), which served as markers of systemic inflammation, and cTnI. The difference of cTnI before and 24 hours after coronary intervention was defined as the gradient of cTnI. RESULTS: The mean gradient of cTnI was 1.77+/-3.4 ng/mL. The concentrations of baseline and post-procedural hs-CRP were 1.57+/-1.3 mg/L and 6.31+/-3.8 mg/L, respectively (p=0.001). There were no significant differences in the gradient of cTnI with hypertention, diabetes, smoking, and hypercholesterolemia. The variable that significantly correlated with the gradient of cTnI was the baseline hs-CRP (R2=0.374, p=0.048). CONCLUSION: Systemic inflammation correlated with periprocedural elevation of cTnI in stable angina patients. These results suggest that inflammation plays a pivotal role in the predictive value of myocardial injury after coronary intervention.
Angina Pectoris ; Angina, Stable* ; Angioplasty, Balloon, Coronary* ; Atherosclerosis ; C-Reactive Protein ; Humans ; Hypercholesterolemia ; Inflammation* ; Smoke ; Smoking ; Stents* ; Troponin I* ; Troponin*

BACKGROUND AND OBJECTIVES: Myocardial injury after percutaneous coronary intervention (PCI) occurs frequently and it is associated with an adverse clinical outcome. Mechanical factors have been implicated in this complication and the role of inflammation has not yet been clearly determined. We evaluated the effect of an inflammatory response during PCI on periprocedural myocardial injury. SUBJECTS AND METHODS: We prospectively studied 231 patients (mean age: 62.8+/-10.6 years, males: 60.6%) who underwent elective coronary stenting. For the exclusion of mechanical injury to the myocardium, we excluded those patients who developed complications during PCI. Blood samples for measuring the high sensitivity C-reactive protein (hsCRP) and troponin T (TnT) were obtained before the procedure and at 6 hours and 24 hours after PCI. The inflammatory response to PCI was calculated as the difference between the peak postprocedural hsCRP level and the preprocedural hsCRP level (delta CRP). We divided the patients according to the median value of delta CRP: Group I <2.2 mg/dL and Group II > or =2.2 mg/dL. RESULTS: Postprocedural TnT elevation was were observed in 72 (31.2%) patients. The baseline clinical and angiographic characteristics were not difference between the two groups. The incidence of any TnT elevations was higher in the Group II than that in Group I (19.8% vs 42.6%, respectively, p<0.001). The incidences of TnT levels over 3 times the upper normal limit and 5 times the upper normal limit were also higher in Group II than in Group I (11.2% vs 21.7%, respectively, p=0.031, for a TnT level 3 times the upper normal limit, and 6.0% vs 13.9%, respectively, for a TnT level 5 times the upper normal limit). Multivariate analysis revealed that postprocedural hsCRP elevation and complex lesion were the significant independent predictors of postprocedural TnT elevation. CONCLUSION: Elevated hsCRP levels were associated with a higher risk of postprocedural troponin elevation in patients undergoing uncomplicated PCI. These results emphasized the role of inflammation in the pathogenesis of periprocedural myocardial injury.
Angioplasty ; C-Reactive Protein ; Humans ; Incidence ; Inflammation ; Multivariate Analysis ; Myocardium ; Percutaneous Coronary Intervention ; Prospective Studies ; Stents ; Trinitrotoluene ; Troponin ; Troponin T

BACKGROUND: The severity scoring system is useful for predicting the outcome of critically ill patients. However, the system is quite complicated and cost-ineffective. Simple serologic markers have been proposed to predict the outcome, which include troponin-I, lactate and C-reactive protein(CRP). The aim of this study was to evaluate the prognostic values of troponin-I, lactate and CRP in critically ill non-cardiac patients. METHODS: From September 2003 to June 2004, 139 patients(Age: 63.3+/-14.7, M:F=88:51), who were admitted to the MICU with non-cardiac critical illness at Gyeongsang National University Hospital, were enrolled in this study. This study evaluated the severity of the illness and the multi-organ failure score (Acute Physiologic and Chronic Health Evaluation II, Simplified Acute Physiologic Score II and Sequential Organ Failure Assessment) and measured the troponin-I, lactate and CRP within 24 hours after admission in the MICU. Each value in the survivors and non-survivors was compared at the 10th and 30th day after ICU admission. The mortality rate was compared at 10th and 30th day in normal and abnormal group. In addition, the correlations between each value and the severity score were assessed. RESULTS: There were significantly higher troponin-I and CRP levels, not lactate, in the non-survivors than in the survivors at 10th day(1.018+/-2.58ng/ml, 98.48+/-69.24mg/L vs. 4.208+/-10.23ng/ml, 137.69 +/-70.18 mg/L) (p<0.05). There were significantly higher troponin-I, lactate and CRP levels in the non-survivors than in the survivors on the 30th day (0.99+/-2.66ng/ml, 8.02+/-9.54ng/dl, 96.87+/-68.83mg/L vs. 3.36+/-8.74ng/ml, 15.42+/-20.57ng/dl, 131.28+/-71.23mg/L) (p<0.05). The mortality rate was significantly higher in the abnormal group of troponin-I, lactate and CRP than in the normal group of troponin-I, lactate and CRP at 10th day(28.1%, 31.6%, 18.9% vs. 11.0%, 15.8 %, 0%) and 30th day(38.6%, 47.4%, 25.8% vs. 15.9%, 21.7%, 14.3%) (p<0.05). Troponin-I and lactate were significantly correlated with the SAPS II score(r2=0.254, 0.365, p<0.05). CONCLUSION: Measuring the troponin-I, lactate and CRP levels upon admission may be useful for predicting the outcome of critically ill non-cardiac patients.
C-Reactive Protein* ; Critical Illness* ; Humans ; Lactic Acid* ; Mortality ; Survivors ; Troponin I*

BACKGROUND: The aim of this study was to investigate the effects of preoperative statin therapy on myocardial protection and morbidity endpoints following off-pump coronary bypass graft surgery (OPCAB) in patients with elevated serum high-sensitivity C-reactive protein (hs-CRP) levels. METHODS: Of the 492 patients who underwent multivessel OPCAB from March 2007 to February 2009, the records of 144 patients whose baseline hs-CRP level > 2 mg/L were reviewed. According to the history of preoperative statin therapy for at least one week, patients were classified as either statin group or control group (72 subjects each). Preoperative and operative characteristics and postoperative data including troponin (Tn)-T level and major morbidity endpoints were obtained and compared. Major morbidity endpoints were defined as permanent stroke, renal dysfunction, hemostatic re-exploration, deep sternal wound infection, and the number of patients requiring prolonged ventilation. RESULTS: Preoperative and operative characteristics were similar between the two groups. There were no significant differences in the incidence of morbidity endpoints between the two groups, except for the number of patients requiring dialysis, which was significantly lower in the statin group (8 vs. 1, P = 0.033). Tn-T level at 24 h after surgery was also significantly lower in the statin group. CONCLUSIONS: In this study, we observed beneficial effects of preoperative statin therapy for at least one week in terms of less myocardial enzyme release and fewer patients requiring dialysis following OPCAB in patients whose preoperative hs-CRP was elevated.
C-Reactive Protein ; Dialysis ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Incidence ; Stroke ; Transplants ; Troponin ; Ventilation ; Wound Infection

BACKGROUND: The aim of this study was to investigate the effects of preoperative statin therapy on myocardial protection and morbidity endpoints following off-pump coronary bypass graft surgery (OPCAB) in patients with elevated serum high-sensitivity C-reactive protein (hs-CRP) levels. METHODS: Of the 492 patients who underwent multivessel OPCAB from March 2007 to February 2009, the records of 144 patients whose baseline hs-CRP level > 2 mg/L were reviewed. According to the history of preoperative statin therapy for at least one week, patients were classified as either statin group or control group (72 subjects each). Preoperative and operative characteristics and postoperative data including troponin (Tn)-T level and major morbidity endpoints were obtained and compared. Major morbidity endpoints were defined as permanent stroke, renal dysfunction, hemostatic re-exploration, deep sternal wound infection, and the number of patients requiring prolonged ventilation. RESULTS: Preoperative and operative characteristics were similar between the two groups. There were no significant differences in the incidence of morbidity endpoints between the two groups, except for the number of patients requiring dialysis, which was significantly lower in the statin group (8 vs. 1, P = 0.033). Tn-T level at 24 h after surgery was also significantly lower in the statin group. CONCLUSIONS: In this study, we observed beneficial effects of preoperative statin therapy for at least one week in terms of less myocardial enzyme release and fewer patients requiring dialysis following OPCAB in patients whose preoperative hs-CRP was elevated.
C-Reactive Protein ; Dialysis ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Incidence ; Stroke ; Transplants ; Troponin ; Ventilation ; Wound Infection

BACKGROUND: There are many evidences that inflammation is an important determinant of the development of atherosclerosis and one of the systemic markers of inflammation, C-reactive protein(CRP), is associated with extent of coronary artery disease and risk of coronary events. We assessed the time response of CRP response after coronary angioplasty and it's influence on the clinical restenosis in angina patients. MATERIALS AND METHODS: Patients included 36 angina patients undergoing single vessel angioplasty. Levels of CRP were measured before and 12, 24, 48, and 72 hours after angioplasty. Clinical restenosis was assessed at 6 months after procedure. RESULTS: Baseline CRP level was 0.30+/-0.01 mg/dL in stable and 0.46+/-0.28 mg/dL in unstable angina patients(p<0.05). After angioplasty, CRP level was increased with peak at 24 hour and persisted to 72 hours after angioplasty. At 24 hour after angioplasty, the magnitude of CRP change was 0.32+/-0.31 mg/dL in stable and 0.79+/-0.73 mg/dL in unstable angina patient(p<0.05). The change of CRP level was not associated with troponin-T after angioplasty. In unstable angina patients, clinical restenosis was developed in 8% of patients with low baseline CRP levels and in 50% of those with high baseline CRP levels more than 0.6 mg/dL(p<0.05). CONCLUSION: In unstable angina patients, inflammatory response is more increased than stable angina patients, and increased inflammatory response effects on the restenosis after coronary angioplasty.
Angina, Stable ; Angina, Unstable ; Angioplasty* ; Atherosclerosis ; C-Reactive Protein* ; Coronary Artery Disease ; Humans ; Inflammation ; Troponin T

BACKGROUND AND OBJECTIVES: Although cardiac troponin I is widely used as a marker for myocardial infarction (MI), minor elevations of cardiac troponin I are also observed in other clinical situations. The prognostic factors for patients with these clinical features are not well established. The aim of this study was to discover the predictors of mortality for the patients who had minor troponin elevations without acute MI. SUBJECTS AND METHODS: We enrolled consecutive 154 patients from the emergency department or inpatient units who had a peak troponin I level greater than the lower limit of detectability (0.04 ng/mL), and the level was also less than the suggestive value of MI (0.6 ng/mL). They were with chest pain or nonspecific symptoms of circulatory abnormality, but they lacked the traditional features of acute MI. The endpoint was defined as death from all causes. The Cox proportional hazard model was used to test the relationship between the clinical and biochemical variables and the outcomes. RESULTS: During the follow-up period of 7.9+/-7.3 months, mortality occurred in 15 patients. Age, the creatine kinase myocardial isoform (CK-MB) level and the C-reactive protein (CRP) level as continuous variables had significant correlations with the occurrence of death. After adjusting for any possible confounders in the multivariate model, these variables remained as independent predictors of mortality: age (HR 1.07, CI 1.02-1.14, p=0.012), CK-MB level (HR 1.61, CI 1.16-2.24, p=0.005), and CRP level (HR 1.01, CI 1.00-1.01, p=0.025). CONCLUSION: Integration of the CK-MB and CRP levels, as well as age, can be used for risk-stratification in the patients showing minor troponin I elevation for reasons other than acute MI.
C-Reactive Protein ; Chest Pain ; Creatine Kinase ; Emergency Service, Hospital ; Follow-Up Studies ; Humans ; Inpatients ; Mortality ; Myocardial Infarction* ; Prognosis ; Proportional Hazards Models ; Troponin ; Troponin I*