Inside ST-elevation myocardial infarction by monitoring concentrations of cardiovascular risk biomarkers in blood

Background: No information is available on the optimal sampling time to catch the highest increase for biomarkers whose elevation after ST-elevation myocardial infarction (STEMI) is prognostic for adverse events. This study aimed to investigate release kinetics and peak times of cardiac troponin I (cTnI), C-reactive protein (CRP), B-type natriuretic peptide (BNP), chromogranin A (CgA) and cystatin C (CyC) in STEMI patients undergoing primary percutaneous coronary intervention (PPCI). Methods: Blood concentrations of cTnI, CRP, BNP, CgA and CyC were measured before and 6. h, 24. h, and 48. h after PPCI in 84 STEMI patients. The averaged trajectory of marker kinetics was estimated by multivariable regression models adjusted for patient characteristics and orthogonal polynomials were used to describe related releases. Results: From the estimated kinetics cTnI peaked at 10. h from symptoms, BNP at 28. h and CRP within 30. h. CyC concentrations did not change, whereas CgA concentrations increased from 6 to 48. h after PPCI. The amount of BNP release was found to be affected by the interaction between gender and age: females < 75 years had BNP concentrations fourfold higher than males. Conclusions: According to different release kinetics a single blood sampling for measuring all biomarkers is not recommended.