John Febi, Kavitha S, Panicker Seema, Nair Tiny, Indira M
Department of Biochemistry, University of Kerala, Kariavattom, Trivandrum 695581, Kerala, India.
Indian Heart J. 2013 May-Jun;65(3):295-9. doi: 10.1016/j.ihj.2013.04.012. Epub 2013 Apr 9.
Myocardial infarction (MI) is often preceded by severe chest pain. The use of inflammatory markers to distinguish between chest pain of cardiac and non cardiac origin are not well reported. The aim of the study was to distinguish the chest pain of non cardiac and cardiac origin by using reliable inflammatory markers.
The present study enrolled 80 subjects including chest pain which lead to myocardial infarction (n=40), non-cardiac chest pain (CP) patients (n=20) and healthy volunteers (N) (n=20). Leukotriene B4 (LTB4) and thromboxane B2 (TXB2) levels were analyzed along with hs-CRP.
Receiver operating characteristic (ROC) curve analysis showed LTB4 and TXB2 to be a good discriminator between patients with chest pain of cardiac and non cardiac in origin. The area under the curve was found to be 0.988 and 0.925 for LTB4 and TXB2, respectively when compared with hs-CRP. The sensitivity and specificity of LTB4 and TXB2 were found to be 90, 85% and 95, 90%, respectively.
The measurement of LTB4 and TXB2 levels may therefore be useful to distinguish the chest pain leading to MI from that of non cardiac in origin and for the management of the disease.
心肌梗死（MI）通常在严重胸痛之前发生。关于使用炎症标志物区分心脏源性和非心脏源性胸痛的报道并不充分。本研究的目的是通过使用可靠的炎症标志物来区分非心脏源性和心脏源性胸痛。
本研究纳入了80名受试者，包括导致心肌梗死的胸痛患者（n = 40）、非心脏性胸痛（CP）患者（n = 20）和健康志愿者（N）（n = 20）。分析了白三烯B4（LTB4）、血栓素B2（TXB2）水平以及高敏C反应蛋白（hs-CRP）。
受试者工作特征（ROC）曲线分析显示，LTB4和TXB2是区分心脏源性和非心脏源性胸痛患者的良好指标。与hs-CRP相比，LTB4和TXB2的曲线下面积分别为0.988和0.925。LTB4和TXB2的敏感性和特异性分别为90%、85%和95%、90%。
因此，测量LTB4和TXB2水平可能有助于区分导致MI的胸痛与非心脏源性胸痛，并有助于疾病的管理。
