Early Prognostic Instrumental and Laboratory Biomarkers in Post-MI
Authors: Marzoog Basheer Abdullah 
Published: January 2024

Background:
Post-myocardial infarction (MI) changes have been frequently reported
in the literature and are associated with determining the prognosis.

Aims:
The aim of this study is to find a prognosis marker for the favorability of determination of
the medium-term outcomes in patients with acute MI.

Objectives:
MI patients’ prognosis is poorly understood and requires further elaboration.

Materials and Methods:
A single center, cross-sectional cohort study involved 211 patients’
medical history with acute MI, for the period 2014-2019, had been evaluated retrospectively for
76 parameters. The data was collected from the Republic Rehabilitation Mordovian Hospital.
The described measurement units were used in the local laboratories to describe the values. The
descriptive values were expressed in the mean average and standard deviation. For statistical
analysis, descriptive statistics, t-test independent by groups and dependent by numerical variables
for repeated analysis for the same patients, multinomial logistic regression, Pearson’s correlation
coefficient, ROC analysis, and for clarification purposes, diagrams and bar figures were
used. For performing the statistical analysis, the SPSS program, version 28 was used.

Results:
Descriptive statistics showed a proportion of men to females 7:3. The mean age of the
MI patients was 61.50 years (Std. Dev. ± 10.68), and the mean height of the sample was 171.00
cm (Std. Dev. ± 7.20). The mean body weight of the sample is 83.62 kg (Std. Dev. ± 12.35), and
the body mass index (BMI) is 29.02 kg/m2 (Std. Dev. ± 5.07). The total hospitalization days are
14.79 (Std. Dev. ± 3.41). The mean heart rate (HR) beat per minute (bpm) was 79.03 (Std. Dev.
± 15.63), and the mean blood pressure was 138.53/84.09 mmHg (Std. Dev. ± 28.66/12.79). On
the complete blood count (CBC), the mean level of the hemoglobin (Hb) 136.33 g/l (Std. Dev. ±
15.29), the mean level of the leukocytes (WBC) 8.76 /μl (Std. Dev. ± 2.77), the mean level of the
red blood cells (RBC) 4.55 /μl (Std. Dev. ± 0.52), the mean level of the relative value of the
lymphocytes 24.46 % (Std. Dev. ± 9.015), and the mean level of the thrombocytes 207.87 /μl
(Std. Dev. ± 64.035). The mean erythrocytes segmentation rate (ESR) is 18.99 mm/hr (Std. Dev.
± 12.16). The regression analysis demonstrated that the dependent variable, complication, in particular,
pericarditis, and the independent factor, concomitant disease, in particular, chronic heart
failure, has a significant regression coefficient of 29.101 at p <0.05. Furthermore, the dependent
variable, complication, in particular, pneumonitis, and the independent factor, concomitant disease,
particularly, arrhythmia, have a significant regression coefficient of 21.937 at p <0.05.

Conclusion:
An elevated level of CPK-MB/LDH/Troponin I is linked to the development of arrhythmia.
Patients with other medical conditions experience high diastolic blood pressure and an enlargement
of the right ventricle. The early complication observed after MI is the formation of a left
ventricular aneurysm. Complications arise due to low levels of potassium and calcium. Chronic Kidney
Disease (CKD) contributes to the End-Diastolic Size (EDS) of the Left Ventricle (LV), Troponin
I, and creatine phosphokinase-MB (CPK-MB). Advanced CKD patients have a hypertrophic left ventricle
and persistently elevated post-myocardial Infarction (MI) cardiac biomarkers (CPKMB/
LDH/Troponin I) due to impaired kidney detoxification. Therefore, prolonged elevation of MI
biomarkers can be an indicative of severe MI or kidney function impairment due to the chronic mild
elevation in the MI biomarkers. Pericarditis development is related to the pre-existence of chronic
heart failure. Moreover, pneumonitis development is related to the pre-existence of arrhythmia.

Others:
Hypertensive patients do not exhibit a significant increase in calcium levels, indicating
that it is not a reliable biomarker in this patient population. Additionally, gender plays a crucial
role in the development of ischemic heart disease, including myocardial infarction.