Electrochemical Assessment of Increased Fatty Acid Level in Myocardial Ischemia

Project no. 23716 · Status: Kapanmış (Yayın bekleniyor) · 2023

Summary

Within the scope of this project, the clinical performance of an innovative electrochemical diagnostic method, chronoimpedance-based sensor technology, developed for use in the diagnosis of acute coronary syndrome (ACS), was evaluated. The study is based on the principle of recording impedance changes obtained from patient-specific serum samples applied to the electrode surface over time. The aim was to verify the hypothesis that this impedance method is as sensitive as or better than high-sensitive troponin T (hs-TnT). The study group consisted of 20 patients diagnosed with ACS (15 with myocardial infarction, 5 with unstable angina) and 98 with non-ischemic chest pain, a total of 118 patients. Electrochemical measurements, serum fatty acid determination, serum routine biochemistry examinations and serum troponin levels were performed from blood samples taken simultaneously when the patients applied to the emergency department. Impedance measurements were made for 500 seconds. Since the impedance curves initially approached a plateau after the logarithmic increase, the impedance change at the 100th second was taken into account in all calculations. The impedance data obtained were analyzed by comparing the serum total fatty acid (FA) level, serum fatty acid/albumin (FA/Alb) ratio, and hs-TnT levels in all patients. In ROC analyses for hs-TnT, the area under the curve was calculated as 0.916, and the cut-off value was 29. Accordingly, sensitivity was 90%, specificity was 88%, positive predictive value was 62%, and negative predictive value was 97%. After taking the hs-TnT cut-off value as 14 as recommended by the manufacturer, sensitivity was calculated as 95%, specificity was 75%, positive predictive value was 44%, and negative predictive value was 98%. In ROC analyses of serum total FA level, the area under the curve was calculated as 0.592, and the cut-off value was 0.79mM. Accordingly, sensitivity was calculated as 85%, specificity was 57%, positive predictive value was 28%, and negative predictive value was 95%. In ROC analyses of serum FA/Alb ratio, the area under the curve was calculated as 0.613, and the cut-off value was 1.18. Accordingly, sensitivity was calculated as 90%, specificity as 51%, positive predictive value as 27% and negative predictive value as 96%. Chronoimpedance 100th second impedance change ROC analysis calculated the area under the curve as 0.783, cut-off value as 12kohm. Accordingly, sensitivity was calculated as 90%, specificity as 69%, positive predictive value as 37% and negative predictive value as 97%. Chronoimpedance and hs-TnT ROC curves and analyses were very close to each other, and no statistical difference was found between them in the comparison (p=0.079). With the chronoimpedance method we have newly defined, acute coronary syndrome (ACS) diagnosis can be made with an accuracy very close to hs-TnT marker. Further clinical studies with larger patient numbers and subgroup analyses are needed.

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