Modification of cardiac biomarkers sensity in hypertensive patiens treated with angiotensin-converting enzyme inhibitors in acute coronary syndrome with non-st segment elevation

Abstract

Background: Patients with non-ST segment elevation myocardial infarction and the mortality risk is associated when Creatine Kinase isoenzyme MB and Troponin I values are increase. Objective: The present study was oriented to study the modification of cTnI and CK-MB sensitivity in the arterial hypertension and its association with drugs in the antihypertensive treatment. Methods: A descriptive and random study included 35 hypertensive patients of both sexes, admitted to the coronary unit of the “Reina Fabiola “Clinic”. The patients were stratified without associated pathologies (Control group), n = 13; and with only hypertension, n = 22 treated with angiotensin-converting enzyme inhibitors (n= 15), beta-blockers (n = 7). Samples of blood were collected and cardiac markers analyzed at the entrance to the coronary care unit (0 hs) and after 8, 12, 24 hs. Results: Creatine Kinase MB activity decreased at 8 hs and Troponin I sensibility showed a decrease in hypertensive patients treated with angiotensin-converting enzyme inhibitors respect control group at 0 hs. Optimal cut points of CK-MB were 13.50, 17.00, 19.50 and 14.00 UI/L, and to cTnI 0.08, 0.17, 0.16 and 0.42 ng/ml at 0, 8, 12, and 24 hs respectively. Conclusions: The remodeling and ventricular hypertrophy states are conditions that could be modify biomarkers levels and sensitivity by the use of antihypertensive drugs. We propose an algorithm incorporating changes in cTnI levels and CK-MB activity to increases the diagnostic sensitivity in AHT patients.