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Mirror, Mirror On The Wall: The Quest For The Earliest Marker of Myocardial Ischaemia
Mirror, Mirror On The Wall: The Quest For The Earliest Marker of Myocardial Ischaemia
doi:10.1093/eurheartj/ehi599
Editorial
This editorial refers to ‘Serum deoxyribonuclease I neither for myocardial ischaemia nor for infarction. Thus,
activity can be used as a sensitive marker for detection reduced cobalt binding has also been reported after
of transient myocardial ischaemia induced by percuta- endurance exercise, such as marathon race, after radiofre-
& The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
2350 Editorial
The exact pathomechanism responsible for DNase I before DNase I activity can become a diagnostic tool for
elevation is still unknown. DNase I is not a cardiospecific patients with suspected ACS.
enzyme, as it is present in biological fluids and is ubiqui-
tously expressed in mammalian tissues. DNase I is an endo- Conflict of interest: H.A.K. has developed the cardiac
nuclease that preferentially degrades double-stranded DNA troponin T assay and holds a patent jointly with Roche
in a Ca2þ-dependent manner to produce oligonucleotides Diagnostics. E.G. and H.A.K. have received honoraria for
with 50 -phospho and 30 -hydroxy termini. lectures from MSD, Roche Diagnostics, Novartis,
There is also a consistent body of evidence suggesting that AstraZeneca, Sanofi and Bayer.
DNase I is involved in DNA breakdown during apoptosis in
patients with cardiomyopathy.7 References
In the present publication, balloon angioplasty and pro-
visional coronary stenting were used as a model to induce 1. Bertrand ME, Simoons ML, Fox KA, Wallentin LC, Hamm CW, McFadden E,
De Feyter PJ, Specchia G, Ruzyllo W; Task Force on the Management of
reversible myocardial ischaemia. However, PCI has several
Acute Coronary Syndromes of the European Society of Cardiology.
shortcomings and is not an ideal model to evaluate the Management of acute coronary syndromes in patients presenting
effects of myocardial ischaemia. First, a substantial pro- without persistent ST-segment elevation. Eur Heart J
portion of patients undergoing elective coronary interven- 2002;23:1809–1840.
tions develop peri-interventional myocardial infarction 2. Fishbein MC, Wang T, Matijasevic M, Hong L, Apple FS. Myocardial tissue
troponins T and I. An immunohistochemical study in experimental models
because of side branch occlusion, major coronary dissec- of myocardial ischemia. Cardiovasc Pathol 2003;12:65–71.