ArticleInternal and emergency medicine2025
Diagnostic role of plasma biomarkers in early myocardial injury due to carbon monoxide poisoning.
Article in Internal and emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
This study aimed to evaluate the predictive value of plasma biomarkers for myocardial injury and the need for hyperbaric oxygen therapy (HBOT) in patients presenting to the emergency department (ED) with carbon monoxide (CO) poisoning. This prospective observational study included patients over 18 years of age who presented to a tertiary care ED with CO poisoning between December 1, 2022, and March 31, 2024. Demographic and clinical data, blood gas and hemogram parameters, and plasma biomarkers including CRP, fibrinogen, albumin, D-dimer, NT-proBNP, and creatine kinase were recorded. Hospital admission, length of stay, complications, and HBOT requirements were also assessed. A total of 82 patients were included (53.7% female, mean age 54 ± 3.9 years). HBOT was administered to 26.6% of patients; 28% were hospitalized, and two patients died. Multivariate analysis revealed that neutrophil-to-lymphocyte ratio (NLR) was an independent predictor of myocardial injury (OR: 1.15; 95% CI: 1.008-1.312; p = 0.038). ROC analysis showed that D-dimer (AUC: 0.791; 95% CI: 0.680-0.902; cut-off: 395; sensitivity 77.3%, specificity 73.3%) and NLR (AUC: 0.787; 95% CI: 0.662-0.912; cut-off: 7.4; sensitivity 77.3%, specificity 86.7%) were the most accurate biomarkers for predicting myocardial injury. For predicting HBOT need, D-dimer (AUC: 0.737; cut-off: 395; sensitivity 70%, specificity 76.9%) and NT-proBNP (AUC: 0.702; cut-off: 126.9; sensitivity 66.7%, specificity 69.2%) were found to be significant predictors. D-dimer, NT-proBNP, and NLR may serve as useful biomarkers in predicting myocardial damage and the need for HBOT in patients with CO poisoning.
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