# US 8,771,961 B2 · Monitoring myocardial infarction and its treatment > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 8,771,961 B2 - Document ID: US8771961B2 - Status: Granted - Kind: B2 - Application number: 12/748,476 - Filed: 2010-03-29 - Published: 2011-09-01 - Granted: 2014-07-08 - Earliest claimed: 2007-10-10 - Assignees: Roche Diagnostics Operations, Inc. - Applicants: Georg Hess; Andrea Horsch; Dietmar Zdunek - Inventors: Georg Hess; Andrea Horsch; Dietmar Zdunek - Web page: https://patentgrep.com/patent/US8771961B2 ## CPC - G01N 33/6887: {from muscle, cartilage or connective tissue} - A61P 9/00: Drugs for disorders of the cardiovascular system - A61P 9/04: Inotropic agents, i.e. stimulants of cardiac contraction; Drugs for heart failure - A61P 9/10: for treating ischaemic or atherosclerotic diseases, e.g. antianginal drugs, coronary vasodilators, drugs for myocardial infarction, retinopathy, cerebrovascula insufficiency, renal arteriosclerosis - G01N 2800/324: Coronary artery diseases, e.g. angina pectoris, myocardial infarction - G01N 2800/52: Predicting or monitoring the response to treatment, e.g. for selection of therapy based on assay results in personalised medicine; Prognosis - G01N: INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES (measuring or testing apparatus or processes other than immunoassay, involving enzymes or microorganisms C12M, C12Q) - A61P: SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS ## Abstract Disclosed is a method of determining which medication is to be applied in a remodeling process of a subject after a myocardial infarction, the method comprising determining an amount of a natriuretic peptide, a cardiac troponin, and an inflammatory marker in a sample from the subject and initiating a remodeling in the subject, wherein the medication to be applied in the remodeling is selected according to the level of the peptides determined. Also disclosed is a method of monitoring the remodeling, wherein further steps include again determining an amount of the natriuretic peptide, the cardiac troponin, and the inflammatory marker in a sample from the subject, calculating the difference between the values from the first and second measurements, and assessing remodeling success from the data obtained. ## Claims ### Claim 1 A method of deciding which treatment is to be administered in a remodeling process of a subject who has suffered a myocardial infarction, the method comprising determining an amount of a natriuretic peptide, a cardiac troponin, and an inflammatory marker in a sample from the subject, wherein the inflammatory marker is selected from growth-differentiation factor-15 (GDF-15), C-reactive protein (CRP), and osteopontin, and initiating a remodeling process in the subject by administering a treatment selected according to the amounts of natriuretic peptide, cardiac troponin and inflammatory marker determined. ### Claim 2 (depends on 1) The method of claim 1, wherein the natriuretic peptide is selected from the group consisting of atrial natriuretic peptide (ANP), N-terminal pro-atrial natriuretic peptide (NT-proANP), brain natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP). ### Claim 3 (depends on 1) The method of claim 1, wherein the natriuretic peptide is NT-proBNP. ### Claim 4 (depends on 3) The method of claim 3, wherein treatment comprises administration of a medication selected from the group consisting of beta blockers, natriuretics, loop diuretics, nitrates, and positive inotropic agents if an amount of NT-proBNP ≧300 pg/ml is determined. ### Claim 5 (depends on 1) The method of claim 1, wherein the inflammatory marker is GDF-15. ### Claim 6 (depends on 5) The method of claim 5, wherein treatment comprises administration of a medication selected from the group consisting of ACE inhibitors, angiotensin receptor antagonists, statins, NSAIDS, and selective COX-2 inhibitors if an amount of GDF-15 ≧800 pg/ml is determined. ### Claim 7 (depends on 1) The method of claim 1, wherein the inflammatory marker is C-reactive protein (CRP). ### Claim 8 (depends on 7) The method of claim 7, wherein treatment comprises administering a medication selected from the group consisting of statins if an amount of CRP >3 mg/L is determined. ### Claim 9 (depends on 1) The method of claim 1, wherein the inflammatory marker is osteopontin. ### Claim 10 (depends on 9) The method of claim 9, wherein treatment comprises administering a medication selected from the group consisting of anti-inflammatory drugs, angiotensin receptor antagonists, and aldosterone antagonists if an amount of osteopontin >500 pg/ml is determined. ### Claim 11 (depends on 1) The method of claim 1, wherein the cardiac troponin is troponin T or troponin I. ### Claim 12 (depends on 11) The method of claim 11, wherein the treatment comprises percutaneous intervention further comprising determining a second amount of troponin T between 2-3 days and ten months after determination of the first amount of troponin T, and applying a percutaneous intervention if the second amount does not drop to 80% or less of the first amount. ### Claim 13 (depends on 12) The method according to claim 12, wherein the first amount is determined 2-3 days after infarction and the second amount is determined about 3 months after the first determination. ### Claim 14 (depends on 13) The method according to claim 13, wherein one or more determinations subsequent to the second determination are made at 3-6 month intervals after the second determination. ### Claim 15 (depends on 1) The method of claim 1, wherein the amounts of the natriuretic peptide, cardiac troponin, and inflammatory marker are determined 1 to 3 days following the myocardial infarction. ### Claim 16 A method of managing treatment of a subject undergoing a remodeling process initiated by administration of medication following a myocardial infarction by monitoring success of the remodeling, the method comprising the steps of: determining an amount of a natriuretic peptide, a cardiac troponin, and an inflammatory marker in a sample from the subject, wherein the inflammatory marker is selected from growth-differentiation factor-15 (GDF-15), C-reactive protein (CRP), and osteopontin, initiating a remodeling process in the subject by administering a medication selected according to the level of the natriuretic peptide, cardiac troponin, and inflammatory marker determined, determining a second amount of the natriuretic peptide, the cardiac troponin, and the inflammatory marker in a sample from the subject, calculating a difference between the amounts from the first and second determination of a natriuretic peptide, a difference between the amounts from the first and second determination of cardiac troponin, and a difference between the amounts from the first and second determination of inflammatory marker, assessing, from the differences obtained, the success of the remodeling process, and managing the treatment by adapting the administration of medication in accordance with the assessment. ### Claim 17 (depends on 16) The method of claim 16, wherein the inflammatory marker is osteopontin and administration of a medication is lowered if the difference is ≧40%. ### Claim 18 (depends on 16) The method of claim 16 wherein the inflammatory marker is GDF-15 and administration of a medication is lowered if the difference is ≧20%. ### Claim 19 (depends on 16) The method of claim 16, wherein the inflammatory marker is CRP and administration of a medication is lowered if a decrease of said second amount to a level of 33 mg/L CRP occurs.