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https://www.readbyqxmd.com/read/28719490/identification-of-hypotensive-emergency-department-patients-with-cardiogenic-etiologies
#1
Daniel J Henning, Kathleen E Kearney, M Kennedy Hall, Claudius Mahr, Nathan I Shapiro, Graham Nichol
OBJECTIVE: Identify predictors of cardiogenic etiology among Emergency Department (ED) patients with hypotension, and use these predictors to create a clinical tool to discern cardiogenic etiology of hypotension. METHODS: This secondary analysis evaluated a prospective cohort of consecutive patients with hypotension in an urban, academic, tertiary care ED from November 2012 to September 2013. We included adults with hypotension, defined as a new vasopressor requirement, systolic blood pressure (SBP) < 90 mmHg after at least 1L of crystalloid or 2 units packed red blood cells, or SBP < 90 mmHg and fluids withheld due to concern for fluid overload...
July 17, 2017: Shock
https://www.readbyqxmd.com/read/28719430/high-sensitivity-cardiac-troponin-t-improves-the-diagnosis-of-perioperative-mi
#2
Jamie C Brown, Eslam Samaha, Srikar Rao, Mohammad A Helwani, Andreas Duma, Frank Brown, Brian F Gage, J Philip Miller, Allan S Jaffe, Fred S Apple, Mitchell G Scott, Peter Nagele
BACKGROUND: The diagnosis of myocardial infarction (MI) after noncardiac surgery has traditionally relied on using relatively insensitive contemporary cardiac troponin (cTn) assays. We hypothesized that using a recently introduced novel high-sensitivity cTnT (hscTnT) assay would increase the detection rate of perioperative MI. METHODS: In this ancillary study of the Vitamins in Nitrous Oxide trial, readjudicated incidence rates of myocardial injury (new isolated cTn elevation) and MI were compared when diagnosed by contemporary cTnI versus hscTnT...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28716801/diabetes-mellitus-microalbuminuria-and-subclinical-cardiac-disease-identification-and-monitoring-of-individuals-at-risk-of-heart-failure
#3
Peter P Swoboda, Adam K McDiarmid, Bara Erhayiem, David P Ripley, Laura E Dobson, Pankaj Garg, Tarique A Musa, Klaus K Witte, Mark T Kearney, Julian H Barth, Ramzi Ajjan, John P Greenwood, Sven Plein
BACKGROUND: Patients with type 2 diabetes mellitus and elevated urinary albumin:creatinine ratio (ACR) have increased risk of heart failure. We hypothesized this was because of cardiac tissue changes rather than silent coronary artery disease. METHODS AND RESULTS: In a case-controlled observational study 130 subjects including 50 ACR+ve diabetes mellitus patients with persistent microalbuminuria (ACR >2.5 mg/mol in males and >3.5 mg/mol in females, ≥2 measurements, no previous renin-angiotensin-aldosterone therapy, 50 ACR-ve diabetes mellitus patients and 30 controls underwent cardiovascular magnetic resonance for investigation of myocardial fibrosis, ischemia and infarction, and echocardiography...
July 17, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28715149/welcome-to-the-real-world-do-the-conditions-of-fda-approval-devalue-high-sensitivity-troponin
#4
Richard Body, Simon Mahler
In January 2017 the Food and Drug Administration (FDA) approved the first high sensitivity cardiac troponin (hs-cTn) assay for use in the United States: the 5(th) generation hs-cTnT assay manufactured by Roche Diagnostics. This landmark decision finally enables Americans to benefit from the same improvements in diagnostic technology that the rest of the world has utilized for some six years. This article is protected by copyright. All rights reserved.
July 17, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28714526/different-postconditioning-cycles-affect-prognosis-of-aged-patients-undergoing-primary-percutaneous-coronary-intervention
#5
Jie Zhang, Xin Zhang, Yuqi Cui, Misbahul Ferdous, Lianqun Cui, Peng Zhao
BACKGROUND: Postconditioning can affect the infarct size in acute myocardial infarction (AMI). However, few studies show an effect of different postconditioning cycles on AMI aged patients. This study sought to assess the effect of different postconditioning cycles on prognosis in aged patients with AMI who underwent primary percutaneous coronary intervention (PCI). METHODS: 74 aged patients were randomly assigned to three groups. Control group; PC-1 group accepted postconditioning 4 cycles of 30 s inflation and 30 s deflation; PC-2 group accepted postconditioning 4 cycles of 60 s...
July 17, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28712855/plasma-high-sensitivity-troponin-t-predicts-end-stage-renal-disease-and-cardiovascular-and-all-cause-mortality-in-patients-with-type-1-diabetes-and-diabetic-nephropathy
#6
Julie Galsgaard, Frederik Persson, Tine Willum Hansen, Anders Jorsal, Lise Tarnow, Hans-Henrik Parving, Peter Rossing
High-sensitivity troponin T (hsTnT) is a marker of cardiovascular disease (CVD) and in type 2 diabetes also a marker of renal events, but has not been evaluated in type 1 diabetics. We therefore reviewed a type 1 diabetes cohort of 442 without and 458 with diabetic nephropathy. Baseline samples were analyzed for hsTnT levels. Cox regression analyses assessed predictive value in relation to the development of end-stage renal disease (ESRD) in 99 patients, all-cause mortality in 178, and CVD events in 134 after up to 12 years of follow-up...
July 13, 2017: Kidney International
https://www.readbyqxmd.com/read/28712187/utility-of-heart-type-fatty-acid-binding-protein-h-fabp-point-of-care-test-in-the-early-hours-of-stemi-compared-with-troponin-i-in-pakistani-population
#7
Walid Ahmad Abbasi, Muhammad Saleem, Shahid Rasheed, Azhar Mahmood Kiyani
BACKGROUND: Acute coronary syndrome remains a dominant cause of high morbidity and mortality despite advancements in treatment This study was conducted to examine the utility of point-of-care test of heart-type fatty-acid binding protein (h-FABP) and compare it with the point-of-care test of cardiac troponin I (cTnI) in the first 06 hours of STEMI. METHODS: This cross-sectional, comparative study which was conducted in Rawalpindi institute of cardiology, Rawalpindi, Pakistan, from January to June 2015...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28704807/high-sensitivity-troponin-t-and-nt-probnp-kinetics-in-breast-cancer-chemotherapy
#8
Pooja Advani, Jonathan Hoyne, Alvaro Moreno-Aspita, Marcia Dubin, Shelly Brock, Caroline Harlow, Saranya Chumsri, Thomas Suter, Joseph L Blackshear
BACKGROUND/AIMS: Doxorubicin (DOX) and trastuzumab (TRA) are associated with cardiac dysfunction. METHOD: High-sensitivity troponin T (hs-TnT) and brain natriuretic peptide attached to the amino acid N-terminal fragment in the prohormone (NT-proBNP) were measured before and on days +1, +2, +3, and +7 during cycles 1 and 2 of therapy with DOX or TRA in breast cancer patients. RESULTS: Five of eleven DOX-treated women, compared with 2/11 TRA-treated women, had undetectable baseline hs-TnT...
July 14, 2017: Chemotherapy
https://www.readbyqxmd.com/read/28704179/analytical-evaluation-of-the-new-beckman-coulter-access-high-sensitivity-cardiac-troponin-i-immunoassay
#9
Giuseppe Lippi, Anna Ferrari, Giorgio Gandini, Matteo Gelati, Claudia Lo Cascio, Gian Luca Salvagno
BACKGROUND: This study was aimed to evaluate the analytical performance of the novel chemiluminescent and fully-automated Beckman Coulter Access hsTnI high-sensitivity immunoassay for measurement of cardiac troponin I (cTnI). METHODS: The study, using lithium heparin samples, included assessment of limit of blank (LOB), limit of detection (LOD), functional sensitivity, linearity, imprecision (within run, between-run and total), calculation of 99th percentile upper reference limit (URL) in 175 healthy blood donors (mean age, 36±12 years; 47% women) and comparison with two other commercial cTnI immunoassays...
July 12, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28701316/diagnostic-performance-of-high-sensitivity-compared-with-contemporary-cardiac-troponin-i-for-the-diagnosis-of-acute-myocardial-infarction
#10
Yader Sandoval, Stephen W Smith, Sarah E Thordsen, Charles A Bruen, Michelle D Carlson, Kenneth W Dodd, Brian E Driver, Katherine Jacoby, Benjamin K Johnson, Sara A Love, Johanna C Moore, Anne Sexter, Karen Schulz, Nathaniel L Scott, Jennifer Nicholson, Fred S Apple
BACKGROUND: We examined the diagnostic performance of high-sensitivity cardiac troponin I (hs-cTnI) vs contemporary cTnI with use of the 99th percentile alone and with a normal electrocardiogram (ECG) to rule out acute myocardial infarction (MI) and serial changes (deltas) to rule in MI. METHODS: We included consecutive patients presenting to a US emergency department with serial cTnI on clinical indication (NCT02060760). Diagnostic performance for acute MI, including MI subtypes, and 30-day outcomes were examined...
July 12, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28700019/assessment-of-subclinical-doxorubicin-induced-cardiotoxicity-in-a-rat-model-by-speckle-tracking-imaging
#11
Yu Kang, Wei Wang, Hang Zhao, Zhiqing Qiao, Xuedong Shen, Ben He
Backgrounds: Despite their clear therapeutic benefits, anthracycline-induced cardiotoxicity is a major concern limiting the ability to reduce morbidity and mortality associated with cancers. The early identification of anthracycline-induced cardiotoxicity is of vital importance to assess the cardiac risk against the potential cancer treatment. Objective: To investigate whether speckle-tracking analysis can provide a sensitive and accurate measurement when detecting doxorubicin-induced left ventricular injury...
July 10, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28698323/performance-of-highly-sensitive-cardiac-troponin-t-assay-to-detect-ischaemia-at-pet-ct-in-low-risk-patients-with-acute-coronary-syndrome-a-prospective-observational-study
#12
Beata Morawiec, Stephane Fournier, Maxime Tapponnier, John O Prior, Pierre Monney, Vincent Dunet, Nathalie Lauriers, Frederique Recordon, Catalina Trana, Juan-Fernando Iglesias, Damian Kawecki, Olivier Boulat, Daniel Bardy, Sabine Lamsidri, Eric Eeckhout, Olivier Hugli, Olivier Muller
BACKGROUND: Highly sensitive troponin T (hs-TnT) assay has improved clinical decision-making for patients admitted with chest pain. However, this assay's performance in detecting myocardial ischaemia in a lowrisk population has been poorly documented. PURPOSE: To assess hs-TnT assay's performance to detect myocardial ischaemia at positron emission tomography/CT (PET-CT) in low-risk patients admitted with chest pain. METHODS: Patients admitted for chest pain with a nonconclusive ECG and negative standard cardiac troponin T results at admission and after 6 hours were prospectively enrolled...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28695975/decreased-admissions-and-hospital-costs-with-a-neutral-effect-on-mortality-following-lowering-of-the-troponin-t-cutoff-point-to-the-99th-percentile
#13
Christian Bjurman, Matteus Zywczyk, Bertil Lindahl, Tobias Carlsson, Per Johanson, Max Petzold, Martin Holzmann, Michael Lx Fu, Ola Hammarsten
BACKGROUND: The implementation of high-sensitivity cardiac troponin T (hs-cTnT) assays and a cutoff based on the 99th cTnT percentile in the evaluation of patients with suspected acute coronary syndrome has not been uniform due to uncertain effects on health benefits and utilization of limited resources. METHODS: Clinical and laboratory data from patients with chest pain or dyspnea at the emergency department (ED) were evaluated before (n = 20516) and after (n = 18485) the lowering of the hs-cTnT cutoff point from 40 ng/L to the 99th hs-cTnT percentile of 14 ng/L in February 2012...
July 11, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28692218/-interpretation-of-high-sensitivity-troponin-in-patients-with-chronic-kidney-failure
#14
Manon Kolb, Alexandre Guinand, Marco Roffi, Patrick Saudan, Mathieu Nendaz
New assays with lower levels of detection of troponin (« high-sensitivity troponin ») increase the difficulty of interpretation of this test for the diagnosis of acute coronary syndrome in patients with chronic kidney disease (CKD). Their baseline concentration of troponin is frequently above the upper reference level, which lowers its specificity. To improve its diagnostic performance after clinical and electrocardiographic evaluation, cut-off levels 2 to 3 times higher than the standard reference have been suggested...
October 19, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28689634/impact-of-the-australian-gender-specific-thresholds-using-the-abbott-high-sensitivity-troponin-i-assay-in-clinical-care
#15
Robert Bender, Faith Njue, Samuel Vasikaran, Ramon Lambert, Jamie Rankin, Graham S Hillis, Damon A Bell
The aim of this study was to ascertain the impact of gender specific hs-TnI thresholds in a clinical setting and determine the clinical characteristics and discharge diagnosis for individuals presenting to the Emergency Department (ED) with elevated troponin I with the Abbott high-sensitivity troponin I (hs-TnI) assay, but non-elevated troponin I on the previous generation assay (STAT TnI-II). Medical records of individuals presenting to the Royal Perth Hospital ED with elevated hs-TnI between 12 November 2013 and 24 December 2013 were retrospectively reviewed...
July 6, 2017: Pathology
https://www.readbyqxmd.com/read/28684396/cardiac-stress-and-inflammatory-markers-as-predictors-of-heart-failure-in-patients-with-type-2-diabetes-the-advance-trial
#16
Toshiaki Ohkuma, Min Jun, Mark Woodward, Sophia Zoungas, Mark E Cooper, Diederick E Grobbee, Pavel Hamet, Giuseppe Mancia, Bryan Williams, Paul Welsh, Naveed Sattar, Jonathan E Shaw, Kazem Rahimi, John Chalmers
OBJECTIVE: This study examined the individual and combined effect of N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin T (hs-cTnT), interleukin-6 (IL-6), and hs-CRP on the prediction of heart failure incidence or progression in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: A nested case-cohort study was conducted in 3,098 participants with type 2 diabetes in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial...
July 6, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28680021/potential-of-lipoproteins-as-biomarkers-in-acute-myocardial-infarction
#17
Haseeb Ahmad Khan, Aishah Ekhzaimy, Isra Khan, Meena Kishore Sakharkar
Acute myocardial infarction (AMI), commonly known as heart attack, is a medical emergency that is potentially fatal if not promptly and properly managed. The early diagnosis of AMI is critically important for the timely institution of pharmacotherapy to prevent myocardial damage and preserve cardiac function. Ischemic insults during AMI cause myocardial tissue damage, releasing the cardiac muscle protein troponin T into the blood stream. Therefore, serum troponin T levels are used as a sensitive and specific indicator of myocardial injury for diagnosing AMI...
July 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28679558/effect-modification-of-chronic-kidney-disease-on-the-association-of-circulating-and-imaging-cardiac-biomarkers-with-outcomes
#18
L Parker Gregg, Beverley Adams-Huet, Xilong Li, Gates Colbert, Nishank Jain, James A de Lemos, S Susan Hedayati
BACKGROUND: Cardiac troponin T and brain natriuretic peptide (BNP) are elevated in >50% of dialysis patients and are associated with poor outcomes. Few data investigated these associations in earlier chronic kidney disease (CKD). METHODS AND RESULTS: We studied whether CKD modified associations of elevated BNP, N-terminal-pro-BNP, high-sensitivity cardiac troponin T, coronary artery calcification, and left ventricular hypertrophy with all-cause death and cardiovascular death/events in 3218 multiethnic individuals followed for 12...
July 5, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28672916/diagnostic-accuracy-of-coronary-ct-angiography-combined-with-dual-energy-myocardial-perfusion-imaging-for-detection-of-myocardial-infarction
#19
Ruijuan Han, Kai Sun, Bin Lu, Ruiping Zhao, Kuncheng Li, Xinchun Yang
The aim of the present study was to evaluate the diagnostic accuracy of second generation dual-energy computed tomography (DECT) myocardial perfusion imaging for the detection of myocardial infarction (MI) in patients with suspected MI. In total, 56 patients underwent DECT. Among those, 40 patients had MI that was detected by catheter coronary angiography and cardiac troponin I elevation and evolution of acute MI detected by electrocardiogram changes. The diagnostic accuracy, including the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the detection of MI were evaluated, as well as the coronary image quality of coronary artery and radiation dose...
July 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28669701/comparative-evaluation-of-2-hour-rapid-diagnostic-algorithms-for-acute-myocardial-infarction-using-high-sensitivity-cardiac-troponin-t
#20
Andrew D McRae, Grant Innes, Michelle Graham, Eddy Lang, James E Andruchow, Hong Yang, Yunqi Ji, Shabnam Vatanpour, Danielle A Southern, Dongmei Wang, Isolde Seiden-Long, Lawrence DeKoning, Peter Kavsak
BACKGROUND: Symptoms of acute coronary syndrome account for a large proportion of emergency department (ED) visits and hospitalizations. High-sensitivity troponin can rapidly rule out or rule in acute myocardial infarction (AMI) within a short time of ED arrival. We sought to validate test characteristics and classification performance of 2-hour high-sensitivity troponin T (hsTnT) algorithms for the rapid diagnosis of AMI. METHODS: We included consecutive patients from 4 academic EDs with suspected cardiac chest pain who had hsTnT assays performed 2 hours apart (± 30 minutes) as part of routine care...
May 3, 2017: Canadian Journal of Cardiology
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