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https://www.readbyqxmd.com/read/28545635/outcomes-in-patients-with-chest-pain-discharged-after%C3%A2-evaluation-using-a-high-sensitivity-troponin-t-assay
#1
Atosa Nejatian, Åsa Omstedt, Jonas Höijer, L O Hansson, Therese Djärv, Kai M Eggers, Per Svensson
BACKGROUND: Most patients with chest pain are discharged from the emergency department (ED) with the diagnosis "unspecified chest pain." It is unknown if evaluation with a high-sensitivity troponin T (hsTnT) assay affects prognosis in this large population. OBJECTIVES: The aim was to investigate whether the introduction of an hsTnT assay is associated with reduced incidence of major adverse cardiac events (MACEs) and cardiovascular (CV) risk profile in patients with chest pain discharged from the ED...
May 30, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28544100/undetectable-concentrations-of-an-fda-approved-high-sensitivity-cardiac-troponin-t-assay-to-rule-out-acute-myocardial-infarction-at-emergency-department-arrival
#2
Andrew D McRae, Grant Innes, Michelle Graham, Eddy Lang, James E Andruchow, Yunqi Ji, Shabnam Vatanpour, Tasnima Abedin, Hong Yang, Danielle A Southern, Dongmei Wang, Isolde Seiden-Long, Lawrence DeKoning, Peter Kavsak
BACKGROUND: The objective of this study was to quantify the sensitivity of very low concentrations of high-sensitivity cardiac troponin T (hsTnT) at ED arrival for acute myocardial infarction (AMI) in a large cohort of chest pain patients evaluated in real-world clinical practice. METHODS: This retrospective study included consecutive ED patients with suspected cardiac chest pain evaluated in four urban EDs were, excluding those with ST-elevation AMI, cardiac arrest or abnormal kidney function...
May 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28542299/preoperative-cardiac-troponin-level-is-associated-with-all-cause-mortality-of-liver-transplantation-recipients
#3
Jungchan Park, Seung Hwa Lee, Sangbin Han, Hyun Sook Jee, Suk-Koo Lee, Gyu-Seong Choi, Gaab Soo Kim
This study was aimed to evaluate the association between preoperative high-sensitivity cardiac troponin I (hs-cTnI) level and mortality in patients undergoing liver transplantation (LT). From January 2011 to May 2016, preoperative hs-cTnI level was measured in consecutive 487 patients scheduled for LT. Patients with elevated preoperative hs-cTnI were compared with those who had normal level. The primary outcome was all-cause death in follow-up period of 30 days to 1 year after operation. Of the 487 patients, 58 (11...
2017: PloS One
https://www.readbyqxmd.com/read/28541600/elevated-high-sensitivity-troponin-does-not-indicate-the-presence-of-coronary-artery-disease-in-patients-presenting-with-supraventricular-tachycardia
#4
Martin Murer, Florim Cuculi, Stefan Toggweiler, Vanessa Weberndoerfer, Mabelle Young, Richard Kobza
BACKGROUND: Patients with supraventricular tachycardia (SVT) and patients with coronary artery disease (CAD) often present with similar symptoms (chest pain, shortness of breath), similar electrocardiographic changes and elevated high-sensitivity troponin (cTn). It is not clear whether troponin reflects critical CAD or is elevated due to other causes in patients presenting with SVT. The aim of this study was to assess the role of elevated troponin in patients presenting with SVT. METHODS: Patients undergoing radiofrequency ablation (RFA) for SVT and simultaneous coronary angiography at the Heart Centre Lucerne, Switzerland between January 2010 and October 2014 were included in this analysis...
May 25, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28537984/postoperative-high-sensitivity-troponin-and-its-association-with-30-day-and-12-month-all-cause-mortality-in-patients-undergoing-on-pump-cardiac-surgery
#5
Eckhard Mauermann, Daniel Bolliger, Jens Fassl, Martin Grapow, Esther E Seeberger, Manfred D Seeberger, Miodrag Filipovic, Giovanna A L Lurati Buse
BACKGROUND: Troponin T is a predictor of cardiac morbidity and mortality after cardiac surgery with most data examining fourth generational troponin T assays. We hypothesize that postoperative high-sensitivity troponin T (hsTnT) measured in increments of the upper limit of the norm independently predicts 30-day all-cause mortality. METHODS: We included consecutive patients undergoing on-pump cardiac surgery from February 2010 to March 2012 in a prospective cohort that measured hsTnT at 0600 of the first and second postoperative day...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28533433/changes-in-the-dynamics-of-the-cardiac-troponin-c-molecule-explain-the-effects-of-ca-2-sensitizing-mutations
#6
Charles M Stevens, Kaveh Rayani, Gurpreet Singh, Bairam Lotfalisalmasi, D Peter Tieleman, Glen F Tibbits
Cardiac troponin C (cTnC) is the regulatory protein that initiates cardiac contraction in response to Ca(2+) TnC binding Ca(2+) initiates a cascade of protein-protein interactions that begins with the opening of the N-terminal domain of cTnC, followed by cTnC binding the Troponin I switch peptide (TnISW). We have evaluated, through isothermal titration calorimetry (ITC) and MD simulation, the effect of several clinically relevant mutations (A8V, L29Q, A31S, L48Q, Q50R and C84Y) on the Ca(2+) affinity, structural dynamics, and calculated interaction strengths between cTnC and each of Ca(2+) and TnISW Surprisingly the Ca(2+) affinity measured by ITC was only significantly affected by half of these mutations, with the exceptions of the L48Q, Q50R and C84Y mutants, which had an affinity 10-fold, 3-fold and 3-fold higher than wild-type, respectively...
May 22, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28532247/high-sensitivity-cardiac-troponin-t-in-patients-not-having-an-acute-coronary-syndrome-results-from-the-trapid-ami-study
#7
Richard Nowak, Christian Müller, E Giannitsis, Michael Christ, Jordi Ordonez-Llanos, Christopher DeFilippi, James McCord, Richard Body, Mauro Panteghini, Tomas Jernberg, Mario Plebani, Franck Verschuren, John K French, Robert Christenson, Gordon Jacobsen, Carina Dinkel, Bertil Lindahl
PURPOSE: To describe the baseline, 1 hour and delta high sensitivity cardiac troponin (hs-cTnT) values in patients with suspected acute myocardial infarction (AMI) but without a final acute coronary syndrome (ACS) diagnosis. MATERIALS AND METHODS: TRAPID-AMI was a prospective diagnostic (hs-cTnT) trial that enrolled Emergency Department (ED) patients with suspected AMI. Final patient diagnoses were adjudicated by a clinical events committee and subjects placed in different clinical groups: AMI, unstable angina, non-ACS cardiac, non-cardiac and unknown origin...
May 23, 2017: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/28530094/troponin-c-mutations-partially-stabilize-the-active-state-of-regulated-actin-and-fully-stabilize-the-active-state-when-paired-with-%C3%AE-14-tnt
#8
Tamatha Baxley, Dylan Johnson, Jose Renato Pinto, Joseph Michael Chalovich
Striated muscle contraction is regulated by the actin associated proteins tropomyosin and troponin. Activation of myosin ATPase activity is lowest in the absence of both Ca2+ and activating crossbridges (i.e. S1-ADP or rigor S1). Binding of activating species of myosin to actin at saturating Ca2+ stabilizes the most active state (M state) of actin-tropomyosin-troponin (regulated actin). Ca2+ binding alone produces partial stabilization of the active state. The extent of stabilization at saturating Ca2+ depends on the isoform of the troponin subunits, the phosphorylation state of troponin and, in the case of cardiac muscle, the presence of hypertrophic cardiomyopathy producing mutants of troponin T and troponin I...
May 22, 2017: Biochemistry
https://www.readbyqxmd.com/read/28528430/risk-classification-of-highly-sensitive-troponin-i-predict-presence-of-vulnerable-plaque-assessed-by-dual-source-coronary-computed-tomography-angiography
#9
Ting Liu, Guan Wang, Peiling Li, Xu Dai
Patients presenting to the emergency department with acute chest pain, negative conventional troponin and electrocardiogram require serial testing to rule out acute coronary syndrome (ACS). We studied the association of highly sensitive troponin (hsTn) I with vulnerable plaque features as detected by coronary dual source computed tomography angiography (DSCTA) and determined whether hsTn I at the time of presentation combined with early DSCTA could improve classification of patients as high-risk or low risk for ACS...
May 20, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28528401/cardiovascular-disease-biomarkers-are-associated-with-declining-renal-function-in-type-2-diabetes
#10
Sara J Jenks, Bryan R Conway, Stela McLachlan, Wei Leng Teoh, Rachel M Williamson, David J Webb, Paul Welsh, Naveed Sattar, Mark W J Strachan, Jackie F Price
AIMS/HYPOTHESIS: We investigated whether biochemical cardiovascular risk factors and/or markers of subclinical cardiovascular disease were associated with the development of reduced renal function in people with type 2 diabetes. METHODS: A cohort of 1066 Scottish men and women aged 60-74 years with type 2 diabetes from the Edinburgh Type 2 Diabetes Study were followed up for a median of 6.7 years. New-onset reduced renal function was defined as two eGFRs <60 ml(-1) min(-1) (1...
May 20, 2017: Diabetologia
https://www.readbyqxmd.com/read/28515820/arterial-velocity-pulse-index-as-a-novel-marker-of-atherosclerosis-using-pulse-wave-analysis-on-high-sensitivity-troponin-t-in-hypertensive-patients
#11
Takashi Hitsumoto
BACKGROUND: The arterial velocity pulse index (AVI) is explored as a novel marker of atherosclerosis using pulse wave analysis in clinical settings. Recent clinical studies have reported that the level of high-sensitivity troponin T (hs-cTnT) is an important biomarker in hypertensive patients. The aim of this study was to clarify the impact of AVI on hs-cTnT in these patients. METHODS: This study enrolled 455 hypertensive outpatients (181 males and 274 females; mean age, 65 ± 11 years (mean ± standard deviation)) without a history of cardiovascular events...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28515106/direct-comparison-of-2-rule-out-strategies-for-acute-myocardial-infarction-2-h-accelerated-diagnostic-protocol-vs-2-h-algorithm
#12
Karin Wildi, Louise Cullen, Raphael Twerenbold, Jaimi H Greenslade, William Parsonage, Jasper Boeddinghaus, Thomas Nestelberger, Zaid Sabti, Maria Rubini-Giménez, Christian Puelacher, Janosch Cupa, Lukas Schumacher, Patrick Badertscher, Karin Grimm, Nikola Kozhuharov, Claudia Stelzig, Michael Freese, Katharina Rentsch, Jens Lohrmann, Wanda Kloos, Andreas Buser, Tobias Reichlin, John Pickering, Martin Than, Christian Mueller
BACKGROUND: We compared 2 high-sensitivity cardiac troponin (hs-cTn)-based 2-h strategies in patients presenting with suspected acute myocardial infarction (AMI) to the emergency department (ED): the 2-h accelerated diagnostic protocol (2h-ADP) combining hs-cTn, electrocardiogram, and a risk score, and the 2-h algorithm exclusively based on hs-cTn concentrations and their absolute changes. METHODS: Analyses were performed in 2 independent diagnostic cohorts [European Advantageous Predictors of Acute Coronary Syndrome Evaluation (APACE) study, Australian-New Zealand 2-h Accelerated Diagnostic Protocol to Assess patients with chest Pain symptoms using contemporary Troponins as the only biomarker (ADAPT) study] employing hs-cTnT (Elecsys) and hs-cTnI (Architect)...
May 17, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28511772/transcoronary-concentration-gradient-of-microrna-133a-and-outcome-in-patients-with-coronary-artery-disease
#13
Roberta De Rosa, Salvatore De Rosa, David Leistner, Jes-Niels Boeckel, Till Keller, Stephan Fichtlscherer, Stefanie Dimmeler, Andreas M Zeiher
Circulating levels of microRNA (miR)-133a are increased in patients with coronary atherosclerotic disease (CAD). Whether the cardiac release of this miR provides any prognostic information in patients with CAD is currently unknown. We aimed to investigate if changes in concentration of miR-133a trough the coronary circulation may be associated with patients' cardiovascular outcome. We enrolled 111 patients (82 with stable CAD and 29 with acute coronary syndromes [ACS]) who underwent coronary angiography. Circulating levels of miR-133a were measured across the transcoronary circulation...
April 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28509704/effectiveness-of-2-hour-troponin-in-high-risk-patients-with-suspected-acute-coronary-syndrome
#14
Joseph Bove, Steven Hochman, Jacob Miller, Stephen Artim
BACKGROUND: Research has shown the safety and effectiveness of drawing a standard troponin level at presentation and again at 2 hours in only low-risk patients. Because high-sensitivity troponins are not currently approved in the United States, we studied the utility of a standard troponin that is presently in use. Our goal was to determine if 2-hour standard troponin would be safe and effective in the evaluation of a high-risk cohort of patients never studied previously. METHODS: We conducted a single-center prospective observational study of adult patients presenting to the emergency department with signs and symptoms suggestive of acute coronary syndrome...
June 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28505563/ultrasensitive-magnetic-field-assisted-surface-plasmon-resonance-immunoassay-for-human-cardiac-troponin-i
#15
Qiong Wu, Ying Sun, Di Zhang, Shuo Li, Yue Zhang, Pinyi Ma, Yang Yu, Xinghua Wang, Daqian Song
An ultrasensitive surface plasmon resonance (SPR) immunoassay was developed for the specific detection of human cardiac troponin I (cTnI), a principle diagnostic marker for myocardial damage. The thin gold film evaporated on a glass slate, which was employed as the SPR sensing film, was modified by hollow gold nanoparticles (HGNPs) and polydopamine (PDA) sequentially, and then was immobilized with antibodies for specific recognition of target analyte. Electronic coupling of the surface plasmon waves originating from the HGNPs and the gold film leads to the remarkable amplification of SPR response...
May 12, 2017: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/28500753/a-0h-1h-protocol-for-safe-early-discharge-of-chest-pain-patients
#16
Arash Mokhtari, Bertil Lindahl, Alexandru Schiopu, Troels Yndigegn, Ardavan Khoshnood, Patrik Gilje, Ulf Ekelund
OBJECTIVES: Guidelines recommend a 0h/1h high-sensitivity cardiac troponin T (hs-cTnT) diagnostic strategy in acute chest pain patients. There is however little data on the performance of this strategy when combined with clinical risk stratification. We aimed to evaluate the diagnostic accuracy of an accelerated diagnostic protocol (ADP) using the 0h/1h hs-cTnT strategy together with an adapted Thrombolysis In Myocardial Infarction (TIMI) score and ECG for ruling out major adverse cardiac events (MACE) within 30 days...
May 13, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28500730/comparative-prognostic-value-of-postprocedural-creatine-kinase-myocardial-band-and-high-sensitivity-troponin-t-in-patients-with-non-st-segment-elevation-myocardial-infarction-undergoing-percutaneous-coronary-intervention
#17
Gjin Ndrepepa, Roisin Colleran, Siegmund Braun, Erion Xhepa, Julia Hieber, Salvatore Cassese, Massimiliano Fusaro, Sebastian Kufner, Karl-Ludwig Laugwitz, Heribert Schunkert, Adnan Kastrati
OBJECTIVES: We aimed to assess the prognostic value of postprocedural creatine kinase myocardial band (CK-MB) and cardiac troponin (cTn) in patients with non-ST-segment elevation myocardial infarction (NSTEMI). BACKGROUND: Whether postprocedural CK-MB or cTn is a better biomarker to stratify the risk after percutaneous coronary intervention (PCI) remains unknown. METHODS: This study included 2,077 patients with NSTEMI undergoing early PCI...
May 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28499665/persistent-t-wave-inversion-predicts-myocardial-damage-after-st-elevation-myocardial-infarction
#18
Martin Reindl, Sebastian Johannes Reinstadler, Hans-Josef Feistritzer, Lea Niess, Constantin Koch, Agnes Mayr, Gert Klug, Bernhard Metzler
BACKGROUND: Persistent T-wave inversion (PTI) after ST-elevation myocardial infarction (STEMI) is associated with worse clinical outcome; however, the underlying mechanism between PTI and poor prognosis is incompletely understood. We sought to investigate the relationship between PTI and myocardial damage assessed by cardiac magnetic resonance (CMR) following STEMI. METHODS: In this prospective observational study, we included 142 consecutive revascularized STEMI patients...
May 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28497398/early-markers-of-myocardial-ischemia-from-the-experimental-model-to-forensic-pathology-cases-of-sudden-cardiac-death
#19
Sara Sabatasso, Milena Moretti, Patrice Mangin, Tony Fracasso
The goal of this study was to assess whether early markers of myocardial ischemia, identified in a previous experimental work, can be applied in forensic pathology cases of sudden, ischemic cardiac death. These markers include desphosphorylated connexin 43 (Cx43), JunB, TUNEL assay, myoglobin, and troponin T. Fourteen cases of sudden cardiac death with gross and/or histological signs of myocardial infarction and 14 cases of sudden cardiac death with signs of early ischemia at histology and positive immunoreactions for fibronectin and C5b-9 were investigated...
May 11, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28494192/prooxidant-antioxidant-balance-hstni-and-hscrp-mortality-prediction-in-haemodialysis-patients-two-year-follow-up
#20
Tanja Antunovic, Aleksandra Stefanovic, Najdana Gligorovic Barhanovic, Milica Miljkovic, Danilo Radunovic, Jasmina Ivanisevic, Vladimir Prelevic, Nebojsa Bulatovic, Marina Ratkovic, Marina Stojanov
Oxidative stress and inflammation are highly intertwined pathophysiological processes. We analyzed the markers of these processes and high-sensitive troponin I (hsTnI) for mortality prediction in patients on haemodialysis. This study enrolled a total of 62 patients on regular haemodialysis. The patients were monitored for two years, and the observed outcomes were all-cause and cardiovascular mortality. Blood samples were taken before one dialysis session for analysis of the baseline concentrations of prooxidant-antioxidant balance (PAB), total antioxidant status (TAS), total oxidative status (TOS), hsTnI, hsCRP and resistin...
November 2017: Renal Failure
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