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Troponin Sensitive Diagnosis

Wouter C Meijers, A Rogier van der Velde, Anneke C Muller Kobold, Janneke Dijck-Brouwer, Alan H Wu, Allan Jaffe, Rudolf A de Boer
AIMS: Biomarkers can be used for diagnosis, risk stratification, or management of patients with heart failure (HF). Knowledge about the biological variation is needed for proper interpretation of serial measurements. Therefore, we aimed to determine and compare the biological variation of a large panel of biomarkers in healthy subjects and in patients with chronic HF. METHODS AND RESULTS: The biological variability of established biomarkers [NT-proBNP and high-sensitivity troponin T (hsTnT)], novel biomarkers [galectin-3, suppression of tumorigenicity 2 (ST2), and growth differentiation factor 15 (GDF-15)], and renal/neurohormonal biomarkers (aldosterone, phosphate, parathyroid hormone, plasma renin concentration, and creatinine) was determined in 28 healthy subjects and 83 HF patients, over a period of 4 months and 6 weeks, respectively...
October 21, 2016: European Journal of Heart Failure
A Ollila, L Vikatmaa, J Virolainen, P Vikatmaa, A Leppäniemi, A Albäck, M Salmenperä, V Pettilä
BACKGROUND AND AIMS: Perioperative myocardial infarction is an underdiagnosed complication causing morbidity, mortality, and considerable costs. However, evidence of preventive and therapeutic options is scarce. We investigated the incidence and outcome of perioperative myocardial infarction in non-cardiac surgery patients in order to define a target population for future interventional trials. MATERIAL AND METHODS: We conducted a prospective single-center study on non-cardiac surgery patients aged 50 years or older...
October 13, 2016: Scandinavian Journal of Surgery: SJS
Chung-Lieh Hung, Ding-Kuo Chien, Shou-Chuan Shih, Wen-Han Chang
BACKGROUND: Accurate diagnosis of acute coronary syndrome (ACS) in a timely fashion is challenging in the elderly population, especially elderly women, who usually exhibit atypical clinical symptoms. A multiple cardiac biomarker (MCB) based approach has been shown to improve diagnostic efficacy of ACS. However, data in various age groups and sex differences remain largely unexplored. METHODS: Point-of-care testing (POCT) was performed on 290 patients (aged ≥18 years) who were admitted to the emergency department (ED) with symptoms of acute chest pain under suspicion of acute coronary syndrome (ACS)...
October 7, 2016: BMC Cardiovascular Disorders
Astrid Petersmann, Till Ittermann, Cornelia Frieß, Norbert Lubenow, Thomas Kohlmann, Andreas Greinacher, Annette Masuch, Matthias Nauck
Determination of cardiac troponin I (cTnI) is one central means for diagnosis of myocardial infarction. Assay performance of three troponin I assays was compared previously in a large reference population detecting sex-differences in the 99th percentile only for the Dimension Vista cTnI assay. The present study examined the underlying effects. Values for cTnI were reused. Creatine kinase (CK) activity was determined in 2358 samples from blood donors. Information on physical activity was evaluated from health questionnaires...
November 1, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
Maha A Al-Mohaissen, Ronald G Carere, G B John Mancini, Karin H Humphries, Beth A Whalen, Terry Lee, Frank X Scheuermeyer, Andrew P Ignaszewski
BACKGROUND: Markers of plaque destabilization and disruption may have a role in identifying non-STE- type 1 Myocardial Infarction in patients presenting with troponin elevation. We hypothesized that a plaque disruption index (PDI) derived from multiple biomarkers and measured within 24 hours from the first detectable troponin in patients with acute non-STE- type 1 MI (NSTEMI-A) will confirm the diagnosis and identify these patients with higher specificity when compared to individual markers and coronary angiography...
2016: PloS One
Lieke J J Klinkenberg, Karin Wildi, Noreen van der Linden, Imre W K Kouw, Marijke Niens, Raphael Twerenbold, Maria Rubini Gimenez, Christian Puelacher, Jean Daniel Neuhaus, Petra Hillinger, Thomas Nestelberger, Jasper Boeddinghaus, Karin Grimm, Zaid Sabti, Judith A P Bons, Jeroen D E van Suijlen, Frans E S Tan, Joop Ten Kate, Otto Bekers, Luc J C van Loon, Marja P van Dieijen-Visser, Christian Mueller, Steven J R Meex
BACKGROUND: Interpretation of serial high-sensitivity cardiac troponin (hs-cTn) measurements for the diagnosis of acute myocardial infarction (AMI) assumes random fluctuation of hs-cTn around an individual's homeostatic set point. The aim of this study was to challenge this diagnostic concept. METHODS: Study 1 examined the presence of a diurnal hs-cTn rhythm by hourly blood sampling, day and night, in 24 individuals without a recent history of AMI. Study 2 assessed morning vs evening diagnostic accuracy of hs-cTnT and hs-cTnI in a prospective multicenter diagnostic study of 2782 unselected patients, presenting to the emergency department with acute chest pain...
October 5, 2016: Clinical Chemistry
Corey Heitz, Justin Morgenstern, William K Milne
This prospectively planned, secondary analysis of data from a large multi-center trial evaluated the diagnostic characteristics of using hs-cTnT levels below the level of detection (LoD), along with EKG findings, to rule out AMI on presentation to the ED. The primary outcome was diagnosis of AMI and the secondary outcome was major adverse cardiac events (MACE) within 30 days. A total of 1,282 patients were included in the study, 16.6% of which were diagnosed with AMI at the index visit. This article is protected by copyright...
October 5, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
O Nallet, N Ketata, N Ferrier, X Marcaggi
Acute chest pain is a common reason of consultation in the emergency department. The difficulty lies in discriminating patients with acute coronary syndrome or other life-threatening conditions from those non-cardiovascular, non-life-threatening chest pain. Only 15 to 25 % of patients with acute chest pain actually have acute coronary syndrome. Algorithms using high sensitivity troponin at admission and a second assessment 1 or 3hours later are validated to "rule in" or "rule out" the diagnosis of non ST-elevation myocardial infarction...
September 29, 2016: Annales de Cardiologie et D'angéiologie
Geza S Bodor
Heart diseases, especially coronary artery diseases (CAD), are the leading causes of morbidity and mortality in developed countries. Effective therapy is available to ensure patient survival and to prevent long term sequelae after an acute ischemic event caused by CAD, but appropriate therapy requires rapid and accurate diagnosis. Research into the pathology of CAD have demonstrated the usefulness of measuring concentrations of chemicals released from the injured cardiac muscle can aid the diagnosis of diseases caused by myocardial ischemia...
April 2016: EJIFCC
Michael J Daly, Dewar D Finlay, Daniel Guldenring, Raymond R Bond, Aaron J McCann, Peter J Scott, Jennifer A Adgey, Mark T Harbinson
INTRODUCTION: Epicardial potentials (EPs) derived from the body surface potential map (BSPM) improve acute myocardial infarction (AMI) diagnosis. In this study, we compared EPs derived from the 80-lead BSPM using a standard thoracic volume conductor model (TVCM) with those derived using a patient-specific torso model (PSTM) based on body mass index (BMI). METHODS: Consecutive patients presenting to both the emergency department and pre-hospital coronary care unit between August 2009 and August 2011 with acute ischaemic-type chest pain at rest were enrolled...
September 26, 2016: European Heart Journal. Acute Cardiovascular Care
Pilar Calmarza, Carlos Lapresta, Sandra García-Castañón, Carlos López-Perales, Ainhoa Pérez-Guerrero, Ana Portolés
OBJECTIVES: This study was conducted in order to evaluate the usefulness of copeptin (a stable fragment of the precursor of arginine vasopressin) in the differential diagnosis of acute chest pain of probable coronary origin. MATERIAL AND METHODS: The study includes 82 patients who were initially evaluated according to the protocol of a patient with suspected acute coronary syndrome (ACS) in our Emergency Department, including the determination of troponin and copeptin with specimens taken on admission (time 0) and at 6h...
September 2016: Clínica e Investigación en Arteriosclerosis
Selçuk Yazıcı, Tuncay Kırış, Ufuk S Ceylan, Şükrü Akyüz, Ahmet O Uzun, Recep Hacı, Sait Terzi, Abdullah Doğan, Ayşe Emre, Kemal Yeşilçimen
BACKGROUND: Cardiac troponins and red cell distribution width (RDW) are associated with increased mortality in acute pulmonary embolism (PE). In this study, we aimed to investigate the accuracy of the combined use of troponin and RDW in predicting short-term mortality in acute PE patients. METHODS: The data of 201 patients with the diagnosis of acute PE were retrospectively analyzed. We obtained troponin-RDW scores (TR scores) using a combination of troponin and RDW values, and then evaluated this score's accuracy in predicting mortality in patients with acute PE...
September 19, 2016: Wiener Klinische Wochenschrift
Majid Asiabanha Rezaee, Mohammad Javad Rasaee, Javad Mohammadnejad
Human cardiac troponin I (cTni) is the gold marker for early diagnosis of myocardial infarction. In this regard, four immune-dominant epitopes of cTni were predicted and their 3D structures were determined. Thereafter, the competitive performance of the peptides was monitored with the developed polyclonal antibody-based indirect competitive ELISA; a half-maximal inhibitory concentration (IC50) of 0.49 (µg/mL) and detection limit of 0.037 (µg/mL) were achieved for recombinant cTni. The competitive ELISA determined sensitivity levels of 0...
August 11, 2016: Journal of Immunoassay & Immunochemistry
Anand K Pyati, Basavaraj B Devaranavadagi, Sanjeev L Sajjannar, Shashikant V Nikam, Mohd Shannawaz, Satish Patil
The study aimed to investigate whether heart-type fatty acid binding protein (H-FABP) measurement provides additional diagnostic value to that of conventional cardiac markers in acute myocardial infarction (AMI) within first 6 h after the onset of symptoms. The study included 120 subjects: 60 AMI cases and 60 age and sex matched controls. The cases and controls were further divided into 2 subgroups depending on the time since onset of chest pain as (1) subjects within 3 h and (2) between 3 and 6 h of onset of chest pain...
October 2016: Indian Journal of Clinical Biochemistry: IJCB
(no author information available yet)
No abstract text is available yet for this article.
2016: BMJ: British Medical Journal
Mangesh S Diware, Hyun Mo Cho, Won Chegal, Yong Jai Cho, Dong Soo Kim, Sang Won O, Kyeong-Suk Kim, Se-Hwan Paek
Acute myocardial infarction (MI) is the leading cause of high mortality and morbidity rate worldwide, early and accurate diagnosis can increase the chances of survival. In this work, we report a simple, ultrasensitive, label-free, and high-throughput solution immersed silicon (SIS) immunosensor based on non-reflection condition (NRC) for p-polarized wave for early diagnosis of MI. SIS sensor chips are just a thin dielectric polymer layer on the silicon surface, which can be functionalized for specific application...
August 18, 2016: Biosensors & Bioelectronics
Xuan Wang, Xiao-Lei Xu, Xi-Ming Li, Ru Zhao, Xu Yang, Hong-Liang Cong
OBJECTIVE: To explore diagnostic performance of mean platelet volume (MPV) for acute myocardial infarction (AMI) of patients with acute coronary syndrome (ACS). METHODS: We compared MPV and other indicators of 1,524 patients with ACS. Among them, 880 patients were diagnosed with AMI, 344 were diagnosed with unstable angina pectoris and 350 were the control group. RESULTS: The level of MPV in ACS group was significantly higher than the control group (9...
August 2016: American Journal of the Medical Sciences
G Currie, J Flynn, M Lindhardt, H Mischak, P Rossing, C Delles
OBJECTIVE: Microalbuminuria (MA) is a marker of diabetic nephropathy (DN) but also indicates subclinical inflammation and vascular disease, limiting its sensitivity and specificity for early prediction of DN in type 2 diabetes. A urinary proteomic classifier based on 273 peptides (CKD273) shows promise for early detection of DN; however, the influence of inflammation and subclinical vascular disease on CKD27 is unknown. DESIGN AND METHOD: To dissect the relationship between CKD273, vascular phenotypes and inflammation without the confounding influence of MA we studied 145 normoalbuminuric patients with Type 2 diabetes participating in the PRIORITY (Proteomic prediction and Renin angiotensin aldosterone system Inhibition prevention Of early diabetic nephRopathy In TYpe 2 diabetes with normoalbuminuria) trial...
September 2016: Journal of Hypertension
Claudio Galli, Giuseppe Lippi
Very seldom, if ever, a single laboratory test has provided such a paradigm shift in the managed care as cardiac troponin (cTn) testing. More than twenty years of improvements in test design and analytical features have contributed to revolutionize the clinical recommendations and guidelines, and the diagnosis of myocardial infarction (MI) is now highly dependent upon the kinetics of cTn within a suggestive clinical setting. Despite the advent of high-sensitivity cTn (HS-cTn) immunoassays has allowed a more accurate and timely diagnosis as well as a higher prognostic accuracy, the focus is now shifting on the most suitable algorithms and on a comprehensive approach to the clinical management of acute coronary syndrome (ACS)...
July 2016: Annals of Translational Medicine
Anne-Sophie Bargnoux, Nils Kuster, Marion Moréna, Gregory Baptista, Leila Chenine, Stéphanie Badiou, Hélène Leray, Anne-Marie Dupuy, Jean-Paul Cristol
New highly sensitive (hs) assays have challenged the interpretation of cardiac troponins (cTn) as markers of injury while natriuretic peptides remain the markers of choice for myocardial dysfunction. However, variability extracardiac factors such as age, gender and renal function may alter circulating levels. In chronic kidney disease (CKD), the increase in circulating levels of these biomarkers in the absence of cardiac disease underlines the problem of discriminative value for diagnosis as well as the need to redefine the thresholds...
August 1, 2016: Annales de Biologie Clinique
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