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Troponin Sensitive Diagnosis

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https://www.readbyqxmd.com/read/28212715/novel-biomarkers-of-heart-failure
#1
A Savic-Radojevic, M Pljesa-Ercegovac, M Matic, D Simic, S Radovanovic, T Simic
Although substantial improvements have been made in majority of cardiac disorders, heart failure (HF) remains a major health problem, with both increasing incidence and prevalence over the past decades. For that reason, the number of potential biomarkers that could contribute to diagnosis and treatment of HF patients is, almost exponentially, increasing over the recent years. The biomarkers that are, at the moment, more or less ready for use in everyday clinical practice, reflect different pathophysiological processes present in HF...
2017: Advances in Clinical Chemistry
https://www.readbyqxmd.com/read/28196358/wellens-syndrome-a-bad-omen
#2
Madalena Coutinho Cruz, Isabel Luiz, Lurdes Ferreira, Rui Cruz Ferreira
Wellens' syndrome is characterized by an electrocardiographic pattern of T-wave changes associated with a critical stenosis of the left anterior descending artery (LAD), which progresses to an extensive anterior myocardial infarction in the majority of cases. For this reason, its recognition and early treatment are extremely important. We report 2 cases of Wellens' syndrome: an 83-year-old male presenting with ill-characterized chest pain, biphasic T waves in V1-V3 during an asymptomatic period, negative cardiac biomarkers, and a 64% stenosis in LAD with a fractional flow reserve of 0...
February 15, 2017: Cardiology
https://www.readbyqxmd.com/read/28196196/identification-of-transthyretin-cardiac-amyloidosis-using-serum-retinol-binding-protein-4-and-a-clinical-prediction-model
#3
Marios Arvanitis, Clarissa M Koch, Gloria G Chan, Celia Torres-Arancivia, Michael P LaValley, Daniel R Jacobson, John L Berk, Lawreen H Connors, Frederick L Ruberg
Importance: Transthyretin cardiac amyloidosis (ATTR) is an underrecognized cause of heart failure (HF) in older individuals, owing in part to difficulty in diagnosis. ATTR can result from substitution of valine for isoleucine at codon 122 of the transthyretin (TTR) gene (V122I), present in 3.43% of African American individuals. Objective: To examine whether serum retinol-binding protein 4 (RBP4), an endogenous TTR ligand, could be used as a diagnostic test for ATTR V122I amyloidosis...
February 8, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28188579/cardiac-biomarkers-of-acute-coronary-syndrome-from-history-to-high-sensitivity-cardiac-troponin
#4
REVIEW
Pankaj Garg, Paul Morris, Asma Lina Fazlanie, Sethumadhavan Vijayan, Balazs Dancso, Amardeep Ghosh Dastidar, Sven Plein, Christian Mueller, Philip Haaf
The role of cardiac troponins as diagnostic biomarkers of myocardial injury in the context of acute coronary syndrome (ACS) is well established. Since the initial 1st-generation assays, 5th-generation high-sensitivity cardiac troponin (hs-cTn) assays have been developed, and are now widely used. However, its clinical adoption preceded guidelines and even best practice evidence. This review summarizes the history of cardiac biomarkers with particular emphasis on hs-cTn. We aim to provide insights into using hs-cTn as a quantitative marker of cardiomyocyte injury to help in the differential diagnosis of coronary versus non-coronary cardiac diseases...
February 11, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28164501/circulating-mir-208b-a-potentially-sensitive-and-reliable-biomarker-for-the-diagnosis-and-prognosis-of-acute-myocardial-infarction
#5
Xiaoxiao Liu, Ling Yuan, Fang Chen, Lizhu Zhang, Xi Chen, Chengjian Yang, Zhijun Han
BACKGROUND: MicroRNAs are present in human plasma and have been reported to be biomarkers for cardiovascular diseases. The aim of this study was to investigate the value of circulating microRNA-208b (miR-208b) for the diagnosis and prognosis of acute myocardial infarction (AMI). METHODS: A total of 100 AMI patients, 80 unstable angina (UA) patients, and 80 healthy controls (HCs) were consecutively included in this study. Plasma was collected from each participant on admission, and the levels of circulating miR-208b were measured using reverse transcription-polymerase chain reaction (RT-PCR)...
January 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28150185/early-diagnosis-of-acute-myocardial-infarction-in-patients-with-mild-elevations-of-cardiac-troponin
#6
Jasper Boeddinghaus, Tobias Reichlin, Thomas Nestelberger, Raphael Twerenbold, Yvette Meili, Karin Wildi, Petra Hillinger, Maria Rubini Giménez, Janosch Cupa, Lukas Schumacher, Marie Schubera, Patrick Badertscher, Sydney Corbière, Karin Grimm, Christian Puelacher, Zaid Sabti, Dayana Flores Widmer, Nicolas Schaerli, Nikola Kozhuharov, Samyut Shrestha, Tobias Bürge, Patrick Mächler, Michael Büchi, Katharina Rentsch, Òscar Miró, Beatriz López, F Javier Martin-Sanchez, Esther Rodriguez-Adrada, Beata Morawiec, Damian Kawecki, Eva Ganovská, Jiri Parenica, Jens Lohrmann, Andreas Buser, Dagmar I Keller, Stefan Osswald, Christian Mueller
BACKGROUND: The early diagnosis of acute myocardial infarction (AMI) in patients with mild elevations of high-sensitivity cardiac troponin (hs-cTn) is a challenge. It is unclear whether copeptin, a marker of endogenous stress, or 1h-hs-cTn changes are better suited to address this important unmet clinical need. METHODS: We prospectively enrolled patients presenting with symptoms suggestive of AMI to the emergency department (ED). Two independent cardiologists adjudicated the final diagnosis...
February 1, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28145489/improving-the-diagnostic-accuracy-of-acute-myocardial-infarction-with-the-use-of-high-sensitive-cardiac-troponin-t-in-different-chronic-kidney-disease-stages
#7
Hongliu Yang, Jing Liu, Han Luo, Xiaoxi Zeng, Xi Tang, Liang Ma, Hongxia Mai, Shenju Gou, Fang Liu, Ping Fu
High-sensitive cardiac troponin T (hs-TnT) is a critical biomarker in diagnosis of acute myocardial infarction (AMI). However, CKD individuals usually have elevated hs-TnT even in the absence of AMI. Our study aimed to explore the optimal cutoff-value of hs-TnT and further to improve diagnostic accuracy of AMI in CKD patients. Clinical data of 489 patients were collected from the maintained database between September 2010 and June 2014. CKD patients with AMI were assigned to CKD+AMI group and CKD patients without AMI were assigned to CKD group...
February 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28107745/femtomolar-detection-of-cardiac-troponin-i-using-a-novel-label-free-and-reagent-free-dendrimer-enhanced-impedimetric-immunosensor
#8
Rashida Akter, Bongjin Jeong, Yong-Mi Lee, Jong-Soon Choi, Md Aminur Rahman
A novel highly sensitive dendrimer coupled impedimetric immunosensor was developed for the label-free and reagent-free detection of cardiac troponin I (TnI) in serum samples. The immunosensor probe was fabricated by covalently attaching carboxylic acid-functionalized third generation (G3) poly (amidoamine) (PAMAM) dendrimer (Den) on the 3, 3', 5, 5'-tetramethyl benzidine (TMB) modified 6-mercaptohexanoic acid (MHA) self-assembled monolayer (SAM) on a gold (Au) electrode. Monoclonal anti-TnI antibody was then covalently immobilized on the Den and TMB attached MHA SAM modified surface...
January 12, 2017: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/28062631/rule-in-and-rule-out-of-myocardial-infarction-using-cardiac-troponin-and-glycemic-biomarkers-in-patients-with-symptoms-suggestive-of-acute-coronary-syndrome
#9
Colleen Shortt, Jinhui Ma, Natasha Clayton, Jonathan Sherbino, Richard Whitlock, Guillaume Pare, Stephen A Hill, Matthew McQueen, Shamir R Mehta, P J Devereaux, Andrew Worster, Peter A Kavsak
BACKGROUND: Early rule-in/rule-out of myocardial infarction (MI) in patients presenting to the emergency department (ED) is important for patient care and resource allocation. Given that dysglycemia is a strong risk factor for MI, we sought to explore and compare different combinations of cardiac troponin (cTn) cutoffs with glycemic markers for the early rule-in/rule-out of MI. METHODS: We included ED patients (n = 1137) with symptoms suggestive of acute coronary syndrome (ACS) who had cTnI, high-sensitivity cTnI (hs-cTnI), hs-cTnT, glucose, and hemoglobin A1c (Hb A1c) measurements...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28062618/use-of-biomarkers-in-predicting-the-onset-monitoring-the-progression-and-risk-stratification-for-patients-with-type-2-diabetes-mellitus
#10
REVIEW
Benjamin M Scirica
BACKGROUND: As the worldwide prevalence of type 2 diabetes mellitus (T2DM) increases, it is even more important to develop cost-effective methods to predict and diagnose the onset of diabetes, monitor progression, and risk stratify patients in terms of subsequent cardiovascular and diabetes complications. CONTENT: Nonlaboratory clinical risk scores based on risk factors and anthropomorphic data can help identify patients at greatest risk of developing diabetes, but glycemic indices (hemoglobin A1c, fasting plasma glucose, and oral glucose tolerance tests) are the cornerstones for diagnosis, and the basis for monitoring therapy...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28062614/myocardial-infarction-type-2-and-myocardial-injury
#11
REVIEW
Yader Sandoval, Kristian Thygesen
BACKGROUND: The development and implementation of sensitive and high-sensitivity cardiac troponin assays has not only expedited the early ruling in and ruling out of acute myocardial infarction, but has also contributed to the identification of patients at risk for myocardial injury with necrosis, as confirmed by the presence of cardiac troponin concentrations above the 99th percentile. Myocardial injury with necrosis may occur either in the presence of overt ischemia from myocardial infarction, or in the absence of overt ischemia from myocardial injury accompanying other conditions...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28062613/consensus-or-controversy-evolution-of-criteria-for-myocardial-infarction-after-percutaneous-coronary-intervention
#12
REVIEW
Pierluigi Tricoci
BACKGROUND: The definition and the clinical implications of myocardial infarction (MI) occurring in the setting of percutaneous coronary intervention have been subjects of unresolved controversy. As a result of the use of more sensitive diagnostic tools such as cardiac troponin, the expanding evidence, and the ensuing debate, the definition of procedural MI (pMI) has evolved, leading to several revisions, different proposed definitions, and lack of standardization in randomized clinical trials...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28062612/cardiac-troponin-assays-guide-to-understanding-analytical-characteristics-and-their-impact-on-clinical-care
#13
REVIEW
Fred S Apple, Yader Sandoval, Allan S Jaffe, Jordi Ordonez-Llanos
BACKGROUND: Cardiac troponin I (cTnI) and cardiac troponin T (cTnT) determinations are fixtures in clinical practice and research. Cardiac troponin testing has been the standard of practice for the diagnosis of acute myocardial infarction (AMI), early rule-out, risk stratification, and outcomes assessment in patients presenting with acute coronary syndrome (ACS) and non-ACS myocardial injury. We recognize from reading the literature over the past several years how poorly understood the analytical characteristics are for cTnI and cTnT assays by laboratorians, clinicians, and scientists who use these assays...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28057184/advances-in-cardiac-biomarkers-of-acute-coronary-syndrome
#14
A K Saenger, N Korpi-Steiner
Acute coronary syndrome (ACS) encompasses a pathophysiological spectrum of cardiovascular diseases, all of which have significant morbidity and mortality. ACS was once considered an acute condition; however, new treatment strategies and improvements in biomarker assays have led to ACS being an acute and chronic disease. Cardiac troponin is the preferred biomarker for the diagnosis of myocardial infarction, and there is considerable interest and efforts toward development and implementation of high-sensitivity cardiac troponin (hs-cTn) assays worldwide...
2017: Advances in Clinical Chemistry
https://www.readbyqxmd.com/read/28040285/diagnostic-performance-of-a-high-sensitive-troponin-t-assay-and-a-troponin-t-point-of-care-assay-in-the-clinical-routine-of-an-emergency-department-a-clinical-cohort-study
#15
Anna Slagman, Johannes von Recum, Martin Möckel, Fabian Holert, Dirk Meyer Zum Büschenfelde, Christian Müller, Julia Searle
BACKGROUND: A point of care test (POCT) for troponin T (TnT) in the Emergency Department (ED) was compared to a high-sensitivity TnT (hsTnT) central laboratory test (CLT) to determine the influence of test system and different cut-off values on the diagnostic performance in patients with suspected acute coronary syndrome (ACS) under routine conditions. METHODS: All patients with routine TnT testing in the ED were enrolled. Only internal medicine patients without STEMI and with both troponin values were analyzed...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28033267/prognostic-value-of-basal-high-sensitive-cardiac-troponin-levels-on-mortality-in-the-general-population-a-meta-analysis
#16
Noreen van der Linden, Lieke J J Klinkenberg, Otto Bekers, Luc J C van Loon, Marja P van Dieijen-Visser, Maurice P Zeegers, Steven J R Meex
Interest in the use of cardiac troponin T (cTnT) and cardiac troponin I (cTnI) has expanded from diagnosis of acute myocardial infarction to risk assessment for morbidity and mortality. Although cTnT and cTnI were shown to have equivalent diagnostic performance in the setting of suspected acute myocardial infarction, potential prognostic differences are largely unexplored.The aim of this study is to quantify and compare the relationship between cTnT and cTnI, and cardiovascular and all-cause mortality in the general population...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28029055/improved-risk-stratification-of-patients-with-acute-coronary-syndromes-using-a-combination-of-hstnt-nt-probnp-and-hscrp-with-the-grace-score
#17
Roland Klingenberg, Soheila Aghlmandi, Lorenz Räber, Baris Gencer, David Nanchen, Dik Heg, Sebastian Carballo, Nicolas Rodondi, François Mach, Stephan Windecker, Peter Jüni, Arnold von Eckardstein, Christian M Matter, Thomas F Lüscher
BACKGROUND: Clinical scores and biomarkers improve risk stratification of patients with acute coronary syndromes. However, little is known about their value in patients referred for coronary angiography. METHODS: Consecutive patients admitted at four Swiss university hospitals with a diagnosis of acute coronary syndrome were enrolled into the SPUM-ACS Biomarker Cohort between 2009 and 2012. Patients were followed at 30 days and 1 year with assessment of adjudicated events including all-cause mortality and the composite of all-cause mortality or non-fatal recurrent myocardial infarction...
December 1, 2016: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28003419/47-year-old-female-with-an-apical-mass
#18
Jack Andrews, Christopher Ce Lang, Marc Dweck
CLINICAL INTRODUCTION: A 47-year-old female with no medical history presented with a sudden collapse. Physical examination, chest X-ray and high-sensitivity cardiac troponin I were normal, however ECG demonstrated anterior T-wave inversion. CT pulmonary angiography was performed which ruled out pulmonary embolism but revealed a non-calcified, homogenous mass at the left ventricular (LV) apex. It was not clear whether this mass was intramyocardial or pericardial. Transthoracic echocardiography confirmed the apical mass but was unable to establish its aetiology...
December 21, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27987279/falsely-elevated-troponin-rare-occurrence-or-future-problem
#19
James Nguyen, Rosy Thachil, Neil Vyas, Thomas Marino
INTRODUCTION: Troponins are known to be released in response to cardiac damage and therefore are the biomarkers of choice for the early diagnosis of acute myocardial infarction (AMI), improving outcome in patients presenting with chest pain. However, false results can occur due to interference from other substances in the blood. CASE: A 52-year-old male with a past medical history of alcohol abuse, hypertension, and coronary artery bypass graft at age 34 with normal stress test 2 years before presented to the emergency department (ED) complaining of 1 day of non-exertional chest pain with radiation to the neck and left arm...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27974383/high-sensitivity-troponin-t-vs-i-in-acute-coronary-syndrome-prediction-of-significant-coronary-lesions-and-long-term-prognosis
#20
Brede Kvisvik, Lars Mørkrid, Helge Røsjø, Milada Cvancarova, Alexander D Rowe, Christian Eek, Bjørn Bendz, Thor Edvardsen, Jørgen Gravning
BACKGROUND: High-sensitivity cardiac troponin (hs-cTn) T and I assays are established as crucial tools for the diagnosis of acute myocardial infarction (AMI), as they have been found superior to old troponin assays. However, eventual differences between the assays in prediction of significant coronary lesions and long-term prognosis in patients with acute coronary syndrome (ACS) have not been fully unraveled. METHODS: Serum concentrations of hs-cTnT (Roche), hs-cTnI (Abbott), and amino-terminal pro-B-type natriuretic peptide (NT-proBNP; Roche) in 390 non-ST-elevation (NSTE) ACS patients were evaluated in relation to significant coronary lesions on coronary angiography (defined as a stenosis >50% of the luminal diameter, with need for revascularization) and prognostic accuracy for cardiovascular mortality, all-cause mortality, as well as the composite end point of cardiovascular mortality and hospitalizations for AMI or heart failure...
December 14, 2016: Clinical Chemistry
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