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Troponin Sensitive Diagnosis

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https://www.readbyqxmd.com/read/28333976/early-diagnosis-of-acute-myocardial-infarction-using-high-sensitivity-troponin-i
#1
Johannes Tobias Neumann, Nils Arne Sörensen, Francisco Ojeda, Thomas Renné, Renate B Schnabel, Tanja Zeller, Mahir Karakas, Stefan Blankenberg, Dirk Westermann
OBJECTIVE: There is a clinical need for early and accurate diagnosis of acute myocardial infarction (AMI). Current European Society of Cardiology (ESC) guidelines recommend diagnosis of non-ST-elevation AMI based on serial troponin measurements. We aimed to challenge the ESC guidelines using 1) a high-sensitivity troponin I (hs-TnI) baseline cutoff, 2) an absolute hs-TnI change after 1 hour and 3) additional application of an ischemic ECG. METHODS: 1,516 patients with suspected AMI presenting to the emergency department were included...
2017: PloS One
https://www.readbyqxmd.com/read/28329906/-the-fabry-s-disease-cardiomyopathy-as-differential-diagnosis-of%C3%A2-acute-coronary-syndrome
#2
Daniel Oder, Stefan Störk, Christoph Wanner, Georg Ertl, Frank Weidemann, Peter Nordbeck
The progressive cardiomyopathy in patients with Fabry disease is often accompanied by angina pectoris and elevated levels of high-sensitive troponin T (hs-TnT), potentially mimicking acute coronary syndrome. Here, we present to representative cases with focus on clinical, diagnostic and therapeutic settings. An overview on the cardiomyopathy associated with Fabry disease and its role as differential diagnosis of acute coronary syndrome is provided. Fabry cardiomyopathy might exhibit similar clinical and biochemical constellations as seen in acute coronary syndrome...
March 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28318537/cardiac-magnetic-resonance-imaging-in-suspected-blunt-cardiac-injury-a-prospective-pilot-cohort-study
#3
Aidan Jc Burrell, David M Kaye, Mark C Fitzgerald, David J Cooper, James L Hare, Benedict T Costello, Andrew J Taylor
INTRODUCTION: The aim of this study was to evaluate the incidence and severity of blunt cardiac injury (BCI) as determined by cardiac magnetic resonance imaging (CMR), and to compare this to currently used diagnostic methods in severely injured patients. MATERIALS AND METHODS: We conducted a prospective, pilot cohort study of 42 major trauma patients from July 2013 to Jan 2015. The cohort underwent CMR within 7 days, enrolling 21 patients with evidence of chest injury and an elevated Troponin I compared to 21 patients without chest injury who acted as controls...
February 27, 2017: Injury
https://www.readbyqxmd.com/read/28314141/assay-validation-of-the-cardiac-isoform-of-troponin-i-in-double-crested-cormorant-phalacrocorax-auritus-plasma-for-diagnosis-of-cardiac-damage
#4
Melissa Daigneault, Kendal E Harr, Karen M Dean, Steven J Bursian
Cardiac abnormalities, initially found in Deepwater Horizon weathered MC252 crude oil exposed Double Crested Cormorants (DCCOs) upon gross necropsy, were further investigated using echocardiography. Clinical and statistically significant changes including decreased ventricular myocardial contractility and arrhythmia were elucidated by echocardiography and interpreted by boarded cardiologists as potentially life threatening. The objective of this investigation was to initiate development of an antemortem, sensitive blood screening test for cardiac damage due to oil exposure of avian species...
March 14, 2017: Ecotoxicology and Environmental Safety
https://www.readbyqxmd.com/read/28292587/diagnosis-of-perioperative-myocardial-infarction-after-heart-valve-surgery-with-new-cut-off-point-of-high-sensitivity-troponin-t-and-new-electrocardiogram-or-echocardiogram-changes
#5
Héctor Cubero-Gallego, Mario Lorenzo, María Heredia, Itziar Gómez, Eduardo Tamayo
OBJECTIVE: Criteria for diagnosing myocardial infarction (MI) after heart valve surgery are not collected in the Third Universal Definition of MI. We aimed to define cut-offs for high-sensitivity cardiac troponin T (hs-cTnT) and creatine kinase-MB (CK-MB) for the diagnosis of perioperative MI after heart valve surgery according to perioperative MI determined by new alterations in electrocardiogram (ECG) and/or transthoracic echocardiogram (TTE). Secondary endpoints were incidence of perioperative MI, postoperative complications, 30-day mortality, and 2-year survival...
February 14, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28283497/direct-comparison-of-four-very-early-rule-out-strategies-for-acute-myocardial-infarction-using-high-sensitivity-cardiac-troponin-i
#6
Jasper Boeddinghaus, Thomas Nestelberger, Raphael Twerenbold, Karin Wildi, Patrick Badertscher, Janosch Cupa, Tobias Bürge, Patrick Mächler, Sydney Corbière, Karin Grimm, Maria Rubini Giménez, Christian Puelacher, Samyut Shrestha, Dayana Flores Widmer, Jakob Fuhrmann, Petra Hillinger, Zaid Sabti, Ursina Honegger, Nicolas Schaerli, Nikola Kozhuharov, Katharina Rentsch, Òscar Miró, Beatriz López Barbeito, F Javier Martin-Sanchez, Esther Rodriguez-Adrada, Beata Morawiec, Damian Kawecki, Eva Ganovská, Jiri Parenica, Jens Lohrmann, Wanda Kloos, Andreas Buser, Nicolas Geigy, Dagmar I Keller, Stefan Osswald, Tobias Reichlin, Christian Müller
Background -Four strategies for very early rule-out of acute myocardial infarction (AMI) using high-sensitivity cardiac troponin I (hs-cTnI) have been identified. It remains unclear which strategy is most attractive for clinical application. Methods -We prospectively enrolled unselected patients presenting to the emergency department (ED) with symptoms suggestive of AMI. The final diagnosis was adjudicated by two independent cardiologists. Hs-cTnI levels were measured at presentation and after 1h in a blinded fashion...
March 10, 2017: Circulation
https://www.readbyqxmd.com/read/28281735/high-sensitive-troponin-levels-in-patients-with-chest-pain-and-kidney-disease-a-multicenter-registry-the-tropic-study
#7
Flavia Ballocca, Fabrizio D'Ascenzo, Claudio Moretti, Roberto Diletti, Carlo Budano, Alberto Palazzuoli, Matthew J Reed, Tullio Palmerini, Dariusz Dudek, Alfredo Galassi, Pierluigi Omedè, Nicolas M Mieghem, David Ferenbach, Marco Pavani, Diego Della Riva, Nick L Mills, Ron T Van Domburgh, Andrea Mariani, Artur Dziewierz, Marco di Cuia, Robert Jan van Geuns, Felix Zijlstra, Serena Bergerone, Sebastiano Marra, Giuseppe Biondi Zoccai, Fiorenzo Gaita
BACKGROUND: Accuracy of high sensitive troponin (hs-cTn) to detect coronary artery disease (CAD) in patients with renal insufficiency is not established. The aim of this study was to evaluate the prognostic role of high sensitivity troponin T and I in patients with chronic kidney disease (CKD). METHODS: All consecutive patients with chest pain, renal insufficiency (eGFR < 60 mL/min/1.73 m²) and high sensitive troponin level were included. The predictive value of baseline and interval troponin (hs-cTnT and I) for the presence of CAD was assessed...
March 10, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28271683/clinical-value-of-combined-detection-of-ck-mb-myo-ctni-and-plasma-nt-probnp-in-diagnosis-of-acute-myocardial-infarction
#8
Jiubo Fan, Ji Ma, Ning Xia, Li Sun, Baoan Li, Haiju Liu
BACKGROUND: Acute myocardial infarction (AMI) is a serious life-threatening and common heart disease that is based on coronary atherosclerosis. The aim is to study the changes in the level of kinase isoenzyme (CK-MB), myoglobin (MYO), cardiac troponin I (cTnI), and plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with acute myocardial infarction (AMI) and the four indicators of joint detection clinical value for diagnosis of AMI. METHODS: Plasma NT-proBNP, CK-MB, MYO, and cTnI were detected by CLIA in 208 AMI patients (AMI group) and 115 non-AMI patients (control group)...
March 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28263716/statistical-considerations-for-determining-high-sensitivity-cardiac-troponin-reference-intervals
#9
Peter E Hickman, Gus Koerbin, Julia M Potter, Walter P Abhayaratna
The troponin 99th percentile is used as the laboratory decision point in the diagnosis of acute myocardial infarction. A recent publication has shown that the statistical treatment for outlier removal may dramatically change the calculated troponin 99th percentile. We have used our large database from the previously reported Canberra Heart Study to independently assess the effect of various methods for removing outliers on the calculated 99th percentile. We have performed the same exercise using the troponin 97...
March 1, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28261896/identifying-low-risk-patients-for-early-discharge-from-emergency-department-without-using-subjective-descriptions-of-chest-pain-insights-from-providing-rapid-out-of-hospital-acute-cardiovascular-treatment-proact-3-and-4-trials
#10
Nariman Sepehrvand, Yinggan Zheng, Paul W Armstrong, Robert C Welsh, Justin A Ezekowitz
BACKGROUND: Several accelerated diagnostic protocols (ADP) have been developed to allow emergency department (ED) physicians to identify appropriate patients for safe early discharge after presentation with symptom of chest pain. Most ADPs require chest pain to be described and modify the algorithm based on the subjective chest pain characteristics. We investigated the performance of 3 established major ADPs simplified by eliminating the need for chest pain as a descriptor. METHODS: We pooled patients from PROACT-3 and 4 trials, in which patients presenting to emergency medical services (EMS) with chest pain or dyspnea were enrolled...
March 6, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28256403/the-utility-of-99m-tc-dpd-scintigraphy-in-the-diagnosis-of-cardiac-amyloidosis-an-australian-experience
#11
Peter T Moore, Matthew K Burrage, Emily Mackenzie, W Philip Law, Dariusz Korczyk, Peter Mollee
BACKGROUND: The uptake of bone-seeking radiotracers in the amyloid heart is well recognised. 99(m)Tc-DPD has been shown to be highly sensitive for cardiac transthyretin (ATTR) amyloid in an overseas population, but is not registered for use in Australia. We explored its utility as a diagnostic tool within our population. METHODS: Patients diagnosed with AL and ATTR (wild-type and inherited) cardiac amyloidosis were prospectively recruited from the Princess Alexandra Hospital Amyloidosis Centre...
February 16, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28256378/high-sensitivity-troponin-and-valvular-heart-disease
#12
REVIEW
Cian P McCarthy, Eoin Donnellan, Dermot Phelan, Brian P Griffin, Maurice Enriquez- Sarano, John W McEvoy
Blood-based biomarkers have been extensively studied in a range of cardiovascular diseases and have established utility in routine clinical care, most notably in the diagnosis of acute coronary syndrome (e.g., troponin) and the management of heart failure (e.g., brain-natriuretic peptide). The role of biomarkers is less well established in the management of valvular heart disease (VHD), in which the optimal timing of surgical intervention is often challenging. One promising biomarker that has been the subject of a number of recent VHD research studies is high sensitivity troponin (hs-cTn)...
January 16, 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28212715/novel-biomarkers-of-heart-failure
#13
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
#14
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
#15
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...
March 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28188579/cardiac-biomarkers-of-acute-coronary-syndrome-from-history-to-high-sensitivity-cardiac-troponin
#16
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...
March 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
#17
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
#18
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
#19
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
#20
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...
May 15, 2017: Biosensors & Bioelectronics
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