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Troponin Sensitive Diagnosis

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https://www.readbyqxmd.com/read/27909290/highly-sensitive-detection-of-minimal-cardiac-ischemia-using-positron-emission-tomography-imaging-of-activated-platelets
#1
Melanie Ziegler, Karen Alt, Brett M Paterson, Peter Kanellakis, Alex Bobik, Paul S Donnelly, Christoph E Hagemeyer, Karlheinz Peter
A reliable method for the diagnosis of minimal cardiac ischemia would meet a strong demand for the sensitive diagnosis of coronary artery disease in cardiac stress testing and risk stratification in patients with chest pain but unremarkable ECGs and biomarkers. We hypothesized that platelets accumulate early on in ischemic myocardium and a newly developed technology of non-invasive molecular PET imaging of activated platelets can thus detect minimal degrees of myocardial ischemia. To induce different degrees of minimal cardiac ischemia, the left anterior descending artery (LAD) was ligated for 10, 20 or 60 min...
December 2, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27888755/high-sensitive-cardiac-troponin-t-testing-the-test
#2
Dominik G Haider, Thomas Klemenz, Georg Martin Fiedler, Christos T Nakas, Aristomenis K Exadaktylos, Alexander B Leichtle
BACKGROUND: High sensitive cardiac troponin T (hs-TnT) found its way into everyday clinical routine to diagnose acute myocardial infarction (AMI). However, its levels vary considerably based on the underlying pathophysiology of the patients. Hence we sought to test the applicability of the currently only available hs-TnT assay (Roche Diagnostics, Switzerland) to diagnose acute myocardial infarction. METHODS AND PATIENTS: Retrospectively, we analyzed the hs-TnT results of 1573 patients admitted to a level A university hospital emergency department...
October 19, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27886161/cardiac-ct-in-the-emergency-department-in-the-era-of-highly-sensitive-troponins-is-there-still-a-role
#3
Admir Dedic, Koen Nieman, Udo Hoffmann, Maros Ferencik
INTRODUCTION: Physicians practicing cardiovascular medicine are every day confronted with patients presenting with symptoms suggestive of an acute coronary syndrome (ACS). Over the years, there have been substantial technical advances, such as the introduction of new non-invasive imaging techniques and the introduction of new highly sensitive cardiac biomarkers. EVIDENCE ACQUISITION AND SYNTHESIS: Physicians have adopted these new assets and have become more experienced with them thus improving medical care...
November 25, 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27879408/a-dual-label-time-resolved-fluorescence-immunoassay-for-the-simultaneous-determination-of-cardiac-troponin-t-and-myoglobin
#4
Ling Wang, Mujuan Xu, Ruolan Huang, Xiao Chang, Cuicui Chen, Laiqing Li, Zhong Zhang, Yue Han
The aim of this study was to establish a dual-label time-resolved fluorescence immunoassay (TRFIA) for the simultaneous determination of cardiac troponin T (cTnT) and myoglobin (MYO) for the early diagnosis of acute myocardial infarction. The sandwich immunoassay was used to detect the concentration of cTnT and MYO in serum. cTnT and MYO in serum were captured by anti-cTnT and anti-MYO antibodies immobilized on microtiter wells and then banded together with another anti-cTnT and anti-MYO labeled with europium(III) Sm(3+) and samarium(III) Eu(3+) chelates, followed by fluorescence measurement using time-resolved fluorometry...
November 22, 2016: Journal of Laboratory Automation
https://www.readbyqxmd.com/read/27847339/analytical-evaluation-of-a-new-point-of-care-system-for-measuring-cardiac-troponin-i
#5
Danielle Wm Kemper, Veronique Semjonow, Femke de Theije, Diederick Keizer, Lian van Lippen, Johannes Mair, Bernadette Wille, Michael Christ, Felicitas Geier, Pierre Hausfater, David Pariente, Volkher Scharnhorst, Joyce Curvers, Jeroen Nieuwenhuis
OBJECTIVES: Point-of-care cardiac troponin testing with adequate analytical performances has the potential to improve chest pain patients flow in the emergency department. We present the analytical evaluation of the newly developed Philips Minicare cTnI point-of-care immunoassay. DESIGN & METHODS: Li-heparin whole blood and plasma were used to perform analytical studies. The sample type comparison study was performed at 4 different hospitals. The 99th percentile upper reference limit (URL) study was performed using Li-heparin plasma, Li-heparin whole blood and capillary blood samples from 750 healthy adults, aging from 18 to 86years...
November 12, 2016: Clinical Biochemistry
https://www.readbyqxmd.com/read/27846783/point-of-care-assessment-of-cardiac-troponin-t-level-in-ckd-patients-with-chest-symptom
#6
Masaki Iwasaki, Kenji Yamazaki, Nobutaka Ikeda, Yuri Tanaka, Toshihide Hayashi, Shun Kubo, Ai Matsukane, Hiroki Hase, Nobuhiko Joki
We challenged to identify the cutoff value of cTnT in chronic kidney disease (CKD) patients by point of care assessment way. A single center, prospective cross-sectional study was planned and performed. 201 consecutive patients who were visited emergency room for chest symptoms were enrolled in this study. All patients were performed routine practice for differential diagnosis of chest symptom by cardiologist. Simultaneously, semiquantitative measurement of cTnT was performed using same blood sampling on the blind condition to cardiologists for this study...
November 15, 2016: Renal Failure
https://www.readbyqxmd.com/read/27823689/safety-and-efficacy-of-the-0-h-3-h-protocol-for-rapid-rule-out-of-myocardial-infarction
#7
Karin Wildi, Berit Nelles, Raphael Twerenbold, Maria Rubini Giménez, Tobias Reichlin, Hélène Singeisen, Sophie Druey, Philip Haaf, Zaid Sabti, Petra Hillinger, Cedric Jaeger, Isabel Campodarve, Philip Kreutzinger, Christian Puelacher, Zoraida Moreno Weidmann, Mathias Gugala, Gilles Pretre, Stephanie Doerflinger, Max Wagener, Fabio Stallone, Michael Freese, Claudia Stelzig, Katharina Rentsch, Stefano Bassetti, Roland Bingisser, Stefan Osswald, Christian Mueller
BACKGROUND: The early and accurate diagnosis of acute myocardial infarction (AMI) is an important medical and economic challenge. We aimed to prospectively evaluate the performance of the new European Society of Cardiology rapid 0-hour/3-hour (0 h/3 h) rule out protocol for AMI. METHODS: We enrolled 2,727 consecutive patients presenting with suspected AMI without persistent ST-segment elevation to the emergency department in a prospective international multicenter study...
November 2016: American Heart Journal
https://www.readbyqxmd.com/read/27818043/ultrasensitive-nanostructure-sensor-arrays-on-flexible-substrates-for-multiplexed-and-simultaneous-electrochemical-detection-of-a-panel-of-cardiac-biomarkers
#8
Nandhinee Radha Shanmugam, Sriram Muthukumar, Shajee Chaudhry, Jonathan Anguiano, Shalini Prasad
Multiplexed detection of protein biomarkers offers new opportunities for early diagnosis and efficient treatment of complex diseases. Cardiovascular diseases (CVDs) has the highest mortality risk in USA and Europe with 15-20 million cases being reported annually. Cardiac Troponins (T and I) are well established protein biomarkers associated with heart muscle damage and point-of-care monitoring of both these two biomarkers has significant benefits on patient care. A flexible disposable electrochemical biosensor device comprising of vertically oriented zinc oxide (ZnO) nanostructures was developed for rapid and simultaneous screening of cardiac Troponin-I (cTnI) and cardiac-Troponin-T (cTnT) in a point-of-care sensor format...
October 20, 2016: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/27811209/discordance-between-icd-coded-myocardial-infarction-and-diagnosis-according-to-the-universal-definition-of-myocardial-infarction
#9
Jorge Díaz-Garzón, Yader Sandoval, Stephen W Smith, Sara Love, Karen Schulz, Sarah E Thordsen, Benjamin K Johnson, Brian Driver, Katherine Jacoby, Michelle D Carlson, Kenneth W Dodd, Johanna Moore, Nathaniel L Scott, Charles A Bruen, Ryan Hatch, Fred S Apple
BACKGROUND: International Classification of Diseases (ICD) coding is the standard diagnostic tool for healthcare management. At present, type 2 myocardial infarction (T2MI) classification by the Universal Definition of Myocardial Infarction (MI) remains ignored in the ICD system. We determined the concordance for the diagnosis of MI using ICD-9 coding vs the Universal Definition. METHODS: Cardiac troponin I (cTnI) was measured by both contemporary (cTnI) and high-sensitivity (hs-cTnI) assays in 1927 consecutive emergency department (ED) patients [Use of TROPonin In Acute coronary syndromes (UTROPIA) cohort] who had cTnI ordered on clinical indication...
November 3, 2016: Clinical Chemistry
https://www.readbyqxmd.com/read/27811206/economic-considerations-of-early-rule-in-rule-out-algorithms-for-the-diagnosis-of-myocardial-infarction-in-the-emergency-department-using-cardiac-troponin-and-glycemic-biomarkers
#10
Colleen Shortt, Feng Xie, Richard Whitlock, Jinhui Ma, Natasha Clayton, Jonathan Sherbino, Stephen A Hill, Guillaume Pare, Matthew McQueen, Shamir R Mehta, P J Devereaux, Andrew Worster, Peter Kavsak
BACKGROUND: We have previously demonstrated the utility of a rule-in/rule-out strategy for myocardial infarction (MI) using glycemic biomarkers in combination with cardiac troponin in the emergency department (ED). Given that the cost of assessing patients with possible MI in the ED is increasing, we sought to compare the health services cost of our previously identified early rule-in/rule-out approaches for MI among patients who present to the ED with symptoms suggestive of acute coronary syndrome (ACS)...
November 3, 2016: Clinical Chemistry
https://www.readbyqxmd.com/read/27780745/cross-sectional-study-of-high-sensitivity-cardiac-troponins-t-and-i-in-a-hospital-and-community-outpatient-setting
#11
Julia M Potter, Aaron J Simpson, Jennifer Kerrigan, Emma Southcott, Marie M Salib, Gus Koerbin, Peter E Hickman
OBJECTIVES: Cardiac troponins are specific for the heart, but not for the acute coronary syndrome. We wanted to assess how common elevated cardiac troponin concentrations were, in a population with significant non-cardiac disease. DESIGN & METHODS: We measured both hs-cTnT and hs-cTnI on all samples submitted to the laboratory during one 24h period, and assessed the magnitude of the cTn concentration with the location and severity of disease of the patient. RESULTS: Community patients and patients from the maternity ward had the lowest cTn concentrations with results above the 99th percentile being only 0-2% of the total...
October 22, 2016: Clinical Biochemistry
https://www.readbyqxmd.com/read/27766733/variability-of-biomarkers-in-patients-with-chronic-heart-failure-and-healthy-controls
#12
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
https://www.readbyqxmd.com/read/27738245/perioperative-myocardial-infarction-in-non-cardiac-surgery-patients-a-prospective-observational-study
#13
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
https://www.readbyqxmd.com/read/27717317/the-feasibility-and-diagnostic-accuracy-by-multiple-cardiac-biomarkers-in-emergency-chest-pain-patients-a-clinical-analysis-to-compare-290-suspected-acute-coronary-syndrome-cases-stratified-by-age-and-gender-in-taiwan
#14
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
https://www.readbyqxmd.com/read/27712987/impact-of-physical-activity-of-individuals-and-creatine-kinase-on-99th-percentiles-of-troponin-i-assays
#15
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
https://www.readbyqxmd.com/read/27711184/a-plaque-disruption-index-identifies-patients-with-non-ste-type-1-myocardial-infarction-within-24-hours-of-troponin-positivity
#16
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
https://www.readbyqxmd.com/read/27707754/diurnal-rhythm-of-cardiac-troponin-consequences-for-the-diagnosis-of-acute-myocardial-infarction
#17
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...
December 2016: Clinical Chemistry
https://www.readbyqxmd.com/read/27706873/hot-off-the-press-the-use-of-very-low-concentrations-of-high-sensitivity-troponin-t-to-rule-out-acute-myocardial-infarction-using-a-single-blood-test
#18
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
https://www.readbyqxmd.com/read/27693165/-fast-track-chest-pain-pathway-in-emergency-department
#19
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
https://www.readbyqxmd.com/read/27683523/biochemical-markers-of-myocardial-damage
#20
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
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