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Troponin Sensitive Diagnosis

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https://www.readbyqxmd.com/read/29215707/the-diagnostic-and-prognostic-value-of-circulating-micrornas-in-coronary-artery-disease-a-novel-approach-to-disease-diagnosis-of-stable-cad-and-acute-coronary-syndrome
#1
REVIEW
Seyed Mostafa Parizadeh, Gordon A Ferns, Maryam Ghandehari, Seyed Mahdi Hasanian, Majid Ghayour-Mobarhan, Seyed Mohammad Reza Parizadeh, Amir Avan
Coronary artery disease (CAD) is the most common manifestation of CVD and the acute coronary syndrome (ACS) is associated with a substantial morbidity and mortality in most populations globally. There are several biomarkers for diagnosis of MI. Troponin is routinely used as a biomarker in patients with chest pain, but it lacks sensitivity in the first hours of onset of symptoms, and so there is still a clinical need for new biomarkers for the diagnosis of CAD events. Recent studies have shown that miRNAs are involved in atherosclerotic plaque formation and their expression is altered during CAD events...
December 7, 2017: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/29208858/correlation-of-troponin-i-level-with-left-ventricular-ejection-fraction-and-in-hospital-outcomes-after-first-attack-of-non-st-segment-elevation-myocardial-infarction
#2
M H Khan, M N Islam, G P Aditya, M Z Islam, A S Bhuiyan, B Saha, K Bhowmick, M Hassan, P K Paul, S Chowdhury, R Rahman
Coronary heart disease (CHD) is the most common cause of heart disease and is the single most important cause of premature death in developed world. Recognizing a patient with ACS is important because the diagnosis triggers both triage and management. cTnI is 100% tissue-specific for the myocardium and it has been shown to be a very sensitive and specific marker for acute myocardial infarction (AMI). Ventricular function is the best predictor of death after an acute coronary syndrome. It serves as a marker of myocardial damage, provides information on systolic function as well as diagnosis and prognosis...
October 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29207933/prognostic-factors-for-in-hospital-mortality-of-patients-hospitalized-for-acutely-decompensated-heart-failure
#3
Štefica Dvornik, Teodora Zaninović Jurjević, Nikolina Jurjević, Amalija Lekić, Luka Zaputović
Objectives Despite improved treatment during last 20 years, prognosis for patients hospitalized for acutely decompensated heart failure (ADHF) is poor and mortality rates reported for these patients are high. Laboratory results can assist clinicians in evaluation and triaging of patients on hospital admission, and are important for the medical decision-making and prognosis assessments. Recently, new guidelines for the diagnosis and treatment of acute and chronic HF patients were published introducing a new group of patients with mid-range left ventricular ejection fraction (LVEF)...
December 5, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29203498/perioperative-myocardial-injury-after-noncardiac-surgery-incidence-mortality-and-characterization
#4
Christian Puelacher, Giovanna Lurati Buse, Daniela Seeberger, Lorraine Sazgary, Stella Marbot, Andreas Lampart, Jaqueline Espinola, Christoph Kindler, Angelika Hammerer, Esther Seeberger, Ivo Strebel, Karin Wildi, Raphael Twerenbold, Jeanne du Fay de Lavallaz, Luzius Steiner, Lorenz Gurke, Tobias Breidthardt, Katharina Rentsch, Andreas Buser, Danielle M Gualandro, Stefan Osswald, Christian Mueller
Background -Perioperative myocardial injury (PMI) seems to be a contributor to mortality after noncardiac surgery. Because the vast majority of PMIs are asymptomatic, PMI usually is missed in the absence of systematic screening. Methods -We performed a prospective diagnostic study enrolling consecutive patients undergoing noncardiac surgery who had a planned postoperative stay of ≥24 hours and were considered at increased cardiovascular risk. All patients received a systematic screening using serial measurements of high-sensitivity cardiac troponin T in clinical routine...
December 4, 2017: Circulation
https://www.readbyqxmd.com/read/29199434/a-single-centre-prospective-cohort-study-addressing-the-effect-of-a-rule-in-rule-out-troponin-algorithm-on-routine-clinical-practice
#5
Jack Marjot, Thomas E Kaier, Katherine Henderson, Laura Hunter, Michael S Marber, Divaka Perera
AIMS: In 2015, the European Society of Cardiology introduced new guidelines for the diagnosis of acute coronary syndromes in patients presenting without persistent ST-segment elevation. These guidelines included the use of high-sensitivity troponin assays for 'rule-in' and 'rule-out' of acute myocardial injury at presentation (using a '0 hour' blood test). Whilst these algorithms have been extensively validated in prospective diagnostic studies, the outcome of their implementation in routine clinical practice has not been described...
December 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29199427/predictive-value-of-routine-point-of-care-cardiac-troponin-t-measurement-for-prehospital-diagnosis-and-risk-stratification-in-patients-with-suspected-acute-myocardial-infarction
#6
Martin B Rasmussen, Carsten Stengaard, Jacob T Sørensen, Ingunn S Riddervold, Troels M Hansen, Matthias Giebner, Claus-Henrik Rasmussen, Hans E Bøtker, Christian J Terkelsen
OBJECTIVE: The purpose of this study was to determine the predictive value of routine prehospital point-of-care cardiac troponin T measurement for diagnosis and risk stratification of patients with suspected acute myocardial infarction. METHODS AND RESULTS: All prehospital emergency medical service vehicles in the Central Denmark Region were equipped with a point-of-care cardiac troponin T device (Roche Cobas h232) for routine use in all patients with a suspected acute myocardial infarction...
December 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29182678/diagnostic-performance-of-point-of-care-and-central-laboratory-cardiac-troponin-assays-in-an-emergency-department
#7
Petra Wilke, Annette Masuch, Oliver Fahron, Stephanie Zylla, Tobias Leipold, Astrid Petersmann
Early diagnosis of myocardial infarction (MI) with cardiac troponin (cTn) assays at the point-of-care (POC) is suggested to shorten turn-around-time in the emergency department (ED). The present study aimed at comparing the diagnostic performance of two POC cTn assays with that of a central laboratory high-sensitivity (hs) method, under routine ED conditions. In 2,163 non-selected ED patients suspected for MI, the diagnostic performance of the POC troponin I (TnI), troponin T (TnT), and hs-TnT assay for the prediction of MI was evaluated based on receiver operating characteristic (ROC) analyses and compared with the performance based on the manufacturers' cut-offs...
2017: PloS One
https://www.readbyqxmd.com/read/29181826/speckle-tracking-imaging-in-inflammatory-heart-diseases
#8
Marina Leitman, Zvi Vered, Vladimir Tyomkin, Boris Macogon, Gil Moravsky, Eli Peleg, Laurian Copel
Accurate diagnosis of acute myocarditis is important for the prognosis and risk stratification of these patients. Cardiac magnetic resonance (CMR) has become a major modality for diagnosis of myocarditis, but not widely available. In this study, we tried to evaluate regional and global longitudinal strain by speckle tracking echocardiography in patients with acute inflammatory myocardial diseases in correlation with CMR. Patients with suspected acute myocarditis were recruited prospectively. Clinical diagnosis was established based on clinical, electrocardiographic, laboratory and conventional echocardiographic data...
November 27, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29170316/19%C3%A2-accuracy-of-biomarkers-for-venous-thromboembolism-in-pregnancy-the-diagnosis-of-pulmonary-embolism-in-pregnancy-dipep-biomarker-study
#9
Steve Goodacre, Beverley Hunt, Kiran Parmar, Neil Shephard, Kimberley Horspool
OBJECTIVE: To estimate the accuracy of biomarkers for venous thromboembolism (VTE) in pregnant and postpartum women with suspected pulmonary embolism (PE). DESIGN: Observational cohort study augmented with additional cases with VTE. SETTING: Emergency departments and maternity units at eleven prospectively recruiting sites. PARTICIPANTS: Pregnant or postpartum women presenting with suspected PE or diagnosed DVT. INTERVENTIONS: Research nurses/midwives collected a blood sample from women with suspected PE or diagnosed DVT and data relating to diagnostic imaging, treatment and adverse outcomes...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29170302/5%C3%A2-a-study-analysing-the-diagnostic-performance-of-ecg-interpretation-for-30-day-major-cardiac-events-in-the-emergency-department
#10
Niall Morris, Rick Body
STUDY OBJECTIVE: This study evaluates the diagnostic accuracy of an Emergency Medicine (EM) clinician at identifying ischaemia on an ECG using 30-day major adverse cardiac events (MACE) as the primary outcome. METHODS: This is a secondary analysis of a prospective, multi-centre, observational cohort at 14 centres: the Bedside Evaluation of Sensitive Troponin study. All fourteen Emergency Departments were based in the United Kingdom. Emergency physicians' assessments of the ECG were collected using a standardised form...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29158437/cardiac-magnetic-resonance-imaging-in-myocarditis-reveals-persistent-disease-activity-despite-normalization-of-cardiac-enzymes-and-inflammatory-parameters-at-3-month-follow-up
#11
Jan Berg, Jan Kottwitz, Nora Baltensperger, Christine K Kissel, Marina Lovrinovic, Tarun Mehra, Frank Scherff, Christian Schmied, Christian Templin, Thomas F Lüscher, Bettina Heidecker, Robert Manka
BACKGROUND: There is a major unmet need to identify high-risk patients in myocarditis. Although decreasing cardiac and inflammatory markers are commonly interpreted as resolving myocarditis, this assumption has not been confirmed as of today. We sought to evaluate whether routine laboratory parameters at diagnosis predict dynamic of late gadolinium enhancement (LGE) as persistent LGE has been shown to be a risk marker in myocarditis. METHODS AND RESULTS: Myocarditis was diagnosed based on clinical presentation, high-sensitivity troponin T, and cardiac magnetic resonance imaging, after exclusion of obstructive coronary artery disease by angiography...
November 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29155984/cysteine-rich-angiogenic-inducer-61-cyr61-a-novel-soluble-biomarker-of-acute-myocardial-injury-improves-risk-stratification-after-acute-coronary-syndromes
#12
Roland Klingenberg, Soheila Aghlmandi, Christoph Liebetrau, Lorenz Räber, Baris Gencer, David Nanchen, David Carballo, Alexander Akhmedov, Fabrizio Montecucco, Stefan Zoller, Chad Brokopp, Dik Heg, Peter Jüni, Helena Marti Soler, Pedro-Manuel Marques-Vidal, Peter Vollenweider, Oliver Dörr, Nicolas Rodondi, François Mach, Stephan Windecker, Ulf Landmesser, Arnold von Eckardstein, Christian W Hamm, Christian M Matter, Thomas F Lüscher
Aims: We aimed to identify a novel biomarker involved in the early events leading to an acute coronary syndrome (ACS) and evaluate its role in diagnosis and risk stratification. Methods and results: Biomarker identification was based on gene expression profiling. In coronary thrombi of ACS patients, cysteine-rich angiogenic inducer 61 (Cyr61, CCN1) gene transcripts were highly up-regulated compared with peripheral mononuclear cells. In a murine ischaemia-reperfusion model (I/R), myocardial Cyr61 expression was markedly increased compared with the controls...
November 16, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29150552/evaluation-of-a-0-hour-1-hour-algorithm-in-the-diagnosis-of-myocardial-infarction-with-high-sensitivity-cardiac-troponin-t1
#13
Jaspreet Kaur Khaira
No abstract text is available yet for this article.
November 17, 2017: Evidence-based Medicine
https://www.readbyqxmd.com/read/29137577/postoperative-troponin-measurement-as-a-screening-tool-for-adverse-cardiac-events-in-adult-patients-undergoing-moderate-or-major-non-cardiac-surgery
#14
D Coric, N A Smith
Elevated troponin levels within three days of surgery are strongly linked to major adverse cardiac events (MACE). However, the value of screening with troponin measurements is controversial. The extent to which this is done in routine practice is uncertain. We examined the medical records of all patients ≥45 years of age undergoing moderate or major non-cardiac surgery in our tertiary referral hospital over a six-month period. We determined how many patients had a troponin (TnT) measurement recorded in the first three days postoperatively, how many of these were abnormal, and the occurrence of MACE within 30 days...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29135622/troponin-limit-of-detection-plus-cardiac-risk-stratification-scores-to-rule-out-acute-myocardial-infarction-and-30-day-major-adverse-cardiac-events-in-ed-patients
#15
Mitchell D Datlow, Kelly M Gray, Adriel Watts, Deborah B Diercks, Bryn E Mumma
When screening for acute myocardial infarction (AMI), troponin levels below the 99th percentile, including those below the limit of detection (LOD), are considered normal. We hypothesized that a low-risk HEART score (0-3) or ACS Pretest Probability Assessment <2% plus a single troponin below the LOD would rule out both AMI and 30-day major adverse cardiac events (MACE). We studied all patients who presented to a single academic emergency department and received a troponin I (Siemens Ultra Troponin I) from September 1, 2013, to November 13, 2013 (n=888)...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29132262/diastolic-dysfunction-is-common-in-survivors-of-pediatric-differentiated-thyroid-carcinoma
#16
Mariëlle Sanne Klein Hesselink, Gianni Bocca, Yoran M Hummel, Adrienne H Brouwers, Johannes G M Burgerhof, Eveline W C M van Dam, Jourik A Gietema, Bas Havekes, Marry M van den Heuvel-Eibrink, Eleonora P M Corssmit, Leontien Kremer, Romana Netea-Maier, Helena J H van der Pal, Robin Peeters, John Th M Plukker, Cécile M Ronckers, Hanneke M van Santen, Peter van der Meer, Thera P Links, Wim J E Tissing
INTRODUCTION: Whether pediatric patients with differentiated thyroid carcinoma (DTC) are at risk of developing treatment-related adverse effects on cardiac function is unknown. We therefore studied in long-term survivors of pediatric DTC the prevalence of cardiac dysfunction and atrial fibrillation (AF) in relation to treatment variables, and the association between cardiac dysfunction and plasma biomarkers. PATIENTS AND METHODS: In this nationwide prospective multicenter study, cardiac assessments were performed in 66 adult survivors of pediatric DTC (age at diagnosis ≤18 years and follow-up ≥5 years after diagnosis) treated in The Netherlands between 1970 and 2009...
November 13, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/29127948/association-of-high-sensitivity-cardiac-troponin-i-concentration-with-cardiac-outcomes-in-patients-with-suspected-acute-coronary-syndrome
#17
Andrew R Chapman, Kuan Ken Lee, David A McAllister, Louise Cullen, Jaimi H Greenslade, William Parsonage, Andrew Worster, Peter A Kavsak, Stefan Blankenberg, Johannes Neumann, Nils A Söerensen, Dirk Westermann, Madelon M Buijs, Gerard J E Verdel, John W Pickering, Martin P Than, Raphael Twerenbold, Patrick Badertscher, Zaid Sabti, Christian Mueller, Atul Anand, Philip Adamson, Fiona E Strachan, Amy Ferry, Dennis Sandeman, Alasdair Gray, Richard Body, Brian Keevil, Edward Carlton, Kim Greaves, Frederick K Korley, Thomas S Metkus, Yader Sandoval, Fred S Apple, David E Newby, Anoop S V Shah, Nicholas L Mills
Importance: High-sensitivity cardiac troponin I testing is widely used to evaluate patients with suspected acute coronary syndrome. A cardiac troponin concentration of less than 5 ng/L identifies patients at presentation as low risk, but the optimal threshold is uncertain. Objective: To evaluate the performance of a cardiac troponin I threshold of 5 ng/L at presentation as a risk stratification tool in patients with suspected acute coronary syndrome. Data Sources: Systematic search of MEDLINE, EMBASE, Cochrane, and Web of Science databases from January 1, 2006, to March 18, 2017...
November 11, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29121105/economic-evaluation-of-the-one-hour-rule-out-and-rule-in-algorithm-for-acute-myocardial-infarction-using-the-high-sensitivity-cardiac-troponin-t-assay-in-the-emergency-department
#18
Apoorva Ambavane, Bertil Lindahl, Evangelos Giannitis, Julie Roiz, Joan Mendivil, Lutz Frankenstein, Richard Body, Michael Christ, Roland Bingisser, Aitor Alquezar, Christian Mueller
BACKGROUND: The 1-hour (h) algorithm triages patients presenting with suspected acute myocardial infarction (AMI) to the emergency department (ED) towards "rule-out," "rule-in," or "observation," depending on baseline and 1-h levels of high-sensitivity cardiac troponin (hs-cTn). The economic consequences of applying the accelerated 1-h algorithm are unknown. METHODS AND FINDINGS: We performed a post-hoc economic analysis in a large, diagnostic, multicenter study of hs-cTnT using central adjudication of the final diagnosis by two independent cardiologists...
2017: PloS One
https://www.readbyqxmd.com/read/29114078/patient-selection-for-high-sensitivity-cardiac-troponin-testing-and-diagnosis-of-myocardial-infarction-prospective-cohort-study
#19
MULTICENTER STUDY
Anoop S V Shah, Yader Sandoval, Ala Noaman, Anne Sexter, Amar Vaswani, Stephen W Smith, Mathew Gibbins, Megan Griffiths, Andrew R Chapman, Fiona E Strachan, Atul Anand, Martin A Denvir, Philip D Adamson, Michelle S D'Souza, Alasdair J Gray, David A McAllister, David E Newby, Fred S Apple, Nicholas L Mills
Objective To evaluate how selection of patients for high sensitivity cardiac troponin testing affects the diagnosis of myocardial infarction across different healthcare settings.Design Prospective study of three independent consecutive patient populations presenting to emergency departments.Setting Secondary and tertiary care hospitals in the United Kingdom and United States.Participants High sensitivity cardiac troponin I concentrations were measured in 8500 consecutive patients presenting to emergency departments: unselected patients in the UK (n=1054) and two selected populations of patients in whom troponin testing was requested by the attending clinician in the UK (n=5815) and the US (n=1631)...
November 7, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29101917/troponin-testing-in-the-primary-care-setting
#20
Manuela S Mauro, Adam J Nelson, Michael B Stokes
BACKGROUND: Chest pain is a common presenting complaint in general practice. Serum troponin testing is an important clinical tool to help identify patients who present with suspected acute coronary syndrome (ACS). OBJECTIVE: This article will discuss the role of troponin testing in the diagnosis of ACS, and the role of high-sensitive troponin, which is now in widespread use. The importance of clinical acumen in the interpretation of troponin testing and the pitfalls of troponin testing in the primary care setting will also be explored...
November 2017: Australian Family Physician
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