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Troponin Sensitive Diagnosis

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https://www.readbyqxmd.com/read/28719430/high-sensitivity-cardiac-troponin-t-improves-the-diagnosis-of-perioperative-mi
#1
Jamie C Brown, Eslam Samaha, Srikar Rao, Mohammad A Helwani, Andreas Duma, Frank Brown, Brian F Gage, J Philip Miller, Allan S Jaffe, Fred S Apple, Mitchell G Scott, Peter Nagele
BACKGROUND: The diagnosis of myocardial infarction (MI) after noncardiac surgery has traditionally relied on using relatively insensitive contemporary cardiac troponin (cTn) assays. We hypothesized that using a recently introduced novel high-sensitivity cTnT (hscTnT) assay would increase the detection rate of perioperative MI. METHODS: In this ancillary study of the Vitamins in Nitrous Oxide trial, readjudicated incidence rates of myocardial injury (new isolated cTn elevation) and MI were compared when diagnosed by contemporary cTnI versus hscTnT...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28712187/utility-of-heart-type-fatty-acid-binding-protein-h-fabp-point-of-care-test-in-the-early-hours-of-stemi-compared-with-troponin-i-in-pakistani-population
#2
Walid Ahmad Abbasi, Muhammad Saleem, Shahid Rasheed, Azhar Mahmood Kiyani
BACKGROUND: Acute coronary syndrome remains a dominant cause of high morbidity and mortality despite advancements in treatment This study was conducted to examine the utility of point-of-care test of heart-type fatty-acid binding protein (h-FABP) and compare it with the point-of-care test of cardiac troponin I (cTnI) in the first 06 hours of STEMI. METHODS: This cross-sectional, comparative study which was conducted in Rawalpindi institute of cardiology, Rawalpindi, Pakistan, from January to June 2015...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28701316/diagnostic-performance-of-high-sensitivity-compared-with-contemporary-cardiac-troponin-i-for-the-diagnosis-of-acute-myocardial-infarction
#3
Yader Sandoval, Stephen W Smith, Sarah E Thordsen, Charles A Bruen, Michelle D Carlson, Kenneth W Dodd, Brian E Driver, Katherine Jacoby, Benjamin K Johnson, Sara A Love, Johanna C Moore, Anne Sexter, Karen Schulz, Nathaniel L Scott, Jennifer Nicholson, Fred S Apple
BACKGROUND: We examined the diagnostic performance of high-sensitivity cardiac troponin I (hs-cTnI) vs contemporary cTnI with use of the 99th percentile alone and with a normal electrocardiogram (ECG) to rule out acute myocardial infarction (MI) and serial changes (deltas) to rule in MI. METHODS: We included consecutive patients presenting to a US emergency department with serial cTnI on clinical indication (NCT02060760). Diagnostic performance for acute MI, including MI subtypes, and 30-day outcomes were examined...
July 12, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28692218/-interpretation-of-high-sensitivity-troponin-in-patients-with-chronic-kidney-failure
#4
Manon Kolb, Alexandre Guinand, Marco Roffi, Patrick Saudan, Mathieu Nendaz
New assays with lower levels of detection of troponin (« high-sensitivity troponin ») increase the difficulty of interpretation of this test for the diagnosis of acute coronary syndrome in patients with chronic kidney disease (CKD). Their baseline concentration of troponin is frequently above the upper reference level, which lowers its specificity. To improve its diagnostic performance after clinical and electrocardiographic evaluation, cut-off levels 2 to 3 times higher than the standard reference have been suggested...
October 19, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28689634/impact-of-the-australian-gender-specific-thresholds-using-the-abbott-high-sensitivity-troponin-i-assay-in-clinical-care
#5
Robert Bender, Faith Njue, Samuel Vasikaran, Ramon Lambert, Jamie Rankin, Graham S Hillis, Damon A Bell
The aim of this study was to ascertain the impact of gender specific hs-TnI thresholds in a clinical setting and determine the clinical characteristics and discharge diagnosis for individuals presenting to the Emergency Department (ED) with elevated troponin I with the Abbott high-sensitivity troponin I (hs-TnI) assay, but non-elevated troponin I on the previous generation assay (STAT TnI-II). Medical records of individuals presenting to the Royal Perth Hospital ED with elevated hs-TnI between 12 November 2013 and 24 December 2013 were retrospectively reviewed...
July 6, 2017: Pathology
https://www.readbyqxmd.com/read/28680021/potential-of-lipoproteins-as-biomarkers-in-acute-myocardial-infarction
#6
Haseeb Ahmad Khan, Aishah Ekhzaimy, Isra Khan, Meena Kishore Sakharkar
Acute myocardial infarction (AMI), commonly known as heart attack, is a medical emergency that is potentially fatal if not promptly and properly managed. The early diagnosis of AMI is critically important for the timely institution of pharmacotherapy to prevent myocardial damage and preserve cardiac function. Ischemic insults during AMI cause myocardial tissue damage, releasing the cardiac muscle protein troponin T into the blood stream. Therefore, serum troponin T levels are used as a sensitive and specific indicator of myocardial injury for diagnosing AMI...
July 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28669701/comparative-evaluation-of-2-hour-rapid-diagnostic-algorithms-for-acute-myocardial-infarction-using-high-sensitivity-cardiac-troponin-t
#7
Andrew D McRae, Grant Innes, Michelle Graham, Eddy Lang, James E Andruchow, Hong Yang, Yunqi Ji, Shabnam Vatanpour, Danielle A Southern, Dongmei Wang, Isolde Seiden-Long, Lawrence DeKoning, Peter Kavsak
BACKGROUND: Symptoms of acute coronary syndrome account for a large proportion of emergency department (ED) visits and hospitalizations. High-sensitivity troponin can rapidly rule out or rule in acute myocardial infarction (AMI) within a short time of ED arrival. We sought to validate test characteristics and classification performance of 2-hour high-sensitivity troponin T (hsTnT) algorithms for the rapid diagnosis of AMI. METHODS: We included consecutive patients from 4 academic EDs with suspected cardiac chest pain who had hsTnT assays performed 2 hours apart (± 30 minutes) as part of routine care...
May 3, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28661786/impact-of-a-soccer-game-on-cardiac-biomarkers-in-adolescent-players
#8
Seyed Mohsen Hosseini, Mojtaba Azizi, Ali Samadi, Nahid Talebi, Gatterer Hannes, Martin Burtscher
PURPOSE: Biochemical markers such as cardiac troponin I (cTnI) and N-terminal pro B-type natriuretic peptide (NT-proBNP) have become indispensable tools for the diagnosis of myocardial injury, providing highly sensitive and specific information about cardiac cell damage and wall stress. The purpose of the present research was to examine the response of cardiac biomarkers to a soccer game in adolescent male soccer players. METHODS: 22 trained adolescent male soccer players (14-16 years) were selected in a purposive manner...
June 29, 2017: Pediatric Exercise Science
https://www.readbyqxmd.com/read/28659139/the-unique-value-of-cardiovascular-magnetic-resonance-in-patients-with-suspected-acute-coronary-syndrome-and-culprit-free-coronary-angiograms
#9
Roman Panovský, Júlia Borová, Martin Pleva, Věra Feitová, Petr Novotný, Vladimír Kincl, Tomáš Holeček, Jaroslav Meluzín, Ondřej Sochor, Radka Štěpánová
BACKGROUND: Patients with chest pain, elevated troponin, and unobstructed coronary disease present a clinical dilemma. The purpose of this study was to investigate the incremental diagnostic value of cardiovascular magnetic resonance (CMR) in a cohort of patients with suspected acute coronary syndrome (ACS) and unobstructed coronary arteries. RESULTS: Data files of patients meeting the inclusion criteria in two cardiology centres were searched and analysed. The inclusion criteria included: 1) thoracic pain suspected with ACS; 2) a significant increase in the high-sensitive Troponin T value; 3) ECG changes; 4) coronary arteries without any significant stenosis; 5) a CMR examination included in the diagnostic process; 6) an uncertain diagnosis before the CMR exam; and 7) the absence of known CMR and contrast media contraindications...
June 28, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28650717/heart-type-fatty-acid-binding-protein-is-a-sensitive-biomarker-for-early-ami-detection-in-troponin-negative-patients-a-pilot-study
#10
Luisa Agnello, Giulia Bivona, Giuseppina Novo, Concetta Scazzone, Roberto Muratore, Piero Levantino, Chiara Bellia, Bruna Lo Sasso, Marcello Ciaccio
BACKGROUND: Early detecting AMI in individuals presenting to the ED with chest pain continues to be a challenge. cTn is the gold standard for AMI diagnosis but early presenters (<1 hours from symptom onset) maybe cTn negative on admission. We analysed the diagnostic value of h-FABP and hs-TnI in patients presenting to ED with chest pain and no cTnI elevations. METHODS: 28 AMI and 28 no-AMI individuals both presented to ED within one hour from pain onset were included...
June 26, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28647406/unstable-angina-in-the-era-of-cardiac-troponin-assays-with-improved-sensitivity-a-clinical-dilemma
#11
K M Eggers, T Jernberg, B Lindahl
INTRODUCTION: There is an expectation that with the adoption of more sensitive cardiac troponin (cTn) assays, unstable angina would become a rarity. However, recent data from the SWEDEHEART registry demonstrated that 15% of patients admitted with non ST-elevation acute coronary syndrome (NSTE-ACS) still were regarded having unstable angina. We aimed to further investigate the clinical characteristics and outcome of these patients. METHODS: Retrospective registry-based analysis (SWEDEHEART) including 3204 unstable patients, 18,194 non ST-elevation myocardial infarction (NSTEMI) patients and 977 controls without acute cardiovascular disease...
June 21, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28641514/clinically-relevant-biomarkers-in-acute-heart-failure-an-update
#12
Agnibh Mukherji, Uzair Ansari, Martin Borggrefe, Ibrahim Akin, Michael Behnes
Acute heart failure (AHF) has been one of the fields, where owing to difficulties in diagnosis, prognostic stratification and management the associated morbidity and mortality remains unusually high. The advent of novel biomarkers apart from the traditional B-type natriuretic peptide and N-terminal proBNP involved in myocardial injury, neuro-hormonal activation, and ventricular remodeling augurs immense hope in redefining our approach towards AHF. METHODS: Biomarkers like midregional proatrial natriuretic peptide, soluble ST2, highly-sensitive troponin, and midregional proadrenomedullin are some such examples that have passed various stages of substantiation while there is an array of potential biomarkers in nascent stages like osteopontin, CTGF, GDF-15 and TGF beta-1 awaiting further reiteration...
June 22, 2017: Current Pharmaceutical Biotechnology
https://www.readbyqxmd.com/read/28634541/campylobacter-jejuni-myocarditis-a-journey-from-the-gut-to-the-heart
#13
M Toba Obafemi, Homeyra Douglas
OBJECTIVES: Campylobacter jejuni is an unusual cause of myocarditis and could easily be missed. METHODS: We describe a case of a 25 year old man, who presented with 3 day history of vomiting and diarrhoea, followed by chest pain and significant high sensitive troponin rise. RESULTS: The patient's profuse diarrhoea was accompanied by raised inflammatory markers, electrocardiogram changes and evidence of cardiomyopathy on transthoracic echocardiogram...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28597214/-diagnosis-of-ischemia-and-revascularization-in-patients-with-ventricular-tachyarrhythmia
#14
REVIEW
Thomas Deneke, Carsten W Israel
Sustained ventricular tachyarrhythmia usually occurs on the basis of structural heart disease, particularly coronary heart disease (CAD). Although monomorphic ventricular tachycardia (VT) appears mainly in patients with CAD, it is typically not triggered by acute ischemia, in contrast to polymorphic VT or ventricular fibrillation (VF). To judge if VT is caused by acute ischemia is even more difficult in context with an elevated highly sensitive troponin T which is generally elevated in sustained VT because tachycardia in chronic stable coronary artery sclerosis causes a mismatch between increased oxygen demand and limited oxygen supply...
June 8, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28588346/a-rational-adoption-of-the-high-sensitive-assay-for-cardiac-troponin-i-in-diagnostic-routine
#15
Antonio Croce, Pietro Brunati, Carlo Colzani, Riccardo Terramocci, Stefano Favero, Gabriele Bordoni, Claudio Galli
We describe the adoption of high sensitive troponin I (hsTnI) in clinical practice in two hospital settings in Italy. Samples from 426 consecutive patients (mean age 68.8 ± 17.0) admitted to the Emergency Department with a suspected acute coronary syndrome (ACS) have been tested at admittance and after 3 and 6 hours by contemporary TnI and hsTnI. Results have been compared to the final clinical diagnosis. Troponin was detectable in 68.6% by TnI and 89.9% by hsTnI. Since hsTnI has a lower threshold for females, 38/41 patients with positive values only by hsTnI were women...
2017: Disease Markers
https://www.readbyqxmd.com/read/28571623/reprint-of-assay-validation-of-the-cardiac-isoform-of-troponin-i-in-double-crested-cormorant-phalacrocorax-auritus-plasma-for-diagnosis-of-cardiac-damage
#16
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...
May 29, 2017: Ecotoxicology and Environmental Safety
https://www.readbyqxmd.com/read/28569321/achieving-biosensing-at-attomolar-concentrations-of-cardiac-troponin-t-in-human-biofluids-by-developing-a-label-free-nanoplasmonic-analytical-assay
#17
Thakshila Liyanage, Andeep Sangha, Rajesh Sardar
Acute myocardial infarction (heart attack) is the fifth leading cause of death in the United States (Dariush et al., Circulation, 2015, 131, e29-e322). This highlights the need for early, rapid, and sensitive detection of its occurrence and severity through assaying cardiac biomarkers in human fluids. Herein we report chip-based fabrication of the first label-free, nanoplasmonic biosensor to assay cardiac troponin T (cTnT) in human biofluids (plasma, serum, and urine) with high specificity. The sensing mechanism is based on the adsorption model that measures the localized surface plasmon resonance (LSPR) wavelength shift of anti-cTnT functionalized gold triangular nanoprisms (Au TNPs) induced by a change of their local dielectric environment upon binding of cTnT...
June 26, 2017: Analyst
https://www.readbyqxmd.com/read/28566132/early-diagnostic-performance-of-heart-type-fatty-acid-binding-protein-in-suspected-acute-myocardial-infarction-evidence-from-a-meta-analysis-of-contemporary-studies
#18
Li-Qian Xu, Yun-Mei Yang, Hong Tong, Chang-Fu Xu
BACKGROUND: Although cardiac troponin is the cornerstone in diagnosis of acute myocardial infarction (AMI), the accuracy is still suboptimal in the early hours after chest pain onset. Due to its small size, heart-type fatty acid-binding protein (H-FABP) has been reported accurate in diagnosis of AMI, however, this remains undetermined. The aim is to investigate the diagnostic performance of H-FABP alone and in conjunction with high-sensitivity troponin (hs-Tn) within six hours of symptom onset...
May 4, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28545635/outcomes-in-patients-with-chest-pain-discharged-after%C3%A2-evaluation-using-a-high-sensitivity-troponin-t-assay
#19
Atosa Nejatian, Åsa Omstedt, Jonas Höijer, L O Hansson, Therese Djärv, Kai M Eggers, Per Svensson
BACKGROUND: Most patients with chest pain are discharged from the emergency department (ED) with the diagnosis "unspecified chest pain." It is unknown if evaluation with a high-sensitivity troponin T (hsTnT) assay affects prognosis in this large population. OBJECTIVES: The aim was to investigate whether the introduction of an hsTnT assay is associated with reduced incidence of major adverse cardiac events (MACEs) and cardiovascular (CV) risk profile in patients with chest pain discharged from the ED...
May 30, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28532247/high-sensitivity-cardiac-troponin-t-in-patients-not-having-an-acute-coronary-syndrome-results-from-the-trapid-ami-study
#20
Richard Nowak, Christian Mueller, Evangelos Giannitsis, Michael Christ, Jordi Ordonez-Llanos, Christopher DeFilippi, James McCord, Richard Body, Mauro Panteghini, Tomas Jernberg, Mario Plebani, Franck Verschuren, John K French, Robert Christenson, Gordon Jacobsen, Carina Dinkel, Bertil Lindahl
PURPOSE: To describe the baseline, 1 hr and delta high sensitivity cardiac troponin (hs-cTnT) values in patients with suspected acute myocardial infarction (AMI) but without a final acute coronary syndrome (ACS) diagnosis. MATERIALS AND METHODS: hs-cTnT assay for RAPID rule out of acute myocardial infarction (TRAPID-AMI) was a prospective diagnostic trial that enrolled emergency department (ED) patients with suspected AMI. Final patient diagnoses were adjudicated by a clinical events committee and subjects placed in different clinical groups: AMI, unstable angina, non-ACS cardiac, non-cardiac and unknown origin...
June 14, 2017: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
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