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Troponin Sensitive Diagnosis

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https://www.readbyqxmd.com/read/29444926/high-sensitivity-cardiac-troponin-i-and-the-diagnosis-of-coronary-artery-disease-in-patients-with-suspected-angina-pectoris
#1
Philip D Adamson, Amanda Hunter, Debbie M Madsen, Anoop S V Shah, David A McAllister, Tania A Pawade, Michelle C Williams, Colin Berry, Nicholas A Boon, Marcus Flather, John Forbes, Scott McLean, Giles Roditi, Adam D Timmis, Edwin J R van Beek, Marc R Dweck, Hans Mickley, Nicholas L Mills, David E Newby
BACKGROUND: We determined whether high-sensitivity cardiac troponin I can improve the estimation of the pretest probability for obstructive coronary artery disease (CAD) in patients with suspected stable angina. METHODS AND RESULTS: In a prespecified substudy of the SCOT-HEART trial (Scottish Computed Tomography of the Heart), plasma cardiac troponin was measured using a high-sensitivity single-molecule counting assay in 943 adults with suspected stable angina who had undergone coronary computed tomographic angiography...
February 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29434124/the-usefulness-and-limitations-of-point-of-care-cardiac-troponin-measurement-in-the-emergency-department
#2
Kenichiro Suzuki, Kimiaki Komukai, Kotaro Nakata, Renshi Kan, Yuhei Oi, Eri Muto, Yusuke Kashiwagi, Mitsutoshi Tominaga, Satoru Miyanaga, Tetsuya Ishikawa, Kenji Okuno, Masahiko Uzura, Michihiro Yoshimura
Objective This study was carried out to examine the usefulness of point-of-care (POC) cardiac troponin in diagnosing acute coronary syndrome (ACS) and to understand the limitations of a POC cardiac troponin I/T-based diagnoses. Methods Patients whose cardiac troponin levels were measured in the emergency department using a POC system (AQT System; Radiometer, Tokyo, Japan) between January and December 2016 were retrospectively examined (N=1449). Patients who were < 20 years of age or who were admitted with cardiopulmonary arrest were excluded...
February 9, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29432376/complementary-diagnostic-value-of-heart-type-fatty-acid-binding-protein-in-early-detection-of-acute-myocardial-infarction
#3
Maryam Sotoudeh Anvari, Mahsa Karimi, Akbar Shafiee, Mohammadali Boroumand, Ali Bozorgi, Reza Sedaghat, Arash Jalali
BACKGROUND: Heart-type fatty acid-binding protein (H-FABP) is a novel biomarker for myocardial injury. We compared the use of H-FABP with serum levels of cardiac troponin-T (cTnT) and creatine kinase-MB (CK-MB) in the diagnosis of patients suspicious to acute myocardial infarction (AMI). METHODS: From October 2013 to December 2014, 182 consecutive patients suspicious to acute coronary syndrome were enrolled in this study, who presented within the past 6 hours from the onset of symptoms...
March 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29432370/experiences-of-a-one-hour-algorithm-in-chest-pain-patients-with-a-nonelevated-troponin-t-at-presentation
#4
Anna Pettersson, Lina Ljung, Caroline Johansson, Umut Heilborn, Tomas Jernberg, Mats Frick, Kai M Eggers, Bertil Lindahl, Rikard Linder, Arne Martinsson, Per Svensson
BACKGROUND: We aimed to evaluate the use of a 1-hour measurement of high-sensitivity cardiac troponin T (hs-cTnT) in an emergency department (ED) population of chest pain patients with a nonelevated baseline hs-cTnT and to examine the prevalence of early dynamic changes in hs-cTnT and the association with admission rate, diagnosis, and outcome. METHODS: All patients with a chief complaint of chest pain presenting to the ED of Karolinska University Hospital, Solna, Sweden, from December 2014 to September 2015 who had a baseline hs-cTnT of ≤14 ng/L and a second value obtained within >30 to ≤90 minutes were followed for 30 days regarding admission, readmission, myocardial infarction (MI), and death...
March 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29414081/a-novel-label-free-photoelectrochemical-sensor-based-on-n-s-gqds-and-cds-co-sensitized-hierarchical-zn2sno4-cube-for-detection-of-cardiac-troponin-i
#5
Dawei Fan, Chunzhu Bao, Malik Saddam Khan, Chuanlei Wang, Yong Zhang, Qinze Liu, Xian Zhang, Qin Wei
A novel label-free photoelectrochemical (PEC) sensor based on graphene quantum dots doped with nitrogen and sulfur (N,S-GQDs) and CdS co-sensitized hierarchical Zn2SnO4 cube was fabricated to detect cardiac troponin I (cTnI). The unique hierarchical Zn2SnO4 cube was synthesized successfully by the solvothermal method, which has a large specific surface to load functional materials. N,S-GQDs nanoparticles were assembled to the surface of cubic Zn2SnO4 coated ITO electrode, which efficiently accelerated the electronic transition and improved photo-to-current conversion efficiency...
January 29, 2018: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/29407114/objectively-measured-physical-activity-and-cardiac-biomarkers-a-cross-sectional-population-based-study-in-older-men
#6
Tessa J Parsons, Claudio Sartini, Paul Welsh, Naveed Sattar, Sarah Ash, Lucy T Lennon, S Goya Wannamethee, I-Min Lee, Peter H Whincup, Barbara J Jefferis
BACKGROUND: N-terminal pro-brain natriuretic peptide (NT-proBNP) and high sensitivity Troponin T (hsTnT) are markers of cardiac injury used in diagnosis of heart failure and myocardial infarction respectively, and associated with increased risk of cardiovascular disease. Since physical activity is protective against cardiovascular disease and heart failure, we investigated whether higher levels of physical activity, and less sedentary behaviour were associated with lower NT-proBNP and hsTnT...
March 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29407013/contemporary-emergency-department-management-of-patients-with-chest-pain-a-concise-review-and-guide-for-the-high-sensitivity-troponin-era
#7
REVIEW
James E Andruchow, Peter A Kavsak, Andrew D McRae
This article synthesizes current best evidence for the evaluation of patients with suspected acute coronary syndrome (ACS) using high-sensitivity troponin assays, enabling physicians to effectively incorporate them into practice. Unlike conventional assays, high-sensitivity assays can precisely measure blood cardiac troponin concentrations in the vast majority of healthy individuals, facilitating the creation of rapid diagnostic algorithms. Very low troponin concentrations on presentation accurately rule out acute myocardial infarction (AMI) and enable the discharge of approximately 20% of patients after a single test, whereas an additional 30%-40% of patients can be safely discharged after short-interval serial sampling in as little as 1 or 2 hours...
February 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29407007/new-insights-into-the-use-of-the-12-lead-electrocardiogram-for-diagnosing-acute-myocardial-infarction-in-the-emergency-department
#8
REVIEW
David F Miranda, Angie S Lobo, Brooks Walsh, Yader Sandoval, Stephen W Smith
The 12-lead electrocardiogram (ECG) remains the most immediately accessible and widely used initial diagnostic tool for guiding management in patients with suspected myocardial infarction (MI). Although the development of high-sensitivity cardiac troponin assays has improved the rule-in and rule-out and risk stratification of acute MI without ST elevation, the immediate management of the subset of acute MI with acute coronary occlusion depends on integrating clinical presentation and ECG findings. Careful interpretation of the ECG might yield subtle features suggestive of ischemia that might facilitate more rapid triage of patients with subtle acute coronary occlusion or, conversely, in identification of ST-elevation MI mimics (pseudo ST-elevation MI patterns)...
February 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29386318/patient-selection-for-high-sensitivity-cardiac-troponin-testing-and-diagnosis-of-myocardial-infarction-prospective-cohort-study
#9
(no author information available yet)
No abstract text is available yet for this article.
January 31, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29362756/ultra-sensitive-chemical-and-biological-analysis-via-specialty-fibers-with-built-in-microstructured-optofluidic-channels
#10
Nan Zhang, Kaiwei Li, Ying Cui, Zhifang Wu, Perry Ping Shum, Jean-Louis Auguste, Xuan Quyen Dinh, Georges Humbert, Lei Wei
All-in-fiber optofluidics is an analytical tool that provides enhanced sensing performance with simplified analyzing system design. Currently, its advance is limited either by complicated liquid manipulation and light injection configuration or by low sensitivity resulting from inadequate light-matter interaction. In this work, we design and fabricate a side-channel photonic crystal fiber (SC-PCF) and exploit its versatile sensing capabilities in in-line optofluidic configurations. The built-in microfluidic channel of the SC-PCF enables strong light-matter interaction and easy lateral access of liquid samples in these analytical systems...
January 24, 2018: Lab on a Chip
https://www.readbyqxmd.com/read/29352700/high-sensitivity-troponin-in-the-management-of-tachyarrhythmias
#11
Mark Mariathas, Cameron Gemmell, Bartosz Olechowski, Zoe Nicholas, Michael Mahmoudi, Nick Curzen
BACKGROUND: The introduction of the highly sensitive troponin (hs-trop) assays into clinical practice has allowed for the more rapid diagnosis or exclusion of type 1 myocardial infarctions (T1MI) by clinicians, in addition type 2 myocardial infarctions (T2MI) are now more frequently detected. Tachyarrhythmias are one of the common causes of T2MI, the medium and long term outcome for this cohort of T2MI is yet to be clarified. METHODS: Retrospective review of consecutive patients admitted with a diagnosis of either (a) non ST-elevation myocardial infarction (NSTEMI) or (b) tachyarrhythmia was performed...
November 28, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29343534/effect-of-acute-coronary-syndrome-probability-on-diagnostic-and-prognostic-performance-of-high-sensitivity-cardiac-troponin
#12
Patrick Badertscher, Jasper Boeddinghaus, Thomas Nestelberger, Raphael Twerenbold, Karin Wildi, Zaid Sabti, Christian Puelacher, Maria Rubini Giménez, Julian Pfäffli, Dayana Flores, Jeanne du Fay de Lavallaz, Òscar Miró, F Javier Martin-Sanchez, Beata Morawiec, Jens Lohrmann, Andreas Buser, Dagmar I Keller, Nicolas Geigy, Tobias Reichlin, Christian Mueller
BACKGROUND: There is concern that high-sensitivity cardiac troponin (hs-cTn) may have low diagnostic accuracy in patients with low acute coronary syndrome (ACS) probability. METHODS: We prospectively stratified patients presenting with acute chest discomfort to the emergency department (ED) into 3 groups according to their probability for ACS as assessed by the treating ED physician using a visual analog scale-≤10%, 11% to 79%, and ≥80%-reviewing all information available at 90 min...
January 17, 2018: Clinical Chemistry
https://www.readbyqxmd.com/read/29335079/-expression-of-plasma-mirna-497-in-children-with-sepsis-induced-myocardial-injury-and-its-clinical-significance
#13
Zhong-Jing Wu, Ya-Feng Chen, Hai-Dao Wang, Fang-Hong Gao
OBJECTIVE: To study the expression of plasma miRNA-497 in children with sepsis-induced myocardial injury and its clinical significance. METHODS: A total of 148 children with sepsis were enrolled. According to the presence or absence of myocardial injury, these children were divided into myocardial injury group (n=58) and non-myocardial injury group (n=90). The two groups were compared in terms of the changes in plasma levels of miRNA-497, cardiac troponin I (cTnI), creatine kinase-MB (CK-MB), N-terminal pro-brain natriuretic peptide (NT-proBNP), procalcitonin (PCT), and C-reactive protein (CRP) and left ventricular ejection fraction (LVEF)...
January 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29332909/type-2-myocardial-infarction%C3%A3-an-evolving-entity
#14
Cian P McCarthy, James L Januzzi, Hanna K Gaggin
Type 2 myocardial infarction (T2MI) refers to myocardial necrosis caused by an imbalance in myocardial oxygen supply and demand and in the absence of acute coronary thrombosis. Despite growing recognition of this entity, there remains little understanding of the pathophysiology and uncertainty over the diagnostic criteria for this subtype of MI. Alarmingly, recent studies suggest that a diagnosis of T2MI pertains a prognosis similar to, if not worse than, type 1 MI. With increasing clinical use of high-sensitivity cardiac troponin assays, the frequency of recognition of T2MI is expected to increase...
January 13, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29317021/proposed-clinical-scale-for-the-diagnosis-of-acute-coronary-syndrome-in-patients-with-an-inconclusive-electrocardiogram-and-myocardial-injury-biomarkers
#15
F J Montero-Pérez, F B Quero-Espinosa, M J Clemente-Millán, J A Castro-Giménez, J de Burgos-Marín, M Á Romero-Moreno
RATIONALE: Acute coronary syndrome (ACS) requires improved diagnostic accuracy through useful, safe and easy-to-apply tools. OBJECTIVES: To obtain an assessment scale for the diagnosis of ACS in patients with chest pain and nondiagnostic electrocardiogram and troponin concentrations. METHODS: A prospective cohort study included 286 patients treated in the emergency department for chest pain, with normal electrocardiogram and troponin levels...
January 6, 2018: Revista Clínica Española
https://www.readbyqxmd.com/read/29303766/no-additional-value-of-conventional-and-high-sensitivity-cardiac-troponin-over-clinical-scoring-systems-in-the-differential-diagnosis-of-type-1-versus-type-2-myocardial-infarction
#16
Luciano Consuegra-Sánchez, Juan José Martínez-Díaz, Luis García de Guadiana-Romualdo, Samantha Wasniewski, Patricia Esteban-Torrella, Francisco Guillermo Clavel-Ruipérez, Alfredo Bardají, Juan Antonio Castillo-Moreno, Juan Carlos Kaski
BACKGROUND: The distinction of type 1 and type 2 myocardial infarction (MI) is of major clinical importance. Our aim was to evaluate the diagnostic ability of absolute and relative conventional cardiac troponin I (cTnI) and high-sensitivity cardiac troponin T (hs-cTnT) in the distinction between type 1 and type 2 MI in patients presenting at the emergency department with non-ST-segment elevation acute chest pain within the first 12 h. METHODS: We measured cTnI (Dimension Vista) and hs-cTnT (Cobas e601) concentrations at presentation and after 4 h in 200 patients presenting with suspected acute MI...
January 5, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29284532/abnormal-elevation-of-myocardial-necrosis-biomarkers-after-coronary-artery-bypass-grafting-without-established-myocardial-infarction-assessed-by-cardiac-magnetic-resonance
#17
Fernando Teiichi Costa Oikawa, Whady Hueb, Cesar Higa Nomura, Alexandre Ciappina Hueb, Alexandre Volney Villa, Leandro Menezes Alves da Costa, Rodrigo Morel Vieira de Melo, Paulo Cury Rezende, Carlos Alexandre Wainrober Segre, Cibele Larrosa Garzillo, Eduardo Gomes Lima, Jose Antonio Franchini Ramires, Roberto Kalil Filho
BACKGROUND: The diagnosis of peri-procedural myocardial infarction is complex, especially after the emergence of high-sensitivity markers of myocardial necrosis. METHODS: In this study, patients with normal baseline cardiac biomarkers and formal indication for elective on-pump coronary bypass surgery were evaluated. Electrocardiograms, cardiac biomarkers, and cardiac magnetic resonance imaging with late gadolinium enhancement were performed before and after procedures...
December 29, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29278915/how-is-cardiac-troponin-released-from-injured-myocardium
#18
Johannes Mair, Bertil Lindahl, Ola Hammarsten, Christian Müller, Evangelos Giannitsis, Kurt Huber, Martin Möckel, Mario Plebani, Kristian Thygesen, Allan S Jaffe
Cardiac troponin I and cardiac troponin T are nowadays the criterion biomarkers for the laboratory diagnosis of acute myocardial infarction due to their very high sensitivities and specificities for myocardial injury. However, still many aspects of their degradation, tissue release and elimination from the human circulation are incompletely understood. Myocardial injury may be caused by a variety of different mechanisms, for example, myocardial ischaemia, inflammatory and immunological processes, trauma, drugs and toxins, and myocardial necrosis is preceded by a substantial reversible prelethal phase...
December 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29278630/predictive-value-of-high-sensitive-troponin-i-assay-in-acute-coronary-syndrome-compared-to-classic-biochemical-markers
#19
Tomislav Čolak, Ivanka Mikulić, Kristina Landeka, Ana Sesar, Marija Vranješ, Ivanka Mikulić
The aims of this study were to compare predictive values of hsTroponin I assay with contemporary assays and its usefulness in diagnosis of acute coronary syndrome (ACS). We also aimed to determine reference values of the assay and the possibility of fast ACS diagnosis using hsTnI. The study included 26 patients with ongoing chest pains and suspected ACS. ACS diagnosis was determined using electrocardiographic changes and international guidelines. Biochemical parameters were measured using standard tests which included Troponin I, hsTroponin I, CK, CK-MB and CRP...
December 2017: Psychiatria Danubina
https://www.readbyqxmd.com/read/29275366/prognostic-value-of-new-generation-troponins-in-st-segment-elevation-myocardial-infarction-in-the-modern-era-the-ruti-stemi-study
#20
Germán Cediel, Ferran Rueda, Cosme García, Teresa Oliveras, Carlos Labata, Jordi Serra, Julio Núñez, Vicent Bodí, Marc Ferrer, Josep Lupón, Antoni Bayes-Genis
BACKGROUND: In ST-segment-elevation myocardial infarction (STEMI), troponins are not needed for diagnosis: symptoms and ECG data are sufficient to activate percutaneous coronary intervention. This study explored the prognostic value of new-generation troponins in a real-life cohort contemporarily treated for STEMI. METHODS AND RESULTS: We studied 1260 consecutive patients with primary STEMI treated with percutaneous coronary intervention between February 22, 2011, and August 31, 2015...
December 23, 2017: Journal of the American Heart Association
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