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Troponin Sensitive Diagnosis

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https://www.readbyqxmd.com/read/28062631/rule-in-and-rule-out-of-myocardial-infarction-using-cardiac-troponin-and-glycemic-biomarkers-in-patients-with-symptoms-suggestive-of-acute-coronary-syndrome
#1
Colleen Shortt, Jinhui Ma, Natasha Clayton, Jonathan Sherbino, Richard Whitlock, Guillaume Pare, Stephen A Hill, Matthew McQueen, Shamir R Mehta, P J Devereaux, Andrew Worster, Peter A Kavsak
BACKGROUND: Early rule-in/rule-out of myocardial infarction (MI) in patients presenting to the emergency department (ED) is important for patient care and resource allocation. Given that dysglycemia is a strong risk factor for MI, we sought to explore and compare different combinations of cardiac troponin (cTn) cutoffs with glycemic markers for the early rule-in/rule-out of MI. METHODS: We included ED patients (n = 1137) with symptoms suggestive of acute coronary syndrome (ACS) who had cTnI, high-sensitivity cTnI (hs-cTnI), hs-cTnT, glucose, and hemoglobin A1c (Hb A1c) measurements...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28062618/use-of-biomarkers-in-predicting-the-onset-monitoring-the-progression-and-risk-stratification-for-patients-with-type-2-diabetes-mellitus
#2
REVIEW
Benjamin M Scirica
BACKGROUND: As the worldwide prevalence of type 2 diabetes mellitus (T2DM) increases, it is even more important to develop cost-effective methods to predict and diagnose the onset of diabetes, monitor progression, and risk stratify patients in terms of subsequent cardiovascular and diabetes complications. CONTENT: Nonlaboratory clinical risk scores based on risk factors and anthropomorphic data can help identify patients at greatest risk of developing diabetes, but glycemic indices (hemoglobin A1c, fasting plasma glucose, and oral glucose tolerance tests) are the cornerstones for diagnosis, and the basis for monitoring therapy...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28062614/myocardial-infarction-type-2-and-myocardial-injury
#3
REVIEW
Yader Sandoval, Kristian Thygesen
BACKGROUND: The development and implementation of sensitive and high-sensitivity cardiac troponin assays has not only expedited the early ruling in and ruling out of acute myocardial infarction, but has also contributed to the identification of patients at risk for myocardial injury with necrosis, as confirmed by the presence of cardiac troponin concentrations above the 99th percentile. Myocardial injury with necrosis may occur either in the presence of overt ischemia from myocardial infarction, or in the absence of overt ischemia from myocardial injury accompanying other conditions...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28062613/consensus-or-controversy-evolution-of-criteria-for-myocardial-infarction-after-percutaneous-coronary-intervention
#4
REVIEW
Pierluigi Tricoci
BACKGROUND: The definition and the clinical implications of myocardial infarction (MI) occurring in the setting of percutaneous coronary intervention have been subjects of unresolved controversy. As a result of the use of more sensitive diagnostic tools such as cardiac troponin, the expanding evidence, and the ensuing debate, the definition of procedural MI (pMI) has evolved, leading to several revisions, different proposed definitions, and lack of standardization in randomized clinical trials...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28062612/cardiac-troponin-assays-guide-to-understanding-analytical-characteristics-and-their-impact-on-clinical-care
#5
REVIEW
Fred S Apple, Yader Sandoval, Allan S Jaffe, Jordi Ordonez-Llanos
BACKGROUND: Cardiac troponin I (cTnI) and cardiac troponin T (cTnT) determinations are fixtures in clinical practice and research. Cardiac troponin testing has been the standard of practice for the diagnosis of acute myocardial infarction (AMI), early rule-out, risk stratification, and outcomes assessment in patients presenting with acute coronary syndrome (ACS) and non-ACS myocardial injury. We recognize from reading the literature over the past several years how poorly understood the analytical characteristics are for cTnI and cTnT assays by laboratorians, clinicians, and scientists who use these assays...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28057184/advances-in-cardiac-biomarkers-of-acute-coronary-syndrome
#6
A K Saenger, N Korpi-Steiner
Acute coronary syndrome (ACS) encompasses a pathophysiological spectrum of cardiovascular diseases, all of which have significant morbidity and mortality. ACS was once considered an acute condition; however, new treatment strategies and improvements in biomarker assays have led to ACS being an acute and chronic disease. Cardiac troponin is the preferred biomarker for the diagnosis of myocardial infarction, and there is considerable interest and efforts toward development and implementation of high-sensitivity cardiac troponin (hs-cTn) assays worldwide...
2017: Advances in Clinical Chemistry
https://www.readbyqxmd.com/read/28040285/diagnostic-performance-of-a-high-sensitive-troponin-t-assay-and-a-troponin-t-point-of-care-assay-in-the-clinical-routine-of-an-emergency-department-a-clinical-cohort-study
#7
Anna Slagman, Johannes von Recum, Martin Möckel, Fabian Holert, Dirk Meyer Zum Büschenfelde, Christian Müller, Julia Searle
BACKGROUND: A point of care test (POCT) for troponin T (TnT) in the Emergency Department (ED) was compared to a high-sensitivity TnT (hsTnT) central laboratory test (CLT) to determine the influence of test system and different cut-off values on the diagnostic performance in patients with suspected acute coronary syndrome (ACS) under routine conditions. METHODS: All patients with routine TnT testing in the ED were enrolled. Only internal medicine patients without STEMI and with both troponin values were analyzed...
December 21, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28033267/prognostic-value-of-basal-high-sensitive-cardiac-troponin-levels-on-mortality-in-the-general-population-a-meta-analysis
#8
Noreen van der Linden, Lieke J J Klinkenberg, Otto Bekers, Luc J C van Loon, Marja P van Dieijen-Visser, Maurice P Zeegers, Steven J R Meex
Interest in the use of cardiac troponin T (cTnT) and cardiac troponin I (cTnI) has expanded from diagnosis of acute myocardial infarction to risk assessment for morbidity and mortality. Although cTnT and cTnI were shown to have equivalent diagnostic performance in the setting of suspected acute myocardial infarction, potential prognostic differences are largely unexplored.The aim of this study is to quantify and compare the relationship between cTnT and cTnI, and cardiovascular and all-cause mortality in the general population...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28029055/improved-risk-stratification-of-patients-with-acute-coronary-syndromes-using-a-combination-of-hstnt-nt-probnp-and-hscrp-with-the-grace-score
#9
Roland Klingenberg, Soheila Aghlmandi, Lorenz Räber, Baris Gencer, David Nanchen, Dik Heg, Sebastian Carballo, Nicolas Rodondi, François Mach, Stephan Windecker, Peter Jüni, Arnold von Eckardstein, Christian M Matter, Thomas F Lüscher
BACKGROUND: Clinical scores and biomarkers improve risk stratification of patients with acute coronary syndromes. However, little is known about their value in patients referred for coronary angiography. METHODS: Consecutive patients admitted at four Swiss university hospitals with a diagnosis of acute coronary syndrome were enrolled into the SPUM-ACS Biomarker Cohort between 2009 and 2012. Patients were followed at 30 days and 1 year with assessment of adjudicated events including all-cause mortality and the composite of all-cause mortality or non-fatal recurrent myocardial infarction...
December 1, 2016: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28003419/47-year-old-female-with-an-apical-mass
#10
Jack Andrews, Christopher Ce Lang, Marc Dweck
CLINICAL INTRODUCTION: A 47-year-old female with no medical history presented with a sudden collapse. Physical examination, chest X-ray and high-sensitivity cardiac troponin I were normal, however ECG demonstrated anterior T-wave inversion. CT pulmonary angiography was performed which ruled out pulmonary embolism but revealed a non-calcified, homogenous mass at the left ventricular (LV) apex. It was not clear whether this mass was intramyocardial or pericardial. Transthoracic echocardiography confirmed the apical mass but was unable to establish its aetiology...
December 21, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27987279/falsely-elevated-troponin-rare-occurrence-or-future-problem
#11
James Nguyen, Rosy Thachil, Neil Vyas, Thomas Marino
INTRODUCTION: Troponins are known to be released in response to cardiac damage and therefore are the biomarkers of choice for the early diagnosis of acute myocardial infarction (AMI), improving outcome in patients presenting with chest pain. However, false results can occur due to interference from other substances in the blood. CASE: A 52-year-old male with a past medical history of alcohol abuse, hypertension, and coronary artery bypass graft at age 34 with normal stress test 2 years before presented to the emergency department (ED) complaining of 1 day of non-exertional chest pain with radiation to the neck and left arm...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27974383/high-sensitivity-troponin-t-vs-i-in-acute-coronary-syndrome-prediction-of-significant-coronary-lesions-and-long-term-prognosis
#12
Brede Kvisvik, Lars Mørkrid, Helge Røsjø, Milada Cvancarova, Alexander D Rowe, Christian Eek, Bjørn Bendz, Thor Edvardsen, Jørgen Gravning
BACKGROUND: High-sensitivity cardiac troponin (hs-cTn) T and I assays are established as crucial tools for the diagnosis of acute myocardial infarction (AMI), as they have been found superior to old troponin assays. However, eventual differences between the assays in prediction of significant coronary lesions and long-term prognosis in patients with acute coronary syndrome (ACS) have not been fully unraveled. METHODS: Serum concentrations of hs-cTnT (Roche), hs-cTnI (Abbott), and amino-terminal pro-B-type natriuretic peptide (NT-proBNP; Roche) in 390 non-ST-elevation (NSTE) ACS patients were evaluated in relation to significant coronary lesions on coronary angiography (defined as a stenosis >50% of the luminal diameter, with need for revascularization) and prognostic accuracy for cardiovascular mortality, all-cause mortality, as well as the composite end point of cardiovascular mortality and hospitalizations for AMI or heart failure...
December 14, 2016: Clinical Chemistry
https://www.readbyqxmd.com/read/27939586/use-of-biomarkers-to-predict-readmission-for-congestive-heart-failure
#13
Sangita Sudharshan, Eric Novak, Karl Hock, Mitchell G Scott, Edward M Geltman
Acute decompensated heart failure (ADHF) is a major reason for repeated hospitalizations. Identifying those patients with ADHF at risk for readmission is critical so that preventive interventions can be implemented. Biomarkers such as B-type natriuretic peptide (BNP), high-sensitivity troponin I, and galectin-3 (Gal-3) assessed at discharge may be useful, although their role in predicting short-term readmission is not well defined in the literature. We enrolled and had follow-up data for 101 participants admitted to our facility from April 2013 to March 2015 with a primary diagnosis of ADHF...
February 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/27934084/highly-sensitive-and-quick-detection-of-acute-myocardial-infarction-biomarkers-using-in2o3-nanoribbon-biosensors-fabricated-using-shadow-masks
#14
Qingzhou Liu, Noppadol Aroonyadet, Yan Song, Xiaoli Wang, Xuan Cao, Yihang Liu, Sen Cong, Fanqi Wu, Mark E Thompson, Chongwu Zhou
We demonstrate a scalable and facile lithography-free method for fabricating highly uniform and sensitive In2O3 nanoribbon biosensor arrays. Fabrication with shadow masks as the patterning method instead of conventional lithography provides low-cost, time-efficient, and high-throughput In2O3 nanoribbon biosensors without photoresist contamination. Combined with electronic enzyme-linked immunosorbent assay for signal amplification, the In2O3 nanoribbon biosensor arrays are optimized for early, quick, and quantitative detection of cardiac biomarkers in diagnosis of acute myocardial infarction (AMI)...
November 22, 2016: ACS Nano
https://www.readbyqxmd.com/read/27932414/serial-sampling-of-high-sensitivity-cardiac-troponin-t-may-not-be-required-for-prediction-of-acute-myocardial-infarction-diagnosis-in-chest-pain-patients-with-highly-abnormal-concentrations-at-presentation
#15
Matthias Mueller-Hennessen, Christian Mueller, Evangelos Giannitsis, Moritz Biener, Mehrshad Vafaie, Christopher R deFilippi, Michael Christ, Jorge Ordóñez-Llanos, Mauro Panteghini, Mario Plebani, Franck Verschuren, Dina Melki, John K French, Robert H Christenson, Richard Body, James McCord, Carina Dinkel, Hugo A Katus, Bertil Lindahl
BACKGROUND: Guidelines for diagnosing acute myocardial infarction (AMI) recommend adding kinetic changes to the initial cardiac troponin (cTn) blood concentration to improve AMI diagnosis. We hypothesized that kinetic changes may not be required in patients presenting with highly abnormal cTn. METHODS: Patients presenting with suspected AMI to the emergency department were enrolled in a prospective diagnostic study. We assessed the positive predictive value (PPV) of initial high-sensitivity cardiac troponin T (hs-cTnT) blood concentrations alone and in combination with kinetic changes for AMI...
December 8, 2016: Clinical Chemistry
https://www.readbyqxmd.com/read/27932136/prognostic-value-of-high-sensitivity-troponin-t-to-identify-patients-at-risk-of-left-ventricular-graft-dysfunction-after-heart-transplantation
#16
A B Méndez, J Ordonez-Llanos, S Mirabet, J Galan, M L Maestre, V Brossa, M T Rivilla, L López, T Koller, A Sionis, E Roig
Primary graft dysfunction after heart transplantation (HTx) has a very high mortality rate, especially if the left ventricle (PGD-LV) is involved. Early diagnosis is important to select the appropriate therapy to improve prognosis. The value of high-sensitivity troponin T (HS-TNT) measurement obtained at patient arrival at the intensive care unit was analyzed in 71 HTx patients. Mild or moderate PGD-LV was defined by hemodynamic compromise with one of the following criteria: left ventricular ejection fraction <40%, hemodynamic compromise with right atrial pressure >15 mm Hg, pulmonary capillary wedge pressure >20 mm Hg, cardiac index <2...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931558/time-to-shift-from-contemporary-to-high-sensitivity-cardiac-troponin-in-diagnosis-of-acute-coronary-syndromes
#17
REVIEW
Jamshed J Dalal, C K Ponde, Brian Pinto, C N Srinivas, Joy Thomas, Sunil Kumar Modi, Sanjay Mehta, Suvin Shetty, Manimarane, Bhupen Desai
Early rule-in and rule-out of non-ST-segment elevation myocardial infarction (NSTEMI) is a challenge. In patients with inconclusive findings on ECG, cardiac biomarkers play a crucial role in the diagnosis. The introduction of the new high-sensitive cardiac troponin test (hs-TnI assay) has changed the landscape of NSTEMI diagnosis. The new hs-TnI assay can detect troponin values at a lower level compared with a contemporary cardiac troponin (cTn) assay. The hs-cTnI assay has a coefficient of variation of ≤10%, well below the 99th percentile value...
November 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27909290/highly-sensitive-detection-of-minimal-cardiac-ischemia-using-positron-emission-tomography-imaging-of-activated-platelets
#18
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
#19
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...
February 1, 2017: 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
#20
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
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