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Troponin Sensitive Diagnosis

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https://www.readbyqxmd.com/read/28822701/clinical-applications-of-biomarkers-in-atrial-fibrillation
#1
REVIEW
Kay-Won Chang, Jonathan C Hsu, Avinash Toomu, Sutton Fox, Alan S Maisel
While biomarkers have greatly impacted the diagnosis and management of myocardial infarction and heart failure, the use of biomarkers has been slow to permeate management of atrial fibrillation. Guideline recommendations on the use of biomarkers in atrial fibrillation were virtually non-existent until the 2016 European Society of Cardiology guidelines on atrial fibrillation offered a class IIb recommendation to consider using biomarkers such as high sensitivity troponin and natriuretic peptide to further refine stroke and bleeding risk in atrial fibrillation patients...
August 16, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28818210/clinical-use-of-high-sensitivity-cardiac-troponin-in-patients-with-suspected-myocardial-infarction
#2
REVIEW
Raphael Twerenbold, Jasper Boeddinghaus, Thomas Nestelberger, Karin Wildi, Maria Rubini Gimenez, Patrick Badertscher, Christian Mueller
High-sensitivity cardiac troponin (hs-cTn) assays have been used clinically by thousands of physicians in many countries throughout the world since their clinical introduction 7 years ago. In the early diagnosis of myocardial infarction (MI), beyond doubt, the most important indication of hs-cTn assays, these simple, inexpensive, and highly reproducible tools complement detailed clinical assessment including chest pain characteristics and the electrocardiogram. Hs-cTn assays for the first time allowed the precise quantification of cardiomyocyte injury around the 99th percentile and thereby substantially increased the accuracy of MI detection from blood obtained at presentation to the emergency department (ED)...
August 22, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28811954/is-neutrophil-to-lymphocyte-ratio-a-predictor-of-coronary-artery-disease-in-western-indians
#3
Kamal Sharma, Alap K Patel, Komal H Shah, Ashwati Konat
INTRODUCTION: The current study was designed to evaluate the association of neutrophil-to-lymphocyte ratio (NLR) with coronary artery disease (CAD) presence. We also aimed to propose a suitable cut-off of NLR for diagnosis of CAD in Western Indians. METHODS: Total 324 patients undergoing coronary angiography were enrolled and were subdivided into two groups: group 1 (n = 99; population without CAD) and group 2 (n = 225; population with CAD). RESULTS: The results indicated significant (p < 0...
2017: International Journal of Inflammation
https://www.readbyqxmd.com/read/28791782/predicting-short-term-risk-of-arrhythmia-among-patients-with-syncope-the-canadian-syncope-arrhythmia-risk-score
#4
Venkatesh Thiruganasambandamoorthy, Ian G Stiell, Marco L A Sivilotti, Brian H Rowe, Muhammad Mukarram, Kirtana Arcot, Kenneth Kwong, Andrew D McRae, George A Wells, Monica Taljaard
BACKGROUND: Syncope can be caused by serious occult arrhythmias not evident during initial emergency department (ED) evaluation. We sought to develop a risk-tool for predicting 30-day arrhythmia or death after ED disposition. METHODS: We conducted a multicenter prospective cohort study at six tertiary-care EDs and included adults (≥16 years) with syncope. We collected standardized variables from clinical evaluation, and investigations including ECG and troponin at index presentation...
August 9, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28781317/impact-of-aging-on-high-sensitivity-cardiac-troponin-t-in-patients-suspected-of-acute-myocardial-infarction
#5
Taro Ichise, Hayato Tada, Kenji Sakata, Masa-Aki Kawashiri, Masakazu Yamagishi, Kenshi Hayashi
Objective High-sensitivity cardiac troponin T (hs-cTnT) is widely used for the diagnosis of acute myocardial infarction (AMI). The current cut-off value of 0.014 ng/mL was determined based on the 99th percentile of a normal reference population; however, little data exist regarding the appropriate cut-off value in the elderly (≥75 years). Accordingly, we aimed to investigate the accuracy of the current cut-off value in an elderly population. Methods We assessed 355 consecutive patients (mean age =66.7±16...
August 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28764841/non-st-elevation-acute-coronary-syndromes-a-comprehensive-review
#6
Tamunoinemi Bob-Manuel, Ikechuckwu Ifedili, Guy Reed, Uzoma N Ibebuogu, Rami N Khouzam
Non-ST elevation-acute coronary syndrome (NSTE-ACS) includes NSTE myocardial infarction and unstable angina. This patient population forms approximately two-thirds of all hospital admissions for ACS in the United States each year and is associated with an in-hospital mortality of 5%. NSTE-ACS is primarily due to an acute change in the supply and demand balance of coronary perfusion and myocardial oxygen consumption, because of the significant coronary artery obstruction presenting as plaque rupture or erosion...
September 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/28763113/distribution-of-cardiac-troponin-i-in-the-japanese-general-population-and-factors-influencing-its-concentrations
#7
Naoya Abe, Kenichiro Tomita, Mayumi Teshima, Maki Kuwabara, Satoshi Sugawa, Nae Hinata, Masaaki Matsuura, Mutsunori Fujiwara, Kazuhiko Takaya, Toru Hiyoshi, Hiroki Uozumi, Hiroshi Ikenouchi, Rie Ishikawa, Junko Shojima, Junko Komatsu
BACKGROUND: The 99th percentile of cardiac troponin I level in the general population is accepted as the cut-off for the diagnosis of acute myocardial infarction (AMI). However, it is not clear whether the cut-offs derived in racially and geographically different populations are applicable in Japan. METHODS: Troponin I was determined using the Abbott ARCHITECT STAT high-sensitive troponin I immunoassay in 698 apparently healthy individuals who visited the Japanese Red Cross Medical Center for a health checkup...
August 1, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28760208/use-of-troponin-assay-99th-percentile-as-the-decision-level-for-myocardial-infarction-diagnosis
#8
MULTICENTER STUDY
Akshay Bagai, Karen P Alexander, Jeffrey S Berger, Roxy Senior, Chakkanalil Sajeev, Radoslaw Pracon, Kreton Mavromatis, Jose Luis Lopez-Sendón, Gilbert Gosselin, Ariel Diaz, Gian Perna, Jarozlaw Drozdz, Dennis Humen, Birute Petrauskiene, Asim N Cheema, Denis Phaneuf, Subhash Banerjee, Todd D Miller, Sasko Kedev, Herwig Schuchlenz, Gregg W Stone, Shaun G Goodman, Kenneth W Mahaffey, Allan S Jaffe, Yves D Rosenberg, Sripal Bangalore, L Kristin Newby, David J Maron, Judith S Hochman, Bernard R Chaitman
BACKGROUND: The Universal Definition of Myocardial Infarction recommends the 99th percentile concentration of cardiac troponin in a normal reference population as part of the decision threshold to diagnose type 1 spontaneous myocardial infarction. Adoption of this recommendation in contemporary worldwide practice is not well known. METHODS: We performed a cohort study of 276 hospital laboratories in 31 countries participating in the National Heart, Lung, and Blood Institute-sponsored International Study of Comparative Health Effectiveness with Medical and Invasive Approaches trial...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28719430/high-sensitivity-cardiac-troponin-t-improves-the-diagnosis-of-perioperative-mi
#9
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
#10
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
#11
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
#12
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
#13
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...
August 2017: Pathology
https://www.readbyqxmd.com/read/28680021/potential-of-lipoproteins-as-biomarkers-in-acute-myocardial-infarction
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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