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High sensitive troponin I

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https://www.readbyqxmd.com/read/28087371/use-of-the-heart-pathway-with-high-sensitivity-cardiac-troponins-a-secondary-analysis
#1
Simon A Mahler, Jason P Stopyra, Fred S Apple, Robert F Riley, Gregory B Russell, Brian C Hiestand, James W Hoekstra, Cedric W Lefebvre, Bret A Nicks, David M Cline, Kim L Askew, David M Herrington, Gregory L Burke, Chadwick D Miller
OBJECTIVES: The HEART Pathway combines a decision aid and serial contemporary cardiac troponin I (cTnI) measures to achieve >99% sensitivity for major adverse cardiac events (MACE) at 30days and early discharge rates >20%. However, the impact of integrating high-sensitivity troponin (hs-cTn) measures into the HEART Pathway has yet to be determined. In this analysis we compare test characteristics of the HEART Pathway using hs-cTnI, hs-cTnT, or cTnI. DESIGN &METHODS: A secondary analysis of participants enrolled in the HEART Pathway RCT was conducted...
January 10, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28087181/challenging-the-99th-percentile-a-lower-troponin-cutoff-leads-to-low-mortality-of-chest-pain-patients
#2
Nils Arne Sörensen, Johannes Tobias Neumann, Francisco Ojeda, Tjark Schwemer, Thomas Renné, Renate B Schnabel, Tanja Zeller, Mahir Karakas, Stefan Blankenberg, Dirk Westermann
BACKGROUND: Rule-out of non-ST-elevation myocardial infarction is based on consecutive measurements of cardiac troponins using the 99th percentile of the respective assay as cutoff. The new ESC guidelines alternatively offer rapid 1h algorithms with lower cutoffs than the 99th percentile for rule-out of non-ST-elevation myocardial infarction. We aimed to compare a recently introduced 1h algorithm based on a high-sensitivity cardiac troponin I (hs-TnI) cutoff of 6ng/L at 0h and 1h to the current standard of care using the 99th percentile (27ng/L) as cutoff with reference to follow-up events in a large chest pain cohort...
December 27, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28069251/elevated-troponin-i-level-assessed-by-a-new-high-sensitive-assay-and-the-risk-of-poor-outcomes-in-patients-with-acute-heart-failure
#3
R Zymliński, M Sokolski, P Siwolowski, J Biegus, S Nawrocka, E A Jankowska, J Todd, R Yerramilli, J Estis, W Banasiak, P Ponikowski
BACKGROUND: The interpretation and clinical usefulness of elevated levels of cardiac troponins in acute heart failure (AHF) remain controversial. We aimed to characterize the relationship between changes in cardiac troponin I (measured using a new high-sensitive immunoassay by single-molecule counting technology, Singulex, Alameda, USA; hs-TnI) during first 48h of hospital stay and patients' characteristics and the outcomes. METHODS AND RESULTS: We measured hs-TnI at baseline, after 24 and 48h in 130 AHF patients (mean age: 65±13years, 77% men)...
January 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28064233/clozapine-associated-with-autoimmune-reaction-fever-and-low-level-cardiotoxicity-a-case-report
#4
Charilaos Gerasimou, Georgia Phaedra Vitali, George D Vavougios, Charalabos Papageorgiou, Athanasios Douzenis, Styliani I Kokoris, Ioannis Liappas, Emmanouil Rizos
BACKGROUND: Clozapine is a second-generation antipsychotic drug used in treatment-resistant schizophrenia. Fever induced by clozapine is a rather frequent side-effect which usually occurs in the first 4 weeks of treatment. Despite its effectiveness, there are potentially life-threatening adverse effects, such as cardiotoxicity. CASE REPORT: We present the case of a 31-year-old caucasian male with refractory schizophrenia who developed benign fever, increase of C-reactive protein and high troponin levels, without presenting any other signs to myocarditis, on the 13th day under clozapine treatment, which declined progressively upon discontinuation of the drug...
January 2017: In Vivo
https://www.readbyqxmd.com/read/28062627/association-of-repeatedly-measured-high-sensitivity-assayed-troponin-i-with-cardiovascular-disease-events-in-a-general-population-from-the-morgam-biomarcare-study
#5
Maria F Hughes, Francisco Ojeda, Olli Saarela, Torben Jørgensen, Tanja Zeller, Tarja Palosaari, Mark G O'Doherty, Anders Borglykke, Kari Kuulasmaa, Stefan Blankenberg, Frank Kee
BACKGROUND: High-sensitivity troponin I (hs-cTnI) concentrations reflect myocardial stress. The role of hs-cTnI in predicting long-term changes in the risk of cardiovascular disease (CVD) in general populations is not clearly defined. METHODS: We investigated whether the change in 3 repeated measures of hs-cTnI collected 5 years apart in a prospective Danish study (3875 participants, initially aged 30-60 years, 51% female, disease free at baseline) improves 10-year prediction of incident CVD compared to using a single most recent hs-cTnI measurement...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28062625/high-sensitivity-troponin-i-in-stable-patients-with-atherosclerotic-disease-in-the-tra-2%C3%A2-p-timi-50-trial
#6
Alon Eisen, Marc P Bonaca, Petr Jarolim, Benjamin M Scirica, Harvey D White, Michal Tendera, Mikael Dellborg, Jose C Nicolau, Joao Morais, Keith A A Fox, Erin A Bohula, Sabina A Murphy, Eugene Braunwald, David A Morrow
BACKGROUND: Cardiac troponin I, measured with a high-sensitivity assay (hs-TnI), is well-established for risk prediction in acute coronary syndromes. However, its prognostic role in stable atherosclerotic disease, particularly for future myocardial infarction (MI), is less well defined. METHODS: We measured hs-TnI (Abbott ARCHITECT) in 15833 patients with prior MI, ischemic stroke, or peripheral arterial disease from the placebo-controlled Thrombin Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events (TRA 2°P)-Thrombolysis in Myocardial Infarction (TIMI) 50 trial of the platelet inhibitor vorapaxar, excluding patients with recent MI (<30 days)...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28062620/application-of-cardiac-troponin-in-cardiovascular-diseases-other-than-acute-coronary-syndrome
#7
REVIEW
Kai M Eggers, Bertil Lindahl
BACKGROUND: Increased cardiac troponin concentrations in acute coronary syndrome (ACS) identify patients with ongoing cardiomyocyte necrosis who are at increased risk. However, with the use of more precise assays, cardiac troponin increases are commonly noted in other cardiovascular conditions as well. This has generated interest in the use of cardiac troponin for prognostic assessment and clinical management of these patients. In this review, we have summarized the data from studies investigating the implications of cardiac troponin concentrations in various acute and chronic conditions beyond ACS, i...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28062612/cardiac-troponin-assays-guide-to-understanding-analytical-characteristics-and-their-impact-on-clinical-care
#8
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/28039523/high-sensitivity-cardiac-troponin-i-and-nt-probnp-as-predictors-of-incident-dementia-and-alzheimer-s-disease-the-finrisk-study
#9
Juho Tynkkynen, Jussi A Hernesniemi, Tiina Laatikainen, Aki S Havulinna, Perttu Salo, Stefan Blankenberg, Tanja Zeller, Veikko Salomaa
Cardiac troponin and N-terminal pro-brain natriuretic peptide (NT-proBNP) are known to associate with incident dementia. The purpose of our study was to examine whether high-sensitivity cardiac troponin I (hs-TnI) and NT-proBNP are associated with incident dementia and Alzheimer's disease (AD) independently of each other. Our study was a part of the national population-based health examination survey, FINRISK 1997, with a total sample of 7114 subjects, including 407 incident dementia cases and 319 AD cases during the follow-up time of 18 years...
December 30, 2016: Journal of Neurology
https://www.readbyqxmd.com/read/28034899/comparison-of-the-efficacy-and-safety-of-early-rule-out-pathways-for-acute-myocardial-infarction
#10
Andrew R Chapman, Atul Anand, Jasper Boeddinghaus, Amy V Ferry, Dennis Sandeman, Philip D Adamson, Jack P Andrews, Stephanie Tan, Sheun F Cheng, Michelle D'Souza, Kate Orme, Fiona E Strachan, Thomas Nestelberger, Raphael Twerenbold, Patrick Badertscher, Tobias Reichlin, Alasdair Gray, Anoop S V Shah, Christian Mueller, David E Newby, Nicholas L Mills
BACKGROUND: -High-sensitivity cardiac troponin assays enable myocardial infarction to be ruled out earlier, but the optimal approach is uncertain. We compared the European Society of Cardiology (ESC) rule-out pathway, with a pathway that incorporates lower cardiac troponin concentrations to risk stratify patients. METHODS: -Patients with suspected acute coronary syndrome (n=1,218) underwent high-sensitivity cardiac troponin I measurement at presentation, 3 and 6 or 12 hours...
December 29, 2016: Circulation
https://www.readbyqxmd.com/read/28033267/prognostic-value-of-basal-high-sensitive-cardiac-troponin-levels-on-mortality-in-the-general-population-a-meta-analysis
#11
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/28031149/diagnostic-and-prognostic-value-of-a-careful-symptom-evaluation-and-high-sensitive-troponin-in-patients-with-suspected-stable-angina-pectoris-without-prior-cardiovascular-disease
#12
Debbie M Madsen, Axel C P Diederichsen, Susanne E Hosbond, Oke Gerke, Hans Mickley
BACKGROUND AND AIMS: Typical angina pectoris (AP) and high-sensitive troponin I (hs-TnI) are independently associated with coronary artery disease (CAD) and future cardiovascular events (CVE). This study aimed to assess the individual and combined diagnostic and prognostic impact of symptoms and hs-TnI in stable chest pain patients without prior cardiovascular disease. METHODS: During a one-year period, 487 patients with suspected stable AP underwent invasive or CT-coronary angiography (significant stenosis ≥50%)...
November 28, 2016: Atherosclerosis
https://www.readbyqxmd.com/read/28029315/left-ventricular-dysfunction-with-trastuzumab-therapy-is-primary-prevention-the-best-option
#13
Paaladinesh Thavendiranathan, Eitan Amir
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
December 28, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28029000/comparison-between-soluble-st2-and-high-sensitivity-troponin-i-in-predicting-short-term-mortality-for-patients-presenting-to-the-emergency-department-with-chest-pain
#14
Rossella Marino, Laura Magrini, Francesca Orsini, Veronica Russo, Patrizia Cardelli, Gerardo Salerno, Mina Hur, Salvatore Di Somma
BACKGROUND: High-sensitivity cardiac troponin I (hs-cTnI) and the soluble isoform of suppression of tumorigenicity 2 (sST2) are useful prognostic biomarkers in acute coronary syndrome (ACS). The aim of this study was to test the short term prognostic value of sST2 compared with hs-cTnI in patients with chest pain. METHODS: Assays for hs-cTnI and sST2 were performed in 157 patients admitted to the Emergency Department (ED) for chest pain at arrival. In-hospital and 30-day follow-up mortalities were assessed...
March 2017: Annals of Laboratory Medicine
https://www.readbyqxmd.com/read/28024754/mips-graphene-nanoplatelets-mwcnts-modified-glassy-carbon-electrode-for-the-determination-of-cardiac-troponin-i
#15
Ya Ma, Xiao-Lei Shen, Hai-Shui Wang, Jia Tao, Jian-Zhi Huang, Qiang Zeng, Li-Shi Wang
An electrochemical sensor with high selectivity in addition to sensitivity was developed for the determination of cardiac troponin I (cTnI), based on the modification of cTnI imprinted polymer film on a glassy carbon electrode (GCE). The sensor was fabricated by layer-by-layer assembled graphene nanoplatelets (GS), multiwalled carbon nanotubes (MWCNTs), chitosan (CS), glutaraldehyde (GA) composites, which can increase the electronic transfer rate and the active surface area to capture a larger number of antigenic proteins...
December 23, 2016: Analytical Biochemistry
https://www.readbyqxmd.com/read/28007133/high-sensitivity-cardiac-troponin-statin%C3%A2-therapy-and-risk-of-coronary%C3%A2-heart%C3%A2-disease
#16
Ian Ford, Anoop S V Shah, Ruiqi Zhang, David A McAllister, Fiona E Strachan, Muriel Caslake, David E Newby, Chris J Packard, Nicholas L Mills
BACKGROUND: Cardiac troponin is an independent predictor of cardiovascular mortality in individuals without symptoms or signs of cardiovascular disease. The mechanisms for this association are uncertain, and a role for troponin testing in the prevention of coronary heart disease has yet to be established. OBJECTIVES: This study sought to determine whether troponin concentration could predict coronary events, be modified by statins, and reflect response to therapy in a primary prevention population...
December 27, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28003419/47-year-old-female-with-an-apical-mass
#17
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/27974385/simulation-models-of-misclassification-error-for-single-thresholds-of-high-sensitivity-cardiac-troponin-i-due-to-assay-bias-and-imprecision
#18
Andrew W Lyon, Peter A Kavsak, Oliver A S Lyon, Andrew Worster, Martha E Lyon
BACKGROUND: Clinical outcome studies for cardiac troponins (cTn) are expensive and difficult to design owing to variation in patients, in the assays, and in the incidence of different types of myocardial infarction (MI). To overcome these difficulties, simulation models were used to estimate the rate of misclassification error for MI and risk prediction resulting from assay bias and imprecision. METHODS: Finite mixture analysis of Abbott high-sensitivity cTnI (hs-cTnI) results at time 0 h in patients presenting early with acute coronary syndrome (ACS) symptoms to the emergency department (ED) [n = 145, Reducing the Time Interval for Identifying New Guideline (RING) study] allowed derivation of a simulation data set (n = 10000)...
December 14, 2016: Clinical Chemistry
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
#19
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/27970272/tct-109-predictive-performance-of-high-sensitivity-cardiac-troponin-i-for-all-cause-death-is-affected-by-cut-off-value-in-patients-enrolled-in-chest-pain-center-at-emergency-department
#20
Il Park, Jin-Ho Choi, Namjoon Kim, Young-Do Jeon, Ji-Sun Choi, Jeong Hoon Yang, Young Bin Song, Joo-Yong Hahn, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Sang Hoon Lee
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
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