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High sensitivity troponin

William R Fox, Deborah B Diercks
Troponins are proteins commonly found in cardiac tissue that are released during myocardial ischemia or necrosis. These troponins can be detected by assays that can then be used to guide clinical decision-making and disposition, especially if the suspected insult is related to acute coronary syndrome. Timing of troponin measurement can be important as elevations may not be detectible immediately after an insult. New assays have been designed to detect troponin con-centrations previously too low to be detected by conventional assays...
March 2016: Clin Exp Emerg Med
Nuccia Morici, Laura Farioli, Laura Michelina Losappio, Giulia Colombo, Michele Nichelatti, Donatella Preziosi, Gianluigi Micarelli, Fabrizio Oliva, Cristina Giannattasio, Silvio Klugmann, Elide Anna Pastorello
OBJECTIVE: To assess the relationship between serum tryptase and the occurrence of major cardiovascular and cerebrovascular events (MACCE) at 2-year follow-up in patients admitted with acute coronary syndrome (ACS). To compare serum tryptase to other validated prognostic markers (maximum high-sensitivity troponin (hs-Tn), C reactive protein (CRP) levels at admission, Synergy between percutaneous coronary intervention with Taxus and Cardiac Surgery (SYNTAX) score). METHODS: We measured serum tryptase at admission in 140 consecutive patients with ACS and in 50 healthy controls...
2016: Open Heart
Benton R Hunter
No abstract text is available yet for this article.
October 18, 2016: Annals of Internal Medicine
Paul Welsh, Katie Tuckwell, Iain B McInnes, Naveed Sattar
BACKGROUND AND AIMS: Observational associations between inflammation and cardiovascular disease are interesting, but randomised experimental data are lacking. We investigated the effect of the IL-6 receptor blocker tocilizumab on N terminal pro B type natriuretic peptide (NT-proBNP) and high sensitivity troponin T (hsTnT) in rheumatoid arthritis (RA) patients. METHODS: A post-hoc study was performed in a subset of patients with moderate to severe RA participating in a randomised controlled trial...
October 8, 2016: Atherosclerosis
Nicolas Faller, Andreas Limacher, Marie Méan, Marc Righini, Markus Aschwanden, Jürg Hans Beer, Beat Frauchiger, Josef Osterwalder, Nils Kucher, Bernhard Lämmle, Jacques Cornuz, Anne Angelillo-Scherrer, Christian M Matter, Marc Husmann, Martin Banyai, Daniel Staub, Lucia Mazzolai, Olivier Hugli, Nicolas Rodondi, Drahomir Aujesky
BACKGROUND: Long-term predictors and causes of death are understudied in elderly patients with acute venous thromboembolism. METHODS: We prospectively followed-up 991 patients aged ≥65 years with acute venous thromboembolism in a multicenter Swiss cohort study. The primary outcome was overall mortality. We explored the association between patient baseline characteristics and mortality, adjusting for other baseline variables and periods of anticoagulation as a time-varying co-variate...
October 11, 2016: American Journal of Medicine
Sebastian Johannes Reinstadler, Hans-Josef Feistritzer, Martin Reindl, Gert Klug, Agnes Mayr, Johannes Mair, Werner Jaschke, Bernhard Metzler
OBJECTIVE: The utility of different biomarkers for the prediction of left ventricular remodelling (LVR) following ST-elevation myocardial infarction (STEMI) has been evaluated in several studies. However, very few data exist on the prognostic value of combined biomarkers. The aim of this study was to comprehensively investigate the prognostic value for LVR of routinely available biomarkers measured after reperfused STEMI. METHODS: Serial measurements of N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin T (hs-cTnT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and high-sensitivity C reactive protein (hs-CRP) were performed in 123 patients with STEMI treated with primary percutaneous coronary intervention in this prospective observational study...
2016: Open Heart
A Ollila, L Vikatmaa, J Virolainen, P Vikatmaa, A Leppäniemi, A Albäck, M Salmenperä, V Pettilä
BACKGROUND AND AIMS: Perioperative myocardial infarction is an underdiagnosed complication causing morbidity, mortality, and considerable costs. However, evidence of preventive and therapeutic options is scarce. We investigated the incidence and outcome of perioperative myocardial infarction in non-cardiac surgery patients in order to define a target population for future interventional trials. MATERIAL AND METHODS: We conducted a prospective single-center study on non-cardiac surgery patients aged 50 years or older...
October 13, 2016: Scandinavian Journal of Surgery: SJS
Myriam A Badr, Jose R Pinto, Michael W Davidson, P Bryant Chase
Cardiac troponin C (cTnC) is a key effector in cardiac muscle excitation-contraction coupling as the Ca2+ sensing subunit responsible for controlling contraction. In this study, we generated several FRET sensors for divalent cations based on cTnC flanked by a donor fluorescent protein (CFP) and an acceptor fluorescent protein (YFP). The sensors report Ca2+ and Mg2+ binding, and relay global structural information about the structural relationship between cTnC's N- and C-domains. The sensors were first characterized using end point titrations to decipher the response to Ca2+ binding in the presence or absence of Mg2+...
2016: PloS One
Yohei Shibata, Hideki Ishii, Susumu Suzuki, Akihito Tanaka, Yosuke Tatami, Shingo Harata, Tomoyuki Ota, Yusaku Shimbo, Yohei Takayama, Ayako Kunimura, Kenshi Hirayama, Kazuhiro Harada, Naohiro Osugi, Toyoaki Murohara
AIMS: Previous studies have shown that aortic valve calcification (AVC) was associated with cardiovascular events and mortality. On the other hand, periprocedural myocardial injury (PMI) in percutaneous coronary intervention (PCI) is a well-known predictor of subsequent mortality and poor clinical outcomes. The purpose of the study was to assess the hypothesis that the presence of AVC could predict PMI in PCI. METHODS: This study included 370 patients treated with PCI for stable angina pectoris...
October 13, 2016: Journal of Atherosclerosis and Thrombosis
Thomas A Mavrakanas, Allan D Sniderman, Paul E Barré, Ahsan Alam
AIM: This study aims to describe the variability of pre-dialysis troponin values in stable haemodialysis patients and compare the performance of single versus fluctuating or persistently elevated troponins in predicting a composite of mortality and cardiac arrest, myocardial infarction, or stroke. METHODS: 128 stable ambulatory chronic haemodialysis patients were enrolled. Pre-dialysis troponin I was measured for three consecutive months. The patients were followed for one year...
October 8, 2016: Nephrology
M Batlle, B Campos, M Farrero, M Cardona, B González, M A Castel, J Ortiz, E Roig, M J Pulgarín, J Ramírez, J L Bedini, M Sabaté, P García de Frutos, F Pérez-Villa
BACKGROUND: Prognostic biomarkers are needed to improve the management of the heart failure (HF) epidemic, being the brain natriuretic peptides the most valuable. Here we evaluate 3 biomarkers, high sensitivity troponin T (hs-TnT), galectin-3 (Gal-3) and C-terminal propeptide of type I procollagen (CICP), compare them with a recently described new candidate (sAXL), and analyze their relationship with BNP. METHODS: HF patients with reduced ejection fraction (n=192) were included in this prospective observational study, with measurements of candidate biomarkers, functional, clinical and echocardiographic variables...
September 28, 2016: International Journal of Cardiology
Matthias Heringlake, Efstratios I Charitos, Kira Erber, Astrid Ellen Berggreen, Hermann Heinze, Hauke Paarmann
BACKGROUND: Growth-differentiation factor-15 (GDF-15) is an emerging humoral marker for risk stratification in cardiovascular disease. Cardiac-surgery-associated acute kidney injury (CSA-AKI), an important complication in patients undergoing cardiac surgery, is associated with poor prognosis. The present secondary analysis of an observational cohort study aimed to determine the role of GDF-15 in predicting CSA-AKI compared with the Cleveland-Clinic Acute Renal Failure (CC-ARF) score and a logistic regression model including variables associated with renal dysfunction...
October 8, 2016: Critical Care: the Official Journal of the Critical Care Forum
Anna Cichocka-Radwan, Małgorzata Lelonek
BACKGROUND: In the elderly the most common cause of hospitalization and the leading cause of death is heart failure. AIM: The purpose was to determine prognostic factors in chronic heart failure (CHF) in octogenarians and nonagenarians. METHODS: The analysis included 197 consecutive patients older than 80 years old (mean age 83.63+3.01 years; 46.19% of men) hospitalized in 2010-2013 in the Department of Cardiology due to CHF. Sixty two parameters were investigated such as: age, gender, NYHA functional class, body mass index, blood pressure, other comorbidities, the parameters of the 12-lead resting ECG and the echocardiography, the results of basic laboratory tests and selected biomarkers, including N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitive troponin T (hs-TnT), high-sensitive C-reactive protein (hs-CRP)...
October 7, 2016: Kardiologia Polska
Maha A Al-Mohaissen, Ronald G Carere, G B John Mancini, Karin H Humphries, Beth A Whalen, Terry Lee, Frank X Scheuermeyer, Andrew P Ignaszewski
BACKGROUND: Markers of plaque destabilization and disruption may have a role in identifying non-STE- type 1 Myocardial Infarction in patients presenting with troponin elevation. We hypothesized that a plaque disruption index (PDI) derived from multiple biomarkers and measured within 24 hours from the first detectable troponin in patients with acute non-STE- type 1 MI (NSTEMI-A) will confirm the diagnosis and identify these patients with higher specificity when compared to individual markers and coronary angiography...
2016: PloS One
Lieke J J Klinkenberg, Karin Wildi, Noreen van der Linden, Imre W K Kouw, Marijke Niens, Raphael Twerenbold, Maria Rubini Gimenez, Christian Puelacher, Jean Daniel Neuhaus, Petra Hillinger, Thomas Nestelberger, Jasper Boeddinghaus, Karin Grimm, Zaid Sabti, Judith A P Bons, Jeroen D E van Suijlen, Frans E S Tan, Joop Ten Kate, Otto Bekers, Luc J C van Loon, Marja P van Dieijen-Visser, Christian Mueller, Steven J R Meex
BACKGROUND: Interpretation of serial high-sensitivity cardiac troponin (hs-cTn) measurements for the diagnosis of acute myocardial infarction (AMI) assumes random fluctuation of hs-cTn around an individual's homeostatic set point. The aim of this study was to challenge this diagnostic concept. METHODS: Study 1 examined the presence of a diurnal hs-cTn rhythm by hourly blood sampling, day and night, in 24 individuals without a recent history of AMI. Study 2 assessed morning vs evening diagnostic accuracy of hs-cTnT and hs-cTnI in a prospective multicenter diagnostic study of 2782 unselected patients, presenting to the emergency department with acute chest pain...
October 5, 2016: Clinical Chemistry
Corey Heitz, Justin Morgenstern, William K Milne
This prospectively planned, secondary analysis of data from a large multi-center trial evaluated the diagnostic characteristics of using hs-cTnT levels below the level of detection (LoD), along with EKG findings, to rule out AMI on presentation to the ED. The primary outcome was diagnosis of AMI and the secondary outcome was major adverse cardiac events (MACE) within 30 days. A total of 1,282 patients were included in the study, 16.6% of which were diagnosed with AMI at the index visit. This article is protected by copyright...
October 5, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Øyvind Skadberg, Sverre Sandberg, Thomas Røraas, Per Hyltoft Petersen, Hilde Sellevoll, Einar Svarstad, Kristin Sæle, Kristin Moberg Aakre
BACKGROUND: Cardiovascular mortality is high in end stage renal disease (ESRD). This study aimed to: (1) calculate within-week within- and between-subject biological variation (CVI and CVG) for hs-cTn in ESRD; (2) determine the magnitude of hs-cTn concentration changes during haemodialysis (HD) treatment; and (3) compare the CVI and CVG to the within and between-subject variation of cTn concentration changes during HD treatments (CVDIFF-I and CVDIFF-G). METHODS: Serum samples were collected from 20 patients before and after 10 consecutive HD treatments...
October 5, 2016: Scandinavian Journal of Clinical and Laboratory Investigation
Alan S Tankel, Yusuf Nagree, Peter Jones, David Mountain, Stephen Pj Macdonald, Paul Hill, Martin Than
BACKGROUND: Multiple cardiac and non-cardiac processes may cause an elevated highly sensitive troponin (hsTn). We postulated that the consumption of a seriously hot vindaloo could cause an increase in hsTn levels in seemingly healthy volunteers. OBJECTIVE: To determine whether eating a very hot curry can cause elevated hsTn. METHODS: This was a prospective observational cohort study. Participants had blood drawn for hsTn pre-ingestion and at 2 and 4 h post-ingestion of, first, a rather mild butter chicken and, 2 weeks later, a seriously hot lamb vindaloo...
October 4, 2016: Emergency Medicine Australasia: EMA
O Nallet, N Ketata, N Ferrier, X Marcaggi
Acute chest pain is a common reason of consultation in the emergency department. The difficulty lies in discriminating patients with acute coronary syndrome or other life-threatening conditions from those non-cardiovascular, non-life-threatening chest pain. Only 15 to 25 % of patients with acute chest pain actually have acute coronary syndrome. Algorithms using high sensitivity troponin at admission and a second assessment 1 or 3hours later are validated to "rule in" or "rule out" the diagnosis of non ST-elevation myocardial infarction...
September 29, 2016: Annales de Cardiologie et D'angéiologie
Magdalena Krintus, Marek Kozinski, Tomasz Fabiszak, Magdalena Kuligowska-Prusinska, Ewa Laskowska, Lieselotte Lennartz, Lena Nowak-Los, Jacek Kubica, Grazyna Sypniewska
OBJECTIVES: i) To assess the relationship between lipid markers and high-sensitivity C-reactive protein (hs-CRP), and high-sensitivity cardiac troponin I (hs-cTnI) in the reference population, and ii) to evaluate the impact of lipid markers and hs-CRP on the 99th percentile upper reference limit (URL) for hs-cTnI. METHODS: 531 questionnaire-identified presumably healthy individuals were enrolled in a single-center, cross-sectional study. Surrogate biomarkers for diabetes, myocardial and renal dysfunction were used to refine the healthy cohort (n=408)...
November 1, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
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