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Troponin diagnosis

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https://www.readbyqxmd.com/read/29779296/the-assessment-and-management-of-chest-pain-in-primary-care-a-focus-on-acute-coronary-syndrome
#1
Richard Thomsett, Louise Cullen
BACKGROUND: Chest pain is a common presentation and diagnosis can be challenging. There are many causes for chest pain, including life-threatening conditions such as acute coronary syndrome (ACS), which can prove difficult to diagnose. OBJECTIVE: This article focuses on diagnosis and early management of patients with possible ACS. Key differentials and essential primary care investigations and management are outlined. Hospital-based risk stratification and management are described, providing an outline of what patients can expect if referred to hospital...
May 2018: Australian journal of general practice
https://www.readbyqxmd.com/read/29771705/the-causality-nexus-between-the-tako-tsubo-syndrome-and-an-assault-a-forensic-case-report
#2
Malek Zribi, Syrine Azza Manoubi, Narjes Karray, Salma Charfeddine, Wiem Benamar, Zouhir Hammami, Samir Kammoun, Samir Maatoug
"Tako-tsubo" cardiomyopathy, also known as "broken heart syndrome," is one of the rarest types of stress-induced cardiomyopathy. It frequently mimics acute coronary syndrome, characterized by transient left ventricular dysfunction, electrocardiographic changes, and release of myocardial enzymes. After treatment, the patients are cured in most cases without sequelae. Tako-tsubo syndrome is rarely considered as a reason for consultation in the forensic department.Herein, we report a case of a 68-year-old woman who was assaulted by her police officer neighbor...
May 4, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29770799/heart-type-fatty-acid-binding-protein-h-fabp-as-a-biomarker-for-acute-myocardial-injury-and-long-term-post-ischemic-prognosis
#3
REVIEW
Xiao-Dong Ye, Yi He, Sheng Wang, Gordon T Wong, Michael G Irwin, Zhengyuan Xia
Acute myocardial infarction (AMI) is a life-threatening event. Even with timely treatment, acute ischemic myocardial injury and ensuing ischemia reperfusion injury (IRI) can still be difficult issues to tackle. Apart from radiological and other auxiliary examinations, laboratory tests of applicable cardiac biomarkers are also necessary for early diagnosis and close monitoring of this disorder. Heart-type fatty acid binding protein (H-FABP), which mainly exists inside cardiomyocytes, has recently emerged as a potentially promising biomarker for myocardial injury...
May 17, 2018: Acta Pharmacologica Sinica
https://www.readbyqxmd.com/read/29768320/monocyte-chemoattractant-protein-1-as-a-predictor-of-coronary-atherosclerosis-in-patients-receiving-coronary-angiography
#4
Simon A Mahler, Thomas C Register, Robert F Riley, Ralph B D'Agostino, Jason P Stopyra, Chadwick D Miller
BACKGROUND: Animal studies suggest that monocyte chemoattractant protein-1 (MCP-1) is a promising biomarker for coronary artery atherosclerosis (CAA), but human studies have been inconclusive. OBJECTIVE: To determine potential relationships between plasma MCP-1 and CAA in patients with acute chest pain. METHODS: A secondary analysis of 150 patients enrolled in emergency department chest pain risk stratification clinical investigations was conducted...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29755623/main-considerations-of-cardiogenic-shock-and-its-predictors-systematic-review
#5
REVIEW
Maria Christiane Valeria Braga Braile-Sternieri, Eliana Migliorini Mustafa, Victor Rodrigues Ribeiro Ferreira, Sofia Braile Sabino, Giovanni Braile Sternieri, Lucia Angelica Buffulin de Faria, Bethina Canaroli Sbardellini, Cibele Olegario Vianna Queiroz, Domingo Marcolino Braile, Idiberto Jose Zotarelli Filho
The mortality rate of post-infarction cardiogenic shock (CS) was 80.0-90.0%. Recent studies show a significant reduction of hospital mortality to approximately 50.0%. CS is defined as systemic tissue hypoperfusion resulting from systolic and/or diastolic heart dysfunction, the main cause of which is acute myocardial infarction (AMI). The main predictors are biological markers such as troponin, CKMB and lactate. A systematic literature review and meta-analysis is performed in order to present and correlate the main literary findings on CS and its evolution with possible changes in biomarkers such as troponin, lactate and CKMB...
April 2018: Cardiology Research
https://www.readbyqxmd.com/read/29754668/resource-utilization-and-outcome-among-patients-with-selective-versus-nonselective-troponin-testing
#6
Alex R Campbell, Alexander J Rodriguez, David M Larson, Craig E Strauss, Ross F Garberich, Matthew F Partridge, Timothy D Henry, Scott W Sharkey
OBJECTIVE: In patients with suspected acute coronary syndrome (ACS), troponin testing is effective for diagnosis and prognosis. Troponin testing has now expanded to include patients without suspected ACS. This nonselective troponin testing has unknown consequences for resource utilization and outcome. Therefore, we examined selective versus nonselective troponin testing with respect to patient characteristics, resource utilization, and outcome. METHODS: This retrospective 1-year study included all patients with troponin testing at a U...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29754053/novel-electrochemical-sensing-platform-for-ultrasensitive-detection-of-cardiac-troponin-i-based-on-aptamer-mos-2-nanoconjugates
#7
Xiujuan Qiao, Kunxia Li, Jinqiong Xu, Ni Cheng, Qinglin Sheng, Wei Cao, Tianli Yue, Jianbin Zheng
Cardiac troponin I (cTnI) is a specific and sensitive biomarker for the early diagnosis of acute myocardial infarction and for the subsequent clinical treatments. In this work, novel electrochemical sensing platform for sensing of cTnI based on aptamer-MoS2 nanoconjugates was proposed. For comparison, core-shell Au@SiO2 @Au nanoparticles were also used for sensing of cTnI. The sensing schemes and electrochemical responses of the proposed sensors were investigated by electrochemical impedance spectroscopy (EIS) in 5...
May 4, 2018: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/29752392/independent-prognostic-value-of-stroke-volume-index-in-patients-with-immunoglobulin-light-chain-amyloidosis
#8
(no author information available yet)
BACKGROUND: Heart involvement is the most important prognostic determinant in AL amyloidosis patients. Echocardiography is a cornerstone for the diagnosis and provides important prognostic information. METHODS AND RESULTS: We studied 754 patients with AL amyloidosis who underwent echocardiographic assessment at the Mayo Clinic, including a Doppler-derived measurement of stroke volume (SV) within 30 days of their diagnosis to explore the prognostic role of echocardiographic variables in the context of a well-established soluble cardiac biomarker staging system...
May 2018: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29750937/the-potential-role-of-a-turbidimetric-heart-type-fatty-acid-binding-protein-assay-to-aid-in-the-interpretation-of-persistently-elevated-non-changing-cardiac-troponin-i-concentrations
#9
Peter A Kavsak, Craig Ainsworth, Donald M Arnold, Terry Scott, Lorna Clark, Josko Ivica, Katharine Mackett, Richard Whitlock, Andrew Worster
BACKGROUND: Elevated and non-changing high-sensitivity cardiac troponin (hs-cTn) concentrations may suggest a process other than acute injury, possibly due to chronic condition(s) causing the elevation, an analytical error/interference or the formation of macrocomplexes. Heart-type fatty acid binding protein (H-FABP) might be useful in this setting to identify the etiology of abnormally high and non-changing cTn concentrations which could aid clinical decision making in the hospital setting...
May 8, 2018: Clinical Biochemistry
https://www.readbyqxmd.com/read/29750698/peri-operative-copeptin-concentrations-and-their-association-with-myocardial-injury-after-vascular-surgery-a-prospective-observational-cohort-study
#10
Firmin Kamber, Eckhard Mauermann, Esther Seeberger, Lorenz Guerke, Christian Mueller, Daniel Bolliger, Giovanna A L Lurati Buse
BACKGROUND: Copeptin levels in conjunction with cardiac troponin may be used to rule out early myocardial infarction in patients presenting with chest pain. Raised pre-operative copeptin has been shown to be associated with postoperative cardiac events. However, very little is known about the peri-operative time course of copeptin or the feasibility of very early postoperative copeptin measurement to diagnose or rule-out myocardial injury. OBJECTIVES: In this preparatory analysis for a larger trial, we sought to examine the time course of peri-operative copeptin and identify the time at which concentrations returned to pre-operative levels...
May 9, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29735489/rise-and-fall-of-the-eosinophils-in-heart-failure-a-rare-but-important-phenomenon-seen-with-cardiomyopathy
#11
Danish Ali, David Snead, Vijay Anand Dhakshinamurthy, Prithwish Banerjee
A 65-year-old lady and a 69-year-old gentleman, both with a background history of adult-onset asthma, presented with clinical features of heart failure (HF). High-sensitivity cardiac troponin T and eosinophils were significantly raised, along with poor left ventricular (LV) systolic function on cardiac imaging. Endocardial and skin biopsy (in cases 1 and 2, respectively) showed eosinophilic infiltration. This in combination with the clinical features confirmed the diagnosis of eosinophilic myocarditis (EM) secondary to eosinophilic granulomatosis with polyangiitis in case 1...
May 7, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29725733/a-novel-fluorescent-aptasensor-for-the-highly-sensitive-and-selective-detection-of-cardiac-troponin-i-based-on-a-graphene-oxide-platform
#12
Dongkui Liu, Xing Lu, Yiwen Yang, Yunyun Zhai, Jian Zhang, Lei Li
Acute myocardial infarction (AMI) is one of the leading risks to global health. Thus, the rapid, accurate early diagnosis of AMI is highly critical. Human cardiac troponin I (cTnI) has been regarded as a golden biomarker for AMI due to its excellent selectivity. In this work, a novel fluorescent aptasensor based on a graphene oxide (GO) platform was developed for the highly sensitive and selective detection of cTnI. GO binds to the fluorescent anti-cTnI aptamer and quenches its fluorescence. In the presence of cTnI, the fluorescent anti-cTnI aptamer leaves the surface of GO, combines with cTnI because of the powerful affinity of the fluorescent anti-cTnI aptamer and cTnI, and then restores the fluorescence of the fluorescent anti-cTnI aptamer...
May 4, 2018: Analytical and Bioanalytical Chemistry
https://www.readbyqxmd.com/read/29725361/predictors-of-decreased-left-ventricular-function-subsequent-to-follow-up-echocardiography-after-percutaneous-coronary-intervention-following-acute-st-elevation-myocardial-infarction
#13
Dong-Hee Kim, Chang-Bum Park, Eun-Sun Jin, Hui-Jeong Hwang, Il Suk Sohn, Jin-Man Cho, Chong-Jin Kim
The preferred treatment for patients with ST elevation myocardial infarction (STEMI) is primary percutaneous coronary intervention (PCI). However, not all patients improve or maintain heart function following primary PCI, and certain patients may experience decreased heart function. The present study investigated factors associated with left ventricular (LV) dysfunction, and improvement or deterioration of LV ejection fraction (LVEF) at follow-up echocardiography following successful primary PCI. The clinical outcomes following primary PCI were also investigated...
May 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29718099/variability-of-high-sensitivity-troponin-t-concentrations-in-emergency-settings-impact-for-the-diagnosis-of-myocardial-infarction
#14
Pierre Douville, Sébastien Thériault
Objectives: To assess biological variation of troponin T in emergency settings and establish limits for interpretation of serial results. Methods: We studied 6,557 consecutive patients with troponin measurements. A stable reference subset was selected to estimate biological variation and threshold limits. Results: The first troponin level was elevated in 32% of patients, and 2,490 had a second troponin level with a myocardial infarction (MI) prevalence of 16...
April 28, 2018: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/29717283/utility-of-ischemia-modified-albumin-as-an-early-marker-for-diagnosis-of-acute-coronary-syndrome
#15
Bijaya Mishra, Sunil Pandey, Surya Raj Niraula, Bijendra Kumar Rai, Prahlad Karki, Nirmal Baral, Madhab Lamsal
BACKGROUND: The diagnosis of acute coronary syndrome remains challenging, as cardiac troponins and creatine kinase-MB do not detect myocardial ischemia. Ischemia modified albumin is biomarker positive within 6-10 minutes following ischemic onset, where oxygen free radicals leads to reduction in binding capacity of human serum albumin to transitional metal-cobalt. The objective of this study was to compare ischemia modified albumin between acute coronary syndrome patients and healthy controls, and evaluate diagnostic performance of ischemia modified albumin compared to cardiac troponins, creatine kinase-MB and electrocardiogram in acute coronary syndrome patients...
March 13, 2018: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/29716823/apical-hypertrophic-cardiomyopathy-a-concerning-electrocardiogram-in-the-emergency-department
#16
Patrick J Rogers, Ann-Jeannette Geib, Darren Cuthbert, Grant Wei
BACKGROUND: Apical hypertrophic cardiomyopathy is a rare, complex phenotypic variant of the classically taught hypertrophic cardiomyopathy. It is highly variable in its pathophysiology as well as its clinical course, spanning the spectrum from a healthy asymptomatic lifestyle to sudden cardiac death and severe diastolic dysfunction. The hallmark electrocardiographic findings of unusually large T-wave inversions, in conjunction with the most common presenting symptom being chest pain, makes this disease entity concerning in the emergency department (ED) setting...
April 28, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29715175/prognostic-implications-of-detectable-cardiac-troponin-i-below-the-99th-percentile-in-patients-admitted-to-an-emergency-department-without-acute-coronary-syndrome
#17
Alfredo Bardají, Gil Bonet, Anna Carrasquer, Maribel González-Del Hoyo, Fernando Domínguez, Rafael Sánchez, Carme Boqué, Germán Cediel
BACKGROUND: Detectable troponin below the 99th percentile may reflect an underlying cardiac abnormality which might entail prognostic consequences. This study aimed to investigate the prognosis of patients admitted to an emergency department (ED) with detectable troponin below the 99th percentile reference limit who did not present with an acute coronary syndrome (ACS). METHODS: We analysed the clinical data of all consecutive patients admitted to the ED during the years 2012 and 2013 in whom cardiac troponin was requested by the attending clinician (cTnI Ultra Siemens, Advia Centaur)...
May 1, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29715123/takotsubo-cardiomyopathy-developed-after-two-stage-surgery-for-double-primary-lung-cancer
#18
Fumihiko Kinoshita, Gouji Toyokawa, Tetsuzo Tagawa, Taichi Matsubara, Yuka Kozuma, Naoki Haratake, Shinkichi Takamori, Takaki Akamine, Fumihiko Hirai, Yoshihiko Maehara
Takotsubo cardiomyopathy (TC) is a syndrome characterized by transient local systolic dysfunction of the left ventricle with no evidence of coronary artery disease or acute plaque rupture. We present the case of 71-year-old woman who developed TC after two-stage surgery for double primary lung cancer. On computed tomography, lung nodules were identified in the left upper and right middle lobes. Based on the diagnosis of double primary lung cancer, we performed two-stage surgery (left upper lobectomy followed by right middle lobectomy)...
May 2018: Anticancer Research
https://www.readbyqxmd.com/read/29710196/long-term-outcomes-of-pediatric-onset-hypertrophic-cardiomyopathy-and-age-specific-risk-factors-for-lethal-arrhythmic-events
#19
Niccolò Maurizi, Silvia Passantino, Gaia Spaziani, Francesca Girolami, Anna Arretini, Mattia Targetti, Iva Pollini, Alessia Tomberli, Silvia Pradella, Giovanni Battista Calabri, Veronica Vinattieri, Bruno Bertaccini, Ornella Leone, Luciano De Simone, Claudio Rapezzi, Niccolò Marchionni, Franco Cecchi, Silvia Favilli, Iacopo Olivotto
Importance: Predictors of lethal arrhythmic events (LAEs) after a pediatric diagnosis of hypertrophic cardiomyopathy (HCM) are unresolved. Existing algorithms for risk stratification are limited to patients older than 16 years because of a lack of data on younger individuals. Objective: To describe the long-term outcome of pediatric-onset HCM and identify age-specific arrhythmic risk factors. Design, Setting, and Participants: This study assessed patients with pediatric-onset hypertrophic cardiomyopathy diagnosed from 1974 to 2016 in 2 national referral centers for cardiomyopathies in Florence, Italy...
April 18, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/29706818/multiple-admissions-to-the-coronary-care-unit-due-to-falsely-elevated-cardiac-troponin
#20
Mohamed Ayan, Zaid Gheith, Aneesha Ananthula, Mohsin Salih, Srikanth Vallurupalli, Jawahar L Mehta
The measurement of cardiac troponin, released from injured cardiomyocytes, is of paramount importance in the diagnosis of acute myocardial infarction. Elevated troponin can be encountered, however, in patients with cardiomyopathy, significant cardiac arrhythmias, vasculitis, right-sided heart strain, critical systemic illnesses, stroke, drug toxicity (such as Adriamycin), poisons (such as snake venoms), renal failure, seizure, and rhabdomyolysis. If the clinical picture is not consistent with any of these causes, a false-positive result should be considered...
April 2018: Proceedings of the Baylor University Medical Center
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