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Troponin diagnosis

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https://www.readbyqxmd.com/read/28925655/pleuritic-chest-pain-sorting-through-the-differential-diagnosis
#1
Brian V Reamy, Pamela M Williams, Michael Ryan Odom
Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling. Pulmonary embolism is the most common serious cause, found in 5% to 21% of patients who present to an emergency department with pleuritic chest pain. A validated clinical decision rule for pulmonary embolism should be employed to guide the use of additional tests such as d-dimer assays, ventilation-perfusion scans, or computed tomography angiography. Myocardial infarction, pericarditis, aortic dissection, pneumonia, and pneumothorax are other serious causes that should be ruled out using history and physical examination, electrocardiography, troponin assays, and chest radiography before another diagnosis is made...
September 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28917314/evaluation-of-cardiopulmonary-and-inflammatory-markers-in-dogs-with-heartworm-infection-treated-using-the-slow-kill-method
#2
W-K Yoon, Y-W Kim, S-I Suh, C Hyun
This study evaluated the changes in the levels of cardiac, hemostatic, and inflammatory biomarkers in 12 dogs with different severities of heartworm infection treated using the slow kill protocol, consisting of 6-10μg/kg of ivermectin and 10mg/kg of doxycycline combination. The serum levels of cardiac troponin-I, D-dimer, C-reactive protein, and interleukin-6 were measured on the day of diagnosis (D0), after termination of doxycycline administration (D30), after termination of the slow kill treatment (D180), and 10 months after the initiation of therapy (D300)...
September 15, 2017: Veterinary Parasitology
https://www.readbyqxmd.com/read/28916516/an-uncommon-manifestation-of-shock-takotsubo-syndrome
#3
Ying X Gue, Sanjay S Bhandari, Mubarak Ahamed
76 year old female presented following an episode of collapse. She was hypotensive with the paramedics and remained refractory despite fluid resuscitation. Her initial baseline tests revealed an elevated troponin; she subsequently underwent a coronary angiogram which showed mild coronary artery disease. Left ventriculogram was performed which showed abnormal mid-wall ballooning and severely impaired systolic function, characteristic of takotsubo syndrome. Echocardiogram confirmed presence of diagnosis and presence of left ventricular outflow tract obstruction with high gradient...
September 15, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28912910/prognostic-significance-of-elevated-cardiac-troponin-in-acute-gastrointestinal-bleeding
#4
Umair Iqbal, Osama Siddique, Ayesha Jameel, Hafsa Anwar, Ahmad Chaudhary
BACKGROUND: Acute gastrointestinal bleeding (AGIB) is responsible for over 140,000 hospitalizations annually. Cardiovascular-related deaths account for 30% of the patients surviving the initial episode of AGIB. The purpose of this study was to identify the impact of elevated troponin on short-term mortality and length of stay (LOS) of these patients. METHODS: From July 2013 to July 2016, 290 patients admitted with a diagnosis of AGIB and who had cardiac troponin I measured within 24 h of presentation were retrospectively reviewed...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28911997/heart-type-fatty-acid-binding-protein-in-cardiovascular-disease-a-systemic-review
#5
REVIEW
Yoichiro Otaki, Tetsu Watanabe, Isao Kubota
Fatty acid-binding proteins, whose clinical applications have been studied, are a family of proteins that reflect tissue injury. Heart-type fatty acid-binding protein (H-FABP) is a marker of ongoing myocardial damage and useful for early diagnosis of acute myocardial infarction (AMI). In the past decade, compared to other cardiac enzymes, H-FABP has shown more promise as an early detection marker for AMI. However, the role of H-FABP is being re-examined due to recent refinement in the search for newer biomarkers, and greater understanding of the role of high-sensitivity troponin...
September 11, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28905041/presepsin-scd14-st-could-it-be-a-novel-marker-for-the-diagnosis-of-st-elevation-myocardial-infarction
#6
Fatma Nihan Turhan Caglar, Nilgun Isiksacan, Ismail Biyik, Selcuk Opan, Hulya Cebe, Ibrahim Faruk Akturk
INTRODUCTION: Acute myocardial infarction (AMI) could be considered to be a state of inflammation. Many inflammatory markers have been evaluated in the AMI setting so far. Presepsin (PSP) is a novel biomarker for diagnosis and prognosis of systemic inflammation that has not been studied in the AMI setting to date. In this study, we aimed to examine serum PSP levels in patients with acute ST elevation myocardial infarction (STEMI). MATERIAL AND METHODS: Forty-eight patients with STEMI and fifty healthy controls without coronary artery disease, verified by coronary angiography, were included in the study...
2017: Arch Med Sci Atheroscler Dis
https://www.readbyqxmd.com/read/28888177/a-label-free-cardiac-biomarker-immunosensor-based-on-phase-shifted-microfiber-bragg-grating
#7
Tong Liu, Li-Li Liang, Peng Xiao, Li-Peng Sun, Yun-Yun Huang, Yang Ran, Long Jin, Bai-Ou Guan
Fiber optics evanescent field based biosensor is an excellent candidate for label-free detection of cardiac biomarkers which is of great importance in rapid, early, and accurate diagnosis of acute myocardial infarction (AMI). In this paper, we report a compact and sensitive cardiac troponin I (cTn-I) immunosensor based on the phase-shifted microfiber Bragg grating probe which is functionalized. The fine reflective signal induced by the phase shift in modulation significantly improves the spectral resolution, enabling the ability of the sensor in perceiving an ultra-small refractive index change due to the specific capture of the cTn-I antigens...
September 4, 2017: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/28879725/quantification-of-renal-function-and-cardiovascular-mortality-in-patients-admitted-to-the-emergency-department-with-suspected-acute-coronary-syndromes
#8
Philipp Bahrmann, Thomas Bertsch, Evangelos Giannitsis, Michael Christ, Benjamin Hofner, Robert Christenson, Bertil Lindahl, Christian Mueller
BACKGROUND: Increases in the novel serum marker cystatin C are detectable much earlier in the course of chronic kidney disease (CKD) even when levels of serum creatinine are still in the normal range. A major factor causing a decrease in serum creatinine is increasing age. Patients with CKD are more likely to develop cardiovascular disease (CVD) than a healthy population and to suffer premature deaths from CVD related to CKD. The aim of this study was to investigate whether cystatin C, serum creatinine, and estimated glomerular filtration rate (eGFR) predict cardiovascular mortality in patients admitted to the emergency department (ED) with suspected acute coronary syndromes (ACS)...
September 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28856047/high-sensitivity-detection-of-cardiac-troponin-i-with-uv-led-excitation-for-use-in-point-of-care-immunoassay
#9
Olga Rodenko, Susann Eriksson, Peter Tidemand-Lichtenberg, Carl Peder Troldborg, Henrik Fodgaard, Sylvana van Os, Christian Pedersen
High-sensitivity cardiac troponin assay development enables determination of biological variation in healthy populations, more accurate interpretation of clinical results and points towards earlier diagnosis and rule-out of acute myocardial infarction. In this paper, we report on preliminary tests of an immunoassay analyzer employing an optimized LED excitation to measure on a standard troponin I and a novel research high-sensitivity troponin I assay. The limit of detection is improved by factor of 5 for standard troponin I and by factor of 3 for a research high-sensitivity troponin I assay, compared to the flash lamp excitation...
August 1, 2017: Biomedical Optics Express
https://www.readbyqxmd.com/read/28843652/using-high-sensitivity-cardiac-troponin-t-for-acute-cardiac-care
#10
REVIEW
Yader Sandoval, Allan S Jaffe
The recent approval of the 5(th) generation cTnT assay which has characteristics clinically of a high sensitivity assay has led to concern that the problems of increased sensitivity will be greater than the benefits. This will not be the case if Cardiology, Emergency Medicine and Laboratory Medicine combine to develop procedures for use of the assay. We advocate sex specific 99(th)% upper reference limit (URL) values of 15ng/L for men and 10ng/L for women. We suggest a 2 hour rule out strategy including a value less than the 99(th)% URL and the lack of a change in values of <4 ng/L...
August 23, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28840515/high-sensitivity-cardiac-troponin-for-the-diagnosis-of-patients-with-acute-coronary-syndromes
#11
REVIEW
Vlad C Vasile, Allan S Jaffe
PURPOSE OF REVIEW: High-sensitivity cardiac troponin (hscTn) assays are replacing the older-generation assays used to detect myocardial injury because they have improved analytical sensitivity and lead to a more rapid diagnosis of acute myocardial infarction (AMI) and enhanced risk stratification in patients with non-ST elevation acute coronary syndromes (NSTE-ACS). This review focuses on advantages and difficulties of using hscTn as diagnostic and prognostic tools in acute coronary syndromes (ACS)...
August 24, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28830266/using-biomarkers-to-guide-heart-failure-management
#12
Kay-Won Chang, Sutton Fox, Sean Mojaver, Alan S Maisel
Biomarkers have revolutionized the diagnosis of heart failure (HF), but it remains unclear how to use biomarkers to guide management of HF. Areas covered: An exhaustive literature search on using biomarkers to guide HF management was performed. HF guidelines were carefully scrutinized for references pertaining to this topic, and Medline was employed to identify further references. This review focused on natriuretic peptides, troponin, and ST2 as biomarkers used to guide HF management. Most trials have examined secondary prevention of chronic HF patients, and data on primary prevention of HF and therapy of acute HF are emerging...
October 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28822701/clinical-applications-of-biomarkers-in-atrial-fibrillation
#13
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
#14
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/28814234/biomarkers-of-cardiovascular-risk-in-haemodialysis-patients
#15
Beata Franczyk, Anna Gluba-Brzózka, Jacek Rysz
BACKGROUND: All stages of chronic kidney disease (CKD) are associated with increased risks of atherosclerosis and cardiovascular morbidity and mortality. According to studies, levels of copeptin, growth differentiation factor-15 (GDF-15) and heart fatty-acid binding protein (h-FABP) are increased in dialysis patients. MATERIALS: This study included 50 patients (19 women, 31 men) chronically undergoing haemodialysis. The concentration of markers: copeptin, GDF-15, h-FABP, troponin and serum creatine kinase MB (CKMB) were measured with the use of ELISA tests...
August 15, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28811954/is-neutrophil-to-lymphocyte-ratio-a-predictor-of-coronary-artery-disease-in-western-indians
#16
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/28811951/granulomatosis-with-polyangiitis-presenting-as-pyrexia-of-unknown-origin-leukocytosis-and-microangiopathic-haemolytic-anemia
#17
Sima Terebelo, Iona Chen
A 66-year-old woman presented to the Emergency Department with a florid sepsis-like picture, a two-week history of fever, relative hypotension with end organ ischemia (unexplained liver enzyme and troponin elevations), and nonspecific constitutional symptoms. She was initially found to have a urinary tract infection but, despite appropriate treatment, her fever persisted and her white blood cell count continued to rise. During her hospitalization the patient manifested leukocytosis to 47,000 WBC/μL, ESR 67 mm/hr (normal range 0-42 mm/hr), CRP 17...
2017: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/28803961/the-99th-percentile-and-imprecision-of-point-of-care-cardiac-troponin-i-in-comparison-to-central-laboratory-tests-in-a-large-reference-population
#18
Anne Greiser, Theresa Winter, Hala Mahfoud, Anders Kallner, Till Ittermann, Annette Masuch, Norbert Lubenow, Thomas Kohlmann, Andreas Greinacher, Matthias Nauck, Astrid Petersmann
OBJECTIVES: Determination of cardiac troponin (cTn) is central in the emergency department (ED) for the diagnosis of myocardial infarction. In view of adverse effects of long waiting time on patient outcome, implementation of point-of-care-testing (POCT) is suggested if the turn-around-time is longer than 60min. The present study aimed to determine the 99th percentile and imprecision of two POCT in a healthy population measuring cTnI and cTnT and compare these analytical characteristics against three central laboratory test (CLT) for cTnI...
August 10, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28793384/factors-that-influence-care-priority-for-chest-pain-patients-using-the-manchester-triage-system
#19
Carine Lais Nonnenmacher, Ananda Ughini Bertoldo Pires, Vitor Monteiro Moraes, Amália de Fátima Lucena
AIMS AND OBJECTIVES: Analyze crucial factors for determining care priority for patients with acute myocardial infarction based on the Manchester Triage System. BACKGROUND: Triage is the first potentially critical step in the care of myocardial infarction patients. However, there are still very few studies on the factors interfering in the lack of care priority for these patients, impacting their treatment and prognosis. DESIGN: Retrospective cohort study with 217 patients in the emergency department of a Brazilian hospital...
August 9, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28791782/predicting-short-term-risk-of-arrhythmia-among-patients-with-syncope-the-canadian-syncope-arrhythmia-risk-score
#20
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
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