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https://www.readbyqxmd.com/read/29332909/type-2-myocardial-infarction%C3%A3-an-evolving-entity
#1
Cian P McCarthy, James L Januzzi, Hanna K Gaggin
Type 2 myocardial infarction (T2MI) refers to myocardial necrosis caused by an imbalance in myocardial oxygen supply and demand and in the absence of acute coronary thrombosis. Despite growing recognition of this entity, there remains little understanding of the pathophysiology and uncertainty over the diagnostic criteria for this subtype of MI. Alarmingly, recent studies suggest that a diagnosis of T2MI pertains a prognosis similar to, if not worse than, type 1 MI. With increasing clinical use of high-sensitivity cardiac troponin assays, the frequency of recognition of T2MI is expected to increase...
January 13, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29317021/proposed-clinical-scale-for-the-diagnosis-of-acute-coronary-syndrome-in-patients-with-an-inconclusive-electrocardiogram-and-myocardial-injury-biomarkers
#2
F J Montero-Pérez, F B Quero-Espinosa, M J Clemente-Millán, J A Castro-Giménez, J de Burgos-Marín, M Á Romero-Moreno
RATIONALE: Acute coronary syndrome (ACS) requires improved diagnostic accuracy through useful, safe and easy-to-apply tools. OBJECTIVES: To obtain an assessment scale for the diagnosis of ACS in patients with chest pain and nondiagnostic electrocardiogram and troponin concentrations. METHODS: A prospective cohort study included 286 patients treated in the emergency department for chest pain, with normal electrocardiogram and troponin levels...
January 6, 2018: Revista Clínica Española
https://www.readbyqxmd.com/read/29307181/smart-drug-delivery-system-inspired-enzyme-linked-immunosorbent-assay-based-on-fret-and-allochroic-effect-induced-dual-modal-colorimetric-and-fluorescent-detection
#3
Luyang Miao, Chengzhou Zhu, Lei Jiao, He Li, Dan Du, Yuehe Lin, Qin Wei
Numerous analytical techniques have been undertaken for the detection of protein biomarkers due to their extensive and significant applications in clinical diagnosis, whereas there are few strategies to develop dual-readout immunosensors to achieve more accurate results. To the best of our knowledge, inspired by smart drug delivery system (DDS), a novel pH- responsive modified enzyme-linked immunosorbent assay (ELISA) was innovatively developed for the first time, realizing dual-modal colorimetric and fluorescent detection of cardiac troponin I (cTnI)...
January 8, 2018: Analytical Chemistry
https://www.readbyqxmd.com/read/29306590/new-definition-criteria-of-myocardial-dysfunction-in-patients-with-liver-cirrhosis-a-speckle-tracking-and-tissue-doppler-imaging-study
#4
Roxana Cristina Rimbaş, Sorina Mihăilă Baldea, Ruxandra Drăgoi Galrinho Antunes Guerra, Simona Ionela Visoiu, Mihai Rimbaş, Corina Silvia Pop, Dragoş Vinereanu
There are no clear recommendations regarding cirrhotic cardiomyopathy (CC) evaluation in patients with pre-transplant liver cirrhosis. The roles of new methods, tissue Doppler imaging (TDI) and speckle tracking echocardiography (STE) in the diagnosis and prognosis of cirrhotic cardiomyopathy remain controversial. We investigated the utility of TDI/STE parameters in cirrhotic cardiomyopathy diagnosis and also in predicting mortality in patients with liver cirrhosis. Left/right ventricular function was studied using conventional TDI (velocities) and STE (strain/strain rate)...
January 3, 2018: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/29304488/factors-associated-with-elevated-cardiac-troponin-levels-in-patients-with-acute-pulmonary-thromboembolism
#5
Samad Ghaffari, Nariman Sepehrvand, Leili Pourafkari, Reza Hajizadeh, Elnaz Javanshir, Mehdi Nadiri, Nader D Nader
PURPOSE: We aimed to investigate the factors that are associated with increased cardiac troponin I (cTnI) leakage in the acute pulmonary embolism (PTE) setting and their alignment with patient outcome. METHODS: Adult patients with a diagnosis of PTE were enrolled in this prospective cohort study. The primary endpoint of interest was major adverse cardio-pulmonary events (MACPE), defined as the composite of in-hospital all-cause mortality, need for thrombolysis and mechanical ventilation and surgical embolectomy during index hospitalization...
December 29, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29303766/no-additional-value-of-conventional-and-high-sensitivity-cardiac-troponin-over-clinical-scoring-systems-in-the-differential-diagnosis-of-type-1-versus-type-2-myocardial-infarction
#6
Luciano Consuegra-Sánchez, Juan José Martínez-Díaz, Luis García de Guadiana-Romualdo, Samantha Wasniewski, Patricia Esteban-Torrella, Francisco Guillermo Clavel-Ruipérez, Alfredo Bardají, Juan Antonio Castillo-Moreno, Juan Carlos Kaski
BACKGROUND: The distinction of type 1 and type 2 myocardial infarction (MI) is of major clinical importance. Our aim was to evaluate the diagnostic ability of absolute and relative conventional cardiac troponin I (cTnI) and high-sensitivity cardiac troponin T (hs-cTnT) in the distinction between type 1 and type 2 MI in patients presenting at the emergency department with non-ST-segment elevation acute chest pain within the first 12 h. METHODS: We measured cTnI (Dimension Vista) and hs-cTnT (Cobas e601) concentrations at presentation and after 4 h in 200 patients presenting with suspected acute MI...
January 5, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29303408/forensic-tools-for-the-diagnosis-of-electrocution-death-case-study-and-literature-review
#7
Cristina Mondello, Antonio Micali, Luigi Cardia, Antonina Argo, Stefania Zerbo, Elvira Ventura Spagnolo
Diagnosis of death by electrocution may be difficult when electric marking is not visible or unclear. Accordingly, the body of a man who appeared to have died from accidental electrocution was carefully forensically analysed. Macroscopic and microscopic analysis of the current mark was carried out using a variable-pressure scanning electron microscope equipped with energy dispersive X-ray microanalyser to highlight skin metallisation, indicating the presence of iron and zinc. The histological findings of electrocution myocardial damage were supported by the results of biochemical analysis which demonstrated the creatine kinase-MB and cardiac troponin I elevation...
January 1, 2018: Medico-legal Journal
https://www.readbyqxmd.com/read/29284532/abnormal-elevation-of-myocardial-necrosis-biomarkers-after-coronary-artery-bypass-grafting-without-established-myocardial-infarction-assessed-by-cardiac-magnetic-resonance
#8
Fernando Teiichi Costa Oikawa, Whady Hueb, Cesar Higa Nomura, Alexandre Ciappina Hueb, Alexandre Volney Villa, Leandro Menezes Alves da Costa, Rodrigo Morel Vieira de Melo, Paulo Cury Rezende, Carlos Alexandre Wainrober Segre, Cibele Larrosa Garzillo, Eduardo Gomes Lima, Jose Antonio Franchini Ramires, Roberto Kalil Filho
BACKGROUND: The diagnosis of peri-procedural myocardial infarction is complex, especially after the emergence of high-sensitivity markers of myocardial necrosis. METHODS: In this study, patients with normal baseline cardiac biomarkers and formal indication for elective on-pump coronary bypass surgery were evaluated. Electrocardiograms, cardiac biomarkers, and cardiac magnetic resonance imaging with late gadolinium enhancement were performed before and after procedures...
December 29, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29278915/how-is-cardiac-troponin-released-from-injured-myocardium
#9
Johannes Mair, Bertil Lindahl, Ola Hammarsten, Christian Müller, Evangelos Giannitsis, Kurt Huber, Martin Möckel, Mario Plebani, Kristian Thygesen, Allan S Jaffe
Cardiac troponin I and cardiac troponin T are nowadays the criterion biomarkers for the laboratory diagnosis of acute myocardial infarction due to their very high sensitivities and specificities for myocardial injury. However, still many aspects of their degradation, tissue release and elimination from the human circulation are incompletely understood. Myocardial injury may be caused by a variety of different mechanisms, for example, myocardial ischaemia, inflammatory and immunological processes, trauma, drugs and toxins, and myocardial necrosis is preceded by a substantial reversible prelethal phase...
December 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29278630/predictive-value-of-high-sensitive-troponin-i-assay-in-acute-coronary-syndrome-compared-to-classic-biochemical-markers
#10
Tomislav Čolak, Ivanka Mikulić, Kristina Landeka, Ana Sesar, Marija Vranješ, Ivanka Mikulić
The aims of this study were to compare predictive values of hsTroponin I assay with contemporary assays and its usefulness in diagnosis of acute coronary syndrome (ACS). We also aimed to determine reference values of the assay and the possibility of fast ACS diagnosis using hsTnI. The study included 26 patients with ongoing chest pains and suspected ACS. ACS diagnosis was determined using electrocardiographic changes and international guidelines. Biochemical parameters were measured using standard tests which included Troponin I, hsTroponin I, CK, CK-MB and CRP...
December 2017: Psychiatria Danubina
https://www.readbyqxmd.com/read/29275366/prognostic-value-of-new-generation-troponins-in-st-segment-elevation-myocardial-infarction-in-the-modern-era-the-ruti-stemi-study
#11
Germán Cediel, Ferran Rueda, Cosme García, Teresa Oliveras, Carlos Labata, Jordi Serra, Julio Núñez, Vicent Bodí, Marc Ferrer, Josep Lupón, Antoni Bayes-Genis
BACKGROUND: In ST-segment-elevation myocardial infarction (STEMI), troponins are not needed for diagnosis: symptoms and ECG data are sufficient to activate percutaneous coronary intervention. This study explored the prognostic value of new-generation troponins in a real-life cohort contemporarily treated for STEMI. METHODS AND RESULTS: We studied 1260 consecutive patients with primary STEMI treated with percutaneous coronary intervention between February 22, 2011, and August 31, 2015...
December 23, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29274187/sex-differences-in-diagnoses-treatment-and-outcomes-for-emergency-department-patients-with-chest-pain-and-elevated-cardiac-troponin
#12
Karin H Humphries, May K Lee, Mona Izadnegahdar, Min Gao, Daniel T Holmes, Frank X Scheuermeyer, Martha Mackay, Andre Mattman, Eric Grafstein
OBJECTIVE: While sex differences in the treatment and outcomes of subjects with acute coronary syndromes are well documented, little is known about the impact of cardiac troponin (cTn) levels obtained in the emergency department (ED) on the observed sex differences. We sought to determine whether cTn levels by chest pain features modify sex differences in diagnosis, treatment and outcomes in patients presenting with chest pain suggestive of ischemia. METHODS: All adults presenting to two hospitals in Vancouver, Canada between May 2008 and Mar 2013 with ischemic chest pain and with cTn testing were included in the study...
December 23, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29260530/-establishment-of-reference-value-of-hs-ctnt-in-sichuan-region-and-its-diagnostic-value-in-patients-with-chest-pain
#13
Ying Guo, Xiang-Yang Du, Hua-Lan Huang, Wei-Qing Wang, Xin Nie, Gui-Xing Li
OBJECTIVE: To establish the reference value of high sensitive cardiac troponin T (hs-cTnT) and the efficiency of reference value in the diagnosis of chest pain. METHODS: Volunteers from eight independent communities in Chengdu,Sichuan were selected with detailed records of physical examination,electrocardiogram,ultrasound examination. The level of hs-cTnT for healthy volunteers was tested to determine ninety-ninth percentile references according to sex and ages...
November 2017: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/29250287/the-significance-of-troponin-elevation-in-atrial-fibrillation
#14
REVIEW
Juan Pablo Costabel, Lucrecia María Burgos, Marcelo Trivi
Cardiac troponin assays have provided a significant contribution for the early diagnosis of cardiovascular events. There is significant evidence about the association between the absolute value of elevated cardiac troponin levels with the prognosis of patients with chest pain. However, it is well-known that elevated cardiac troponin levels may occur in situations other than acute coronary syndromes, as it happens with atrial fibrillation. The significance and prognosis of this elevation are not entirely clear...
April 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29246240/myocardial-inflammation-injury-and-infarction-during-on-pump-coronary-artery-bypass-graft-surgery
#15
Shirjel R Alam, Colin Stirrat, Nick Spath, Vipin Zamvar, Renzo Pessotto, Marc R Dweck, Colin Moore, Scott Semple, Ahmed El-Medany, Divya Manoharan, Nicholas L Mills, Anoop Shah, Saeed Mirsadraee, David E Newby, Peter A Henriksen
BACKGROUND: Myocardial inflammation and injury occur during coronary artery bypass graft (CABG) surgery. We aimed to characterise these processes during routine CABG surgery to inform the diagnosis of type 5 myocardial infarction. METHODS: We assessed 87 patients with stable coronary artery disease who underwent elective CABG surgery. Myocardial inflammation, injury and infarction were assessed using plasma inflammatory biomarkers, high-sensitivity cardiac troponin I (hs-cTnI) and cardiac magnetic resonance imaging (CMR) using both late gadolinium enhancement (LGE) and ultrasmall superparamagnetic particles of iron oxide (USPIO)...
December 16, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29241463/-myocardial-contusion-following-trauma
#16
R T Stolmeijer, H Lameijer
BACKGROUND: Myocardial contusion is a potentially life threatening condition, which should be considered in patients with a compatible thoracic trauma. Guidelines for diagnosis and determination of management are non-existent. CASE DESCRIPTION: A 51-year-old man arrived at the accident and emergency department with thoracic trauma after being knocked down by a bus. A myocardial contusion was diagnosed based on the ECG and elevated high-sensitivity (hs) troponin levels...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29236093/trends-in-troponin-only-testing-for-ami-in-academic-teaching-hospitals-and-the-impact-of-choosing-wisely%C3%A2
#17
Micah T Prochaska, Samuel F Hohmann, Matthew Modes, Vineet M Arora
BACKGROUND: Identifying hospitals that are both early and consistent adopters of high-value care can help shed light on the culture and practices at those institutions that are necessary to promote high-value care nationwide. The use of troponin to diagnose acute myocardial infarction (AMI), and not to test for myoglobin or creatine kinase-MB (CK-MB), is a high-value recommendation of the Choosing Wisely® campaign. OBJECTIVE: To examine the variation in cardiac biomarker testing and the effect of the Choosing Wisely® troponin-only recommendation for the diagnosis of AMI...
December 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29233491/utility-of-myeloperoxidase-in-the-differential-diagnosis-of-acute-coronary-syndrome
#18
Pilar Calmarza, Carlos Lapresta, María Martínez, Raquel Lahoz, Javier Povar
OBJECTIVES: To determine the usefulness of myeloperoxidase in discriminating between patients with acute coronary syndrome and patients with chest pain by other causes. METHODS: The study included all patients over 18 years of age who come consecutively to the emergency department from September 2015 to December 2015 with chest pain of non-traumatic origin. The initial patient evaluation was performed according to the study protocol for patients with suspected acute coronary syndrome (ACS) in our Emergency Department...
December 7, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/29230129/paraneoplastic-cardiac-involvement-in-renal-cell-carcinoma-with-dermatomyositis-sine-dermatitis
#19
Htoo Kyaw, Atif Z Shaikh, Cesar Ayala-Rodriguez, Misra Deepika
Background: Dermatomyositis is an idiopathic inflammatory myopathy that has been established as one of the many paraneoplastic phenomena. Cardiac involvement can occur with dermatomyositis but has rarely been reported in the literature because symptoms are usually subclinical. Case Report: A 72-year-old female presented with generalized weakness for 1 month after a recent diagnosis of renal cell carcinoma. Her weakness was attributed to a myopathic process that was identified as dermatomyositis after muscle biopsy...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29227899/cardiac-troponins-and-nt-probnp-in-the-forensic-setting-overview-of-sampling-site-postmortem-interval-cardiopulmonary-resuscitation-and-review-of-the-literature
#20
Cristian Palmiere, Camilla Tettamanti, Alessandro Bonsignore, Francesco De Stefano, Jessica Vanhaebost, Guillaume Rousseau, Maria Pia Scarpelli, Daniel Bardy
The possible use of biochemical markers in the postmortem diagnosis of myocardial ischemia is well known in the forensic setting, though several issues have limited its widespread adoption. The study presented herein focuses of N-terminal pro-B-type natriuretic peptide, troponin T, and troponin I, and the possible influence due to sampling site chosen, postmortem interval elapsed, and cardiopulmonary resuscitation attempts. Comparisons were performed between antemortem serum levels of these markers and postmortem levels measured in pericardial fluid and postmortem serum samples obtained from different sampling sites (n=16)...
January 2018: Forensic Science International
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