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Troponin diagnosis

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https://www.readbyqxmd.com/read/28811954/is-neutrophil-to-lymphocyte-ratio-a-predictor-of-coronary-artery-disease-in-western-indians
#1
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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28776390/value-of-troponin-levels-in-the-diagnosis-of-cardiac-dysfunction-in-moderate-scorpion-envenomation
#6
O Chakroun-Walha, R Karray, M Jerbi, A Ben Rebeh, C Jammeli, M Bahloul, R Ammar, I Chabchoub, M Bouaziz, A Nasri, N Rekik
CONTEXT: Cardiac dysfunction is one of the most serious consequences of scorpion envenomation. The best tool to evaluate cardiac function is echocardiography, but it is not available at all emergency departments. Many studies aimed to describe biological predictive factors of cardiac dysfunction in scorpion envenomation. Troponin is one of these biomarkers but its correlation with myocarditis is not well established. The aim of this study was to evaluate correlation between troponin levels and cardiac dysfunction in moderate scorpion envenomation...
January 1, 2017: Human & Experimental Toxicology
https://www.readbyqxmd.com/read/28776362/acute-heart-failure-and-rhabdomyolysis-a-clue-for-the-diagnosis-of-polymyositis-with-cardiac-involvement
#7
P Pinto-Lopes, L Carneiro-Leão, R Morais, J Pinheiro, A Vieira Lopes, P Bettencourt
Polymyositis is an idiopathic inflammatory myopathy, characterized by proximal muscle weakness and sometimes extramuscular manifestations. We report the case of a 51-year-old male, with history of complete heart block, which required pacemaker implantation, and subsequently heart failure, presenting to the emergency department with worsening of dyspnea and peripheral edema. He was admitted to the Internal Medicine ward with acute heart failure and started on diuretic therapy. During hospitalization, he was discovered to have marked rhabdomyolysis...
August 3, 2017: Reumatismo
https://www.readbyqxmd.com/read/28765984/-acute-chest-pain
#8
REVIEW
M Möckel, T Störk
Patients presenting with acute chest pain are a challenge for attending physicians in private practice and specialists for emergency and acute medicine in hospitals because a wide spectrum of diagnoses may be the cause, ranging from acute myocardial infarction (AMI) to harmless muscular tension. The evaluation of patients with acute chest pain follows basic principles independent of the setting: A thorough clinical investigation by the responsible physician including medical history and physical examination, followed by a 12-channel electrocardiogram (ECG) and further focused diagnostics...
August 1, 2017: Der Internist
https://www.readbyqxmd.com/read/28764841/non-st-elevation-acute-coronary-syndromes-a-comprehensive-review
#9
Tamunoinemi Bob-Manuel, Ikechuckwu Ifedili, Guy Reed, Uzoma N Ibebuogu, Rami N Khouzam
Non-ST elevation-acute coronary syndrome (NSTE-ACS) includes NSTE myocardial infarction and unstable angina. This patient population forms approximately two-thirds of all hospital admissions for ACS in the United States each year and is associated with an in-hospital mortality of 5%. NSTE-ACS is primarily due to an acute change in the supply and demand balance of coronary perfusion and myocardial oxygen consumption, because of the significant coronary artery obstruction presenting as plaque rupture or erosion...
September 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/28763113/distribution-of-cardiac-troponin-i-in-the-japanese-general-population-and-factors-influencing-its-concentrations
#10
Naoya Abe, Kenichiro Tomita, Mayumi Teshima, Maki Kuwabara, Satoshi Sugawa, Nae Hinata, Masaaki Matsuura, Mutsunori Fujiwara, Kazuhiko Takaya, Toru Hiyoshi, Hiroki Uozumi, Hiroshi Ikenouchi, Rie Ishikawa, Junko Shojima, Junko Komatsu
BACKGROUND: The 99th percentile of cardiac troponin I level in the general population is accepted as the cut-off for the diagnosis of acute myocardial infarction (AMI). However, it is not clear whether the cut-offs derived in racially and geographically different populations are applicable in Japan. METHODS: Troponin I was determined using the Abbott ARCHITECT STAT high-sensitive troponin I immunoassay in 698 apparently healthy individuals who visited the Japanese Red Cross Medical Center for a health checkup...
August 1, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28760208/use-of-troponin-assay-99th-percentile-as-the-decision-level-for-myocardial-infarction-diagnosis
#11
MULTICENTER STUDY
Akshay Bagai, Karen P Alexander, Jeffrey S Berger, Roxy Senior, Chakkanalil Sajeev, Radoslaw Pracon, Kreton Mavromatis, Jose Luis Lopez-Sendón, Gilbert Gosselin, Ariel Diaz, Gian Perna, Jarozlaw Drozdz, Dennis Humen, Birute Petrauskiene, Asim N Cheema, Denis Phaneuf, Subhash Banerjee, Todd D Miller, Sasko Kedev, Herwig Schuchlenz, Gregg W Stone, Shaun G Goodman, Kenneth W Mahaffey, Allan S Jaffe, Yves D Rosenberg, Sripal Bangalore, L Kristin Newby, David J Maron, Judith S Hochman, Bernard R Chaitman
BACKGROUND: The Universal Definition of Myocardial Infarction recommends the 99th percentile concentration of cardiac troponin in a normal reference population as part of the decision threshold to diagnose type 1 spontaneous myocardial infarction. Adoption of this recommendation in contemporary worldwide practice is not well known. METHODS: We performed a cohort study of 276 hospital laboratories in 31 countries participating in the National Heart, Lung, and Blood Institute-sponsored International Study of Comparative Health Effectiveness with Medical and Invasive Approaches trial...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28759844/circulating-soluble-receptor-for-advanced-glycation-end-product-cross-sectional-associations-with-cardiac-markers-and-subclinical-vascular-disease-in-older-men-with-and-without-diabetes
#12
S Goya Wannamethee, Paul Welsh, Olia Papacosta, Elizabeth A Ellins, Julian P J Halcox, Peter H Whincup, Naveed Sattar
BACKGROUND AND AIMS: The soluble receptor for advanced glycation end products (sRAGE) has been implicated in diabetic vascular complications. We have examined the association between sRAGE and cardiac markers [NT-proBNP and cardiac troponin T (cTnT)] and subclinical vascular markers in older men with and without diabetes. METHODS: We performed a cross-sectional study of 1159 men aged 71-92 years with no history of cardiovascular disease (myocardial infarction, stroke, heart failure, coronary artery bypass graft operation or angioplasty)...
July 12, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28751286/troponin-elevation-in-other-conditions-than-acute-coronary-syndromes
#13
Wafa Masri, Edouard Le Guillou, Eya Hamdi, Khaldoun Ghazal, Elise Lebigot, Claudine Cosson, Françoise Blonde Cynober, Patrice Therond
Troponin is a specific cardiac infarction isoform (TnIc, TnTc) and its determination is used for the diagnosis of myocardial infarction even with normal Electrocardiography. The increase of cardiac troponins occurs in a variety of clinical situations without an acute coronary syndrome (ACS), cardiologists and emergency physicians are often confronted with positive troponins that are difficult to interpret. Few data exist about the occurrence, the clinical characteristics and the predictive value in case of absence of ACS...
August 1, 2017: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/28742647/the-dis-utility-of-a-change-in-troponin-i-for-diagnosis-of-non-st-segment-elevation-myocardial-infarction-in-an-observation-unit
#14
Iani Patsias, Benjamin Swanson, Michael Hudson, Sachin Parikh, Khaled Nour, Gordon Jacobsen, James McCord
BACKGROUND: Observation units (OUs) may be an efficient and effective setting to diagnose and risk stratify patients with coronary ischemia and myocardial infarction (MI). Given improved cardiac troponin I (cTnI) assays and expanded utilization of OUs, it is not uncommon for patients with mildly elevated cTnI to be evaluated in OUs. We investigated the serial cTnI results in OU patients to determine whether absolute or relative cTnI changes were useful for the diagnosis of MI. METHODS: This was a retrospective study of 260 patients placed in the OU from a single center in 2007, with an initial cTnI in the indeterminate range of 0...
September 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28720694/myocardial-infarction-masquerading-as-myocarditis-in-a-patient-with-factor-v-leiden-unmasked-with-mr
#15
Jason Leo Walsh, Benjamin Howell Lole Harris, Walid Gharzuddine, Hussain Isma'eel
We present a case of a 21-year-old man presenting with sharp left-sided chest pain. A CT pulmonary angiogram was negative, ECG was unremarkable and a mild troponin rise was observed. Myocarditis was suspected as the most likely diagnosis, particularly in view of the patient's previous diagnosis of myocarditis 3 years prior. A cardiac MRI was indicative of an acute mid-anterior myocardial infarction (MI) and an old inferior MI with an associated aneurysm. A subsequent angiogram revealed a subtotal occlusion in the second diagonal artery, likely precipitated by homozygous factor V Leiden...
July 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28719430/high-sensitivity-cardiac-troponin-t-improves-the-diagnosis-of-perioperative-mi
#16
Jamie C Brown, Eslam Samaha, Srikar Rao, Mohammad A Helwani, Andreas Duma, Frank Brown, Brian F Gage, J Philip Miller, Allan S Jaffe, Fred S Apple, Mitchell G Scott, Peter Nagele
BACKGROUND: The diagnosis of myocardial infarction (MI) after noncardiac surgery has traditionally relied on using relatively insensitive contemporary cardiac troponin (cTn) assays. We hypothesized that using a recently introduced novel high-sensitivity cTnT (hscTnT) assay would increase the detection rate of perioperative MI. METHODS: In this ancillary study of the Vitamins in Nitrous Oxide trial, readjudicated incidence rates of myocardial injury (new isolated cTn elevation) and MI were compared when diagnosed by contemporary cTnI versus hscTnT...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28717414/cardiac-magnetic-resonance-in-patients-with-acute-cardiac-injury-and-unobstructed-coronary-arteries
#17
Giovanni Salvatore Camastra, Stefano Sbarbati, Massimiliano Danti, Luca Cacciotti, Raffaella Semeraro, Sabino Walter Della Sala, Gerardo Ansalone
AIM: To define the role of cardiac magnetic resonance (CMR) by analyzing a particular group of patients with suspected acute coronary syndrome (ACS) and normal coronary angiogram. METHODS: From January 2009 to December 2015, we examined 220 patients with clinical suspicion of ACS, Troponin elevation [the threshold used to define a positive Troponin T test (TnT) was 0.1 ng/mL] and no significant coronary disease at angiography (the patients were considered to have significant angiographic disease only a 50% stenosis was detected in any of their coronary arteries)...
June 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/28712188/a-novel-link-between-adipokines-and-lipoprotein-a-to-contemplate-their-diagnostic-role-in-patients-with-stemi-and-nstemi
#18
Shazia Rashid, Rukhshan Khurshid, Uzma Faryal Amir, Arif Malik, Sumera Qazi
BACKGROUND: Early detection of cardiac events allow better and cost-effective triage and welltimed management of these patients. Study was conducted to evaluate the prognostic significance of plasma adiponectin, resistin and lipoprotein (a) in a group of patients with ST segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction. These parameters were also compared with other predictors like troponin T, troponin I and CK-MB. METHODS: Present study was based on the 100 patients with AMI of whom 52 had a diagnosis of STEMI, and 48 had NSTEMI...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28712187/utility-of-heart-type-fatty-acid-binding-protein-h-fabp-point-of-care-test-in-the-early-hours-of-stemi-compared-with-troponin-i-in-pakistani-population
#19
Walid Ahmad Abbasi, Muhammad Saleem, Shahid Rasheed, Azhar Mahmood Kiyani
BACKGROUND: Acute coronary syndrome remains a dominant cause of high morbidity and mortality despite advancements in treatment This study was conducted to examine the utility of point-of-care test of heart-type fatty-acid binding protein (h-FABP) and compare it with the point-of-care test of cardiac troponin I (cTnI) in the first 06 hours of STEMI. METHODS: This cross-sectional, comparative study which was conducted in Rawalpindi institute of cardiology, Rawalpindi, Pakistan, from January to June 2015...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28710236/complement-factor-b-mutation-associated-ahus-and-myocardial-infarction
#20
Natália Noronha, Filipa Dias Costa, Andrea Dias, Alexandra Dinis
A 6-month-old female infant was referred with a 3-day history of low-grade fever, slight nasal congestion and rhinorrhoea. On admission, the clinical findings were unremarkable and she was discharged home. However, she became progressively more listless with a decreased urine output and was once again seen in the emergency department. Analytically she was found to have metabolic acidosis, hyperkalaemia, thrombocytopaenia, anaemia and schistocytes in the peripheral blood smear. Based on these findings, the diagnosis of haemolyticâ-uremic syndrome was made...
July 14, 2017: BMJ Case Reports
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