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Troponin ultra sensitive

Bernhard M Kaess, Tonia de Las Heras Gala, Astrid Zierer, Christa Meisinger, Simone Wahl, Annette Peters, John Todd, Christian Herder, Cornelia Huth, Barbara Thorand, Wolfgang Koenig
Troponins are sensitive markers of myocardial injury and predictive of cardiovascular events, but conventional assays fail to detect slightly elevated troponins in a considerable proportion of the general population. Using a novel ultrasensitive assay, we explored the relationship of troponin levels with the incidence of coronary heart disease (CHD) in a case-cohort sample (mean age 52.5 ± 0.2 years, 51.5% women) comprising 803 CHD cases and 1942 non-cases. Ultrasensitive troponin I was detectable in 99...
June 5, 2017: European Journal of Epidemiology
Xue-Miao Tang, Hao Chen, Yu Liu, Bin-Lian Huang, Xiu-Quan Zhang, Jian-Mei Yuan, Xia He
The cardiac safety of cetuximab, particularly as single approach, has not been investigated extensively. This trial was designed to evaluate the cardiac safety of cetuximab as salvage monotherapy in Chinese chemotherapy-refractory metastatic colorectal cancer (mCRC) patients.Cetuximab was administrated at an initial dose of 400 mg/mon day 1 (week 1), followed by a maintenance dose of 250 mg/m on day 1 of each 7-day cycle. Electrocardiograph (ECG), routine laboratory tests, and troponin I (TNI) Ultra were performed at baseline, during, and after the cetuximab therapy...
January 2017: Medicine (Baltimore)
Simon A Mahler, Jason P Stopyra, Fred S Apple, Robert F Riley, Gregory B Russell, Brian C Hiestand, James W Hoekstra, Cedric W Lefebvre, Bret A Nicks, David M Cline, Kim L Askew, David M Herrington, Gregory L Burke, Chadwick D Miller
OBJECTIVES: The HEART Pathway combines a decision aid and serial contemporary cardiac troponin I (cTnI) measures to achieve >99% sensitivity for major adverse cardiac events (MACE) at 30days and early discharge rates >20%. However, the impact of integrating high-sensitivity troponin (hs-cTn) measures into the HEART Pathway has yet to be determined. In this analysis we compare test characteristics of the HEART Pathway using hs-cTnI, hs-cTnT, or cTnI. DESIGN & METHODS: A secondary analysis of participants enrolled in the HEART Pathway RCT was conducted...
May 2017: Clinical Biochemistry
Deepika Bhatnagar, Inderpreet Kaur, Ashok Kumar
An ultrasensitive cardiac troponin I antibody conjugated with graphene quantum dots (GQD) and polyamidoamine (PAMAM) nanohybrid modified gold electrode based sensor was developed for the rapid detection of heart attack (myocardial infarction) in human. Screen printed gold (Au) electrode was decorated with 4-aminothiophenol for amine functionalization of the Au surface. These amino groups were further coupled with carboxyl functionalities of GQD with EDC-NHS reaction. In order to enhance the sensitivity of the sensor, PAMAM dendrimer was successively embedded on GQD through carbodiimide coupling to provide ultra-high surface area for antibody immobilization...
February 2017: International Journal of Biological Macromolecules
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 covariate...
February 2017: American Journal of Medicine
William J Reagan, Robert Barnes, Peter Harris, Sandy Summers, Sarah Lopes, Makeida Stubbs, David Blackwell, Jill Steidl-Nichols
Limited information has been published on the use of cardiac troponin I (cTnI) as a biomarker of cardiac injury in monkeys. The purpose of these studies was to characterize the cTnI response seen in cynomolgus macaques during routine dosing and blood collection procedures typically used in preclinical safety studies and to better understand the pathogenesis of this response. We measured cTnI using two different methods, the Siemens Immulite cTnI assay and the more sensitive Siemens Troponin I-Ultra assay. We were able to demonstrate that after oral, subcutaneous, or intravenous dosing of common vehicles, as well as serial chair restraint for venipuncture blood collection, that minimal to mild transient increases in cTnI could be detected in monkeys with both assays...
February 2017: Toxicologic Pathology
S Badiou, A Boudet, H Leray-Moragues, A Rodriguez, A S Bargnoux, A M Dupuy, J P Cristol
PURPOSE OF RESEARCH: Circulating cardiac troponin (cTn) has been identified as a risk factor for cardiovascular and overall mortality in patients undergoing hemodialysis. However, its interpretation remains difficult due to the high prevalence of patients with cTn level beyond the 99th percentile. Determining the cTn reference change value (RCV) may help in assessing a clinically significant change of cTn during regular follow-up of patients. We aimed to determine the long-term RCV of cTn in such patients and to calculate the perdialytic reduction rate of cTn...
October 2016: Clinical Biochemistry
Richard Body, Christian Mueller, Evangelos Giannitsis, Michael Christ, Jorge Ordonez-Llanos, Christopher R de Filippi, Richard Nowak, Mauro Panteghini, Tomas Jernberg, Mario Plebani, Franck Verschuren, John K French, Robert Christenson, Silvia Weiser, Garnet Bendig, Peter Dilba, Bertil Lindahl
BACKGROUND: Recent single-center and retrospective studies suggest that acute myocardial infarction (AMI) could be immediately excluded without serial sampling in patients with initial high-sensitivity cardiac troponin T (hs-cTnT) levels below the limit of detection (LoD) of the assay and no electrocardiogram (ECG) ischemia. OBJECTIVE: We aimed to determine the external validity of those findings in a multicenter study at 12 sites in nine countries. METHODS: TRAPID-AMI was a prospective diagnostic cohort study including patients with suspected cardiac chest pain within 6 hours of peak symptoms...
September 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Shahram Taheri, Ali Asghar Pilehvarian, Nafiseh Akbari, Samane Musavi, Afsoon Emami Naeini
OBJECTIVE: Patients on hemodialysis (HD) have a high risk for cardiovascular morbidity and mortality. Cardiac troponins are biomarkers for diagnosing acute myocardial injury or infarction. There is considerable controversy that exists in the frequency and significance of cardiac troponins in predicting cardiac injury and ischemia in HD patients. METHODS: In this cross-sectional study, all HD patients more than 18-year-old, who were at least 3 months under HD, and had no sign and symptom of active cardiovascular disease (CVD), in two HD centers were enrolled...
April 2016: Journal of Research in Pharmacy Practice
Aldo Clerico, Andrea Ripoli, Silvia Masotti, Concetta Prontera, Simona Storti, Antonio Fortunato, Paola Buzzi, Ivo Casagranda, Maria Franzini, Rudina Ndreu, Gian Carlo Zucchelli, Martina Zaninotto, Mario Plebani
BACKGROUND: The aim of this study is to evaluate whether it is possible to reduce the between-methods variability of troponin I (cTnI) immunoassays using mathematical algorithms calculated from the results of both patients' samples and quality control materials distributed in an external quality assessment (EQA) scheme. METHODS: We collected 122 heparinized plasma samples of patients admitted to the emergency department with thoracic pain or supraventricular tachyarrhythmia...
May 1, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
Fabrizio Ricci, Rosa Di Scala, Cristiano Massacesi, Marta Di Nicola, Gianni Cremonese, Doranna De Pace, Serena Rossi, Irma Griffo, Ivana Cataldo, Stefano Martinotti, Domenico Rotondo, Allan S Jaffe, Marco Zimarino, Raffaele De Caterina
OBJECTIVES: We tested the noninferiority of a fast-track rule-out protocol for the diagnosis of non-ST-segment elevation myocardial infarction vs noncoronary chest pain based on the single-sampling combined assessment of medium-sensitivity cardiac troponin I and ultra-sensitive copeptin compared with the serial assessment of medium-sensitivity cardiac troponin I. METHODS: Ultra-sensitive copeptin and medium-sensitivity cardiac troponin I levels were measured at presentation in 196 consecutive patients admitted to the emergency department for acute nontraumatic chest pain within 6 hours from symptoms onset and without ST-segment elevation on a 12-lead electrocardiogram...
January 2016: American Journal of Medicine
Affan Irfan, Tobias Reichlin, Raphael Twerenbold, Clarissa Fischer, Paola Ballarino, Berit Nelles, Karin Wildi, Christa Zellweger, Maria Rubini Gimenez, Mira Mueller, Philip Haaf, Andreas Fischer, Heike Freidank, Stefan Osswald, Christian Mueller
OBJECTIVE: We explored whether hemodynamic cardiac stress leads to a differential release of cardiomyocyte injury biomarkers, used in the diagnosis of acute myocardial infarction (AMI). METHODS: In an observational international multicenter study, we enrolled 831 unselected patients presenting with symptoms suggestive of AMI to the emergency department. The final diagnosis was adjudicated by two independent cardiologists. Hemodynamic cardiac stress was quantified by levels of B-type natriuretic peptide (BNP)...
December 2015: Clinical Biochemistry
Nazia Parveen, K N Subhakumari, Sajitha Krishnan
In recent years, an important objective of cardiovascular research has been to find new markers that would improve the risk stratification and diagnosis of patients presenting with symptoms of acute coronary syndrome (ACS). Established biomarkers for diagnosis of ACS includes troponins and creatine kinase MB (CK-MB). Pregnancy associated plasma protein A (PAPP-A) is an emerging marker which has been described as a marker of plaque instability. PAPP-A is a large metalloproteinase involved in insulin-like growth factor signaling and has been shown to be involved in pathological processes like atherosclerosis...
April 2015: Indian Journal of Clinical Biochemistry: IJCB
Richard Body, Gillian Burrows, Simon Carley, Philip S Lewis
OBJECTIVE: With a high-sensitivity troponin assay, it may be possible to exclude acute myocardial infarction with a single blood test on arrival in the emergency department by using a novel 'rule out' cut-off set at the limit of detection of the assay. We aimed to determine whether this can also be achieved using a contemporary sensitive troponin assay that does not meet 'high-sensitivity' criteria. METHODS: In a prospective diagnostic cohort study, we included patients presenting to the emergency department with suspected cardiac chest pain...
September 2015: Annals of Clinical Biochemistry
Anne-Maree Kelly, Sharon Klim
BACKGROUND: Recently there have been efforts to derive safe, efficient processes to rule out acute coronary syndrome (ACS) in emergency department (ED) chest pain patients. We aimed to prospectively validate an ACS assessment pathway (the 2-Hour Accelerated Diagnostic Protocol to Assess Patients with Chest Pain Symptoms Using Contemporary Troponins as the Only Biomarker (ADAPT) pathway) under pragmatic ED working conditions. METHODS: This prospective cohort study included patients with atraumatic chest pain in whom ACS was suspected but who did not have clear evidence of ischaemia on ECG...
2014: International Journal of Emergency Medicine
Thomas W Barrett, Nandhinee Radha Shanmugam, Anjan Panneer Selvam, Steven C Kazmierczak, Shalini Prasad
BACKGROUND: Troponin is the preferred biomarker for diagnosing myocardial infarction. Point of care devices have not matched the sensitivity of laboratory-based methods for measuring troponin. The Nanomonitor is a novel point-of-care device that uses the change in electrical impedance that occurs when a biomarker binds to its antibody, which is then correlated to the concentration of the target biomarker. METHODS: Performance characteristics of the Nanomonitor were evaluated and compared to a standard laboratory-based method...
March 10, 2015: Clinica Chimica Acta; International Journal of Clinical Chemistry
Innam Lee, Xiliang Luo, Jiyong Huang, Xinyan Tracy Cui, Minhee Yun
The detection of myoglobin (Myo), cardiac troponin I (cTnI), creatine kinase-MB (CK-MB), and b-type natriuretic peptide (BNP) plays a vital role in diagnosing cardiovascular diseases. Here we present single site-specific polyaniline (PANI) nanowire biosensors that can detect cardiac biomarkers such as Myo, cTnI, CK-MB, and BNP with ultra-high sensitivity and good specificity. Using single PANI nanowire-based biosensors integrated with microfluidic channels, very low concentrations of Myo (100 pg/mL), cTnI (250 fg/mL), CK-MB (150 fg/mL), and BNP (50 fg/mL) were detected...
2012: Biosensors
Anne-Maree Kelly, Sharon Klim
AIM: Recent evidence suggests that an undetectable troponin level at emergency department (ED) presentation can rule out the presence of myocardial infarction (MI) in low-risk patients. The aim of this study was to investigate whether an undetectable troponin I (TnI) level at presentation using a contemporary troponin assay can accurately rule out MI at various front-door thrombolysis in myocardial infarction (fTIMI) score cut-offs. METHODS: Planned substudy of a prospective observational cohort study of patients presenting to ED with chest pain without ECG evidence of ischaemia who underwent a 'rule out' acute coronary syndrome process...
October 2015: Emergency Medicine Journal: EMJ
Marc P Bonaca, Ryan G O'Malley, Sabina A Murphy, Petr Jarolim, Michael J Conrad, Eugene Braunwald, Marc S Sabatine, David A Morrow
BACKGROUND: Newer troponin assays offer the ability to quantify circulating troponin levels at an order of magnitude lower than contemporary assays, fueling continued debate over the prognostic implications of very low-level increases in concentration. We evaluated the prognostic implications of low-level increases in cardiac troponin I (cTnI) using an investigational single-molecule high-sensitivity assay in patients with acute coronary syndrome (ACS). METHODS: We measured cTnI using both a high-sensitivity troponin I (hsTnI) assay (Erenna, Singulex, 99(th) percentile 9 pg/ml) and a current generation sensitive assay (TnI-Ultra, Siemens, 99(th) percentile 40 pg/ml) at baseline in 1807 patients with non-ST elevation ACS and compared their prognostic ability for adverse cardiovascular events at 30 days and one year...
October 2015: European Heart Journal. Acute Cardiovascular Care
Renate B Schnabel, Philipp S Wild, Sandra Wilde, Francisco M Ojeda, Andreas Schulz, Tanja Zeller, Christoph R Sinning, Jan Kunde, Karl J Lackner, Thomas Munzel, Stefan Blankenberg
BACKGROUND: Different biological pathways have been related to atrial fibrillation (AF). Novel biomarkers capturing inflammation, oxidative stress, and neurohumoral activation have not been investigated comprehensively in AF. METHODS AND RESULTS: In the population-based Gutenberg Health Study (n = 5000), mean age 56 ± 11 years, 51% males, we measured ten biomarkers representing inflammation (C-reactive protein, fibrinogen), cardiac and vascular function (midregional pro adrenomedullin [MR-proADM], midregional pro atrial natriuretic peptide [MR-proANP], N-terminal pro-B-type natriuretic peptide [Nt-proBNP], sensitive troponin I ultra [TnI ultra], copeptin, and C-terminal pro endothelin-1), and oxidative stress (glutathioneperoxidase-1, myeloperoxidase) in relation to manifest AF (n = 161 cases)...
2014: PloS One
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