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Highly sensitive troponin

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https://www.readbyqxmd.com/read/28528430/risk-classification-of-highly-sensitive-troponin-i-predict-presence-of-vulnerable-plaque-assessed-by-dual-source-coronary-computed-tomography-angiography
#1
Ting Liu, Guan Wang, Peiling Li, Xu Dai
Patients presenting to the emergency department with acute chest pain, negative conventional troponin and electrocardiogram require serial testing to rule out acute coronary syndrome (ACS). We studied the association of highly sensitive troponin (hsTn) I with vulnerable plaque features as detected by coronary dual source computed tomography angiography (DSCTA) and determined whether hsTn I at the time of presentation combined with early DSCTA could improve classification of patients as high-risk or low risk for ACS...
May 20, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28528401/cardiovascular-disease-biomarkers-are-associated-with-declining-renal-function-in-type-2-diabetes
#2
Sara J Jenks, Bryan R Conway, Stela McLachlan, Wei Leng Teoh, Rachel M Williamson, David J Webb, Paul Welsh, Naveed Sattar, Mark W J Strachan, Jackie F Price
AIMS/HYPOTHESIS: We investigated whether biochemical cardiovascular risk factors and/or markers of subclinical cardiovascular disease were associated with the development of reduced renal function in people with type 2 diabetes. METHODS: A cohort of 1066 Scottish men and women aged 60-74 years with type 2 diabetes from the Edinburgh Type 2 Diabetes Study were followed up for a median of 6.7 years. New-onset reduced renal function was defined as two eGFRs <60 ml(-1) min(-1) (1...
May 20, 2017: Diabetologia
https://www.readbyqxmd.com/read/28515820/arterial-velocity-pulse-index-as-a-novel-marker-of-atherosclerosis-using-pulse-wave-analysis-on-high-sensitivity-troponin-t-in-hypertensive-patients
#3
Takashi Hitsumoto
BACKGROUND: The arterial velocity pulse index (AVI) is explored as a novel marker of atherosclerosis using pulse wave analysis in clinical settings. Recent clinical studies have reported that the level of high-sensitivity troponin T (hs-cTnT) is an important biomarker in hypertensive patients. The aim of this study was to clarify the impact of AVI on hs-cTnT in these patients. METHODS: This study enrolled 455 hypertensive outpatients (181 males and 274 females; mean age, 65 ± 11 years (mean ± standard deviation)) without a history of cardiovascular events...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28515106/direct-comparison-of-2-rule-out-strategies-for-acute-myocardial-infarction-2-h-accelerated-diagnostic-protocol-vs-2-h-algorithm
#4
Karin Wildi, Louise Cullen, Raphael Twerenbold, Jaimi H Greenslade, William Parsonage, Jasper Boeddinghaus, Thomas Nestelberger, Zaid Sabti, Maria Rubini-Giménez, Christian Puelacher, Janosch Cupa, Lukas Schumacher, Patrick Badertscher, Karin Grimm, Nikola Kozhuharov, Claudia Stelzig, Michael Freese, Katharina Rentsch, Jens Lohrmann, Wanda Kloos, Andreas Buser, Tobias Reichlin, John Pickering, Martin Than, Christian Mueller
BACKGROUND: We compared 2 high-sensitivity cardiac troponin (hs-cTn)-based 2-h strategies in patients presenting with suspected acute myocardial infarction (AMI) to the emergency department (ED): the 2-h accelerated diagnostic protocol (2h-ADP) combining hs-cTn, electrocardiogram, and a risk score, and the 2-h algorithm exclusively based on hs-cTn concentrations and their absolute changes. METHODS: Analyses were performed in 2 independent diagnostic cohorts [European Advantageous Predictors of Acute Coronary Syndrome Evaluation (APACE) study, Australian-New Zealand 2-h Accelerated Diagnostic Protocol to Assess patients with chest Pain symptoms using contemporary Troponins as the only biomarker (ADAPT) study] employing hs-cTnT (Elecsys) and hs-cTnI (Architect)...
May 17, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28511772/transcoronary-concentration-gradient-of-microrna-133a-and-outcome-in-patients-with-coronary-artery-disease
#5
Roberta De Rosa, Salvatore De Rosa, David Leistner, Jes-Niels Boeckel, Till Keller, Stephan Fichtlscherer, Stefanie Dimmeler, Andreas M Zeiher
Circulating levels of microRNA (miR)-133a are increased in patients with coronary atherosclerotic disease (CAD). Whether the cardiac release of this miR provides any prognostic information in patients with CAD is currently unknown. We aimed to investigate if changes in concentration of miR-133a trough the coronary circulation may be associated with patients' cardiovascular outcome. We enrolled 111 patients (82 with stable CAD and 29 with acute coronary syndromes [ACS]) who underwent coronary angiography. Circulating levels of miR-133a were measured across the transcoronary circulation...
April 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28509704/effectiveness-of-2-hour-troponin-in-high-risk-patients-with-suspected-acute-coronary-syndrome
#6
Joseph Bove, Steven Hochman, Jacob Miller, Stephen Artim
BACKGROUND: Research has shown the safety and effectiveness of drawing a standard troponin level at presentation and again at 2 hours in only low-risk patients. Because high-sensitivity troponins are not currently approved in the United States, we studied the utility of a standard troponin that is presently in use. Our goal was to determine if 2-hour standard troponin would be safe and effective in the evaluation of a high-risk cohort of patients never studied previously. METHODS: We conducted a single-center prospective observational study of adult patients presenting to the emergency department with signs and symptoms suggestive of acute coronary syndrome...
June 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28500753/a-0h-1h-protocol-for-safe-early-discharge-of-chest-pain-patients
#7
Arash Mokhtari, Bertil Lindahl, Alexandru Schiopu, Troels Yndigegn, Ardavan Khoshnood, Patrik Gilje, Ulf Ekelund
OBJECTIVES: Guidelines recommend a 0h/1h high-sensitivity cardiac troponin T (hs-cTnT) diagnostic strategy in acute chest pain patients. There is however little data on the performance of this strategy when combined with clinical risk stratification. We aimed to evaluate the diagnostic accuracy of an accelerated diagnostic protocol (ADP) using the 0h/1h hs-cTnT strategy together with an adapted Thrombolysis In Myocardial Infarction (TIMI) score and ECG for ruling out major adverse cardiac events (MACE) within 30 days...
May 13, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28500730/comparative-prognostic-value-of-postprocedural-creatine-kinase-myocardial-band-and-high-sensitivity-troponin-t-in-patients-with-non-st-segment-elevation-myocardial-infarction-undergoing-percutaneous-coronary-intervention
#8
Gjin Ndrepepa, Roisin Colleran, Siegmund Braun, Erion Xhepa, Julia Hieber, Salvatore Cassese, Massimiliano Fusaro, Sebastian Kufner, Karl-Ludwig Laugwitz, Heribert Schunkert, Adnan Kastrati
OBJECTIVES: We aimed to assess the prognostic value of postprocedural creatine kinase myocardial band (CK-MB) and cardiac troponin (cTn) in patients with non-ST-segment elevation myocardial infarction (NSTEMI). BACKGROUND: Whether postprocedural CK-MB or cTn is a better biomarker to stratify the risk after percutaneous coronary intervention (PCI) remains unknown. METHODS: This study included 2,077 patients with NSTEMI undergoing early PCI...
May 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28499665/persistent-t-wave-inversion-predicts-myocardial-damage-after-st-elevation-myocardial-infarction
#9
Martin Reindl, Sebastian Johannes Reinstadler, Hans-Josef Feistritzer, Lea Niess, Constantin Koch, Agnes Mayr, Gert Klug, Bernhard Metzler
BACKGROUND: Persistent T-wave inversion (PTI) after ST-elevation myocardial infarction (STEMI) is associated with worse clinical outcome; however, the underlying mechanism between PTI and poor prognosis is incompletely understood. We sought to investigate the relationship between PTI and myocardial damage assessed by cardiac magnetic resonance (CMR) following STEMI. METHODS: In this prospective observational study, we included 142 consecutive revascularized STEMI patients...
May 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28497398/early-markers-of-myocardial-ischemia-from-the-experimental-model-to-forensic-pathology-cases-of-sudden-cardiac-death
#10
Sara Sabatasso, Milena Moretti, Patrice Mangin, Tony Fracasso
The goal of this study was to assess whether early markers of myocardial ischemia, identified in a previous experimental work, can be applied in forensic pathology cases of sudden, ischemic cardiac death. These markers include desphosphorylated connexin 43 (Cx43), JunB, TUNEL assay, myoglobin, and troponin T. Fourteen cases of sudden cardiac death with gross and/or histological signs of myocardial infarction and 14 cases of sudden cardiac death with signs of early ischemia at histology and positive immunoreactions for fibronectin and C5b-9 were investigated...
May 11, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28494192/prooxidant-antioxidant-balance-hstni-and-hscrp-mortality-prediction-in-haemodialysis-patients-two-year-follow-up
#11
Tanja Antunovic, Aleksandra Stefanovic, Najdana Gligorovic Barhanovic, Milica Miljkovic, Danilo Radunovic, Jasmina Ivanisevic, Vladimir Prelevic, Nebojsa Bulatovic, Marina Ratkovic, Marina Stojanov
Oxidative stress and inflammation are highly intertwined pathophysiological processes. We analyzed the markers of these processes and high-sensitive troponin I (hsTnI) for mortality prediction in patients on haemodialysis. This study enrolled a total of 62 patients on regular haemodialysis. The patients were monitored for two years, and the observed outcomes were all-cause and cardiovascular mortality. Blood samples were taken before one dialysis session for analysis of the baseline concentrations of prooxidant-antioxidant balance (PAB), total antioxidant status (TAS), total oxidative status (TOS), hsTnI, hsCRP and resistin...
November 2017: Renal Failure
https://www.readbyqxmd.com/read/28493232/anthracycline-induced-cardiotoxicity-biomarkers-and-omics-technology-in-the-era-of-patient-specific-care
#12
REVIEW
Shayan Moazeni, Martin Cadeiras, Eric H Yang, Mario C Deng, Kim-Lien Nguyen
Anthracyclines are highly effective against a variety of malignancies. However, their dose-dependent cardiotoxic effects can potentially limit their use. In the past decade, serum biomarkers have been used to diagnose, monitor, predict, and prognosticate disease. Biomarkers such as cardiac troponin and natriuretic peptides have some predictive value, but still lack reliability in this patient population. Novel biomarkers such as galectin-3, soluble ST-2 proteins, myeloperoxidase, and fibrocytes are being explored as potential biomarkers to reliably predict the onset of cardiotoxicity...
December 2017: Clinical and Translational Medicine
https://www.readbyqxmd.com/read/28491088/novel-biomarkers-for-cardiovascular-risk-prediction
#13
REVIEW
Juan Wang, Guo-Juan Tan, Li-Na Han, Yong-Yi Bai, Miao He, Hong-Bin Liu
Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. The primary prevention of CVD is dependent upon the ability to identify high-risk individuals long before the development of overt events. This highlights the need for accurate risk stratification. An increasing number of novel biomarkers have been identified to predict cardiovascular events. Biomarkers play a critical role in the definition, prognostication, and decision-making regarding the management of cardiovascular events...
February 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28486646/altered-preoperative-coagulation-and-fibrinolysis-are-associated-with-myocardial-injury-after-non-cardiac-surgery
#14
J Górka, K Polok, T Iwaniec, K Górka, A Wludarczyk, J Fronczek, P J Devereaux, J W Eikelboom, J Musial, W Szczeklik
Background: Myocardial injury after non-cardiac surgery (MINS), a complication with unclear pathogenesis, occurs within the first 30 days after surgery and worsens prognosis. Hypercoagulability induced by surgery might contribute to plaque rupture, with subsequent thrombosis and myocardial injury. This study assessed haemostatic markers before surgery and evaluated their association with MINS. Methods: This is a substudy of VISION, a prospective cohort study of perioperative cardiovascular events...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28485179/what-to-do-when-you-question-cardiac-troponin-values
#15
Johannes Mair, Bertil Lindahl, Christian Müller, Evangelos Giannitsis, Kurt Huber, Martin Möckel, Mario Plebani, Kristian Thygesen, Allan S Jaffe
High-sensitivity cardiac troponin assays enable cardiac troponin measurement with a high degree of analytical sensitivity and a low level of analytical imprecision at the low measuring range. One of the most important advantages of these new assays is that they allow novel, more rapid approaches for ruling in or ruling out acute myocardial infarctions. The increase in the early diagnostic sensitivity of high-sensitivity cardiac troponin assays comes at the cost of a reduced acute myocardial infarction specificity of the biomarker, because more patients with other causes of acute or chronic myocardial injury without overt myocardial ischaemia are detected than with previous cardiac troponin assays...
May 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28482356/heart-type-fatty-acid-binding-protein-after-ultramarathon-running-and-relationship-with-high-sensitivity-troponin-i
#16
Giuseppe Lippi, Mariella Dipalo, Rosalia Aloe, Gian Luca Salvagno, Federico Schena
No abstract text is available yet for this article.
December 2016: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28475274/remote-ischaemic-preconditioning-for-coronary-artery-bypass-grafting-with-or-without-valve-surgery
#17
REVIEW
Carina Benstoem, Christian Stoppe, Oliver J Liakopoulos, Julia Ney, Dirk Hasenclever, Patrick Meybohm, Andreas Goetzenich
BACKGROUND: Despite substantial improvements in myocardial preservation strategies, coronary artery bypass grafting (CABG) is still associated with severe complications. It has been reported that remote ischaemic preconditioning (RIPC) reduces reperfusion injury in people undergoing cardiac surgery and improves clinical outcome. However, there is a lack of synthesised information and a need to review the current evidence from randomised controlled trials (RCTs). OBJECTIVES: To assess the benefits and harms of remote ischaemic preconditioning in people undergoing coronary artery bypass grafting, with or without valve surgery...
May 5, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28466882/asia-pacific-consensus-statement-on-the-optimal-use-of-high-sensitivity-troponin-assays-in-acute-coronary-syndromes-diagnosis-focus-on-hs-tni
#18
COMMENT
Jack Wei Chieh Tan, Carolyn S P Lam, Sazzli Shahlan Kasim, Tar Choon Aw, Joel M Abanilla, Wei-Ting Chang, Van Phuoc Dang, Maria Iboleon-Dy, Sari Sri Mumpuni, Arintaya Phommintikul, Manh Cuong Ta, Punkiat Topipat, Kai Hang Yiu, Louise Cullen
OBJECTIVE: High-sensitivity troponin (hs-Tn) assays need to be applied appropriately to improve diagnosis and patient outcomes in acute coronary syndromes (ACS). METHODS: Experts from Asia Pacific convened in 2015 to provide data-driven consensus-based, region-specific recommendations and develop an algorithm for the appropriate incorporation of this assay into the ACS assessment and treatment pathway. RESULTS: Nine recommendations were developed by the expert panel: (1) troponin is the preferred cardiac biomarker for diagnostic assessment of ACS and is indicated for patients with symptoms of possible ACS; (2) hs-Tn assays are recommended; (3) serial testing is required for all patients; (4) testing should be performed at presentation and 3 hours later; (5) gender-specific cut-off values should be used for hs-Tn I assays; (6) hs-Tn I level >10 times the upper limit of normal should be considered to 'rule in' a diagnosis of ACS; (7) dynamic change >50% in hs-Tn I level from presentation to 3-hour retest identifies patients at high risk for ACS; (8) where only point-of-care testing is available, patients with elevated readings should be considered at high risk, while patients with low/undetectable readings should be retested after 6 hours or sent for laboratory testing and (9) regular education on the appropriate use of troponin tests is essential...
2017: Heart Asia
https://www.readbyqxmd.com/read/28462952/high-sensitivity-cardiac-troponin-i-assays-in-the-diagnosis-of-acute-myocardial-infarction
#19
EDITORIAL
Andrew R Chapman, David E Newby, Nicholas L Mills
No abstract text is available yet for this article.
2017: Heart Asia
https://www.readbyqxmd.com/read/28462739/improving-early-exclusion-of-acute-coronary-syndrome-in-primary-care-the-added-value-of-point-of-care-troponin-as-stated-by-general-practitioners
#20
Michelle M A Kip, Amber M Noltes, Hendrik Koffijberg, Maarten J IJzerman, Ron Kusters
Aim To investigate general practitioners' (GPs') desire and perceived added value of point-of-care (POC) troponin, its effect on referral decisions, and test requirements. BACKGROUND: Excluding acute coronary syndrome (ACS) in primary care remains a diagnostic challenges for GPs. Consequently, referral rates of chest pain patients are high, while the incidence of a cardiovascular problem is only 8-15%. Previous studies have shown that GPs are interested in a POC troponin test. This test could enhance rapid exclusion of ACS, thereby preventing unnecessary patient distress, without compromising safety and while reducing costs...
May 2, 2017: Primary Health Care Research & Development
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