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https://www.readbyqxmd.com/read/28344141/single-high-sensitivity-cardiac-troponin-i-to-rule-out-acute-myocardial-infarction
#1
Yader Sandoval, Stephen W Smith, Sara A Love, Anne Sexter, Karen Schulz, Fred S Apple
PURPOSE: Examine the performance of single high-sensitivity cardiac troponin I (hs-cTnI) measurement strategies to rule-out acute myocardial infarction. METHODS: Prospective, observational study of consecutive patients presenting to the emergency department (n=1,631) in whom cTnI measurements where obtained using an investigational hs-cTnI assay. Negative predictive value (NPV) and sensitivity for the a) diagnosis of acute myocardial infarction, type 1 myocardial infarction, and type 2 myocardial infarction and b) safety outcome of acute myocardial infarction or cardiac death at 30 days using hs-cTnI less than the limit of detection (LoD) (<1...
March 23, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28343173/fast-track-protocols-using-highly-sensitive-troponin-assays-for-ruling-out-and-ruling-in-non-st-elevation-acute-coronary-syndrome
#2
Simona Ferraro, Alberto Dolci, Mauro Panteghini
The introduction of "highly sensitive" cardiac troponin assays (hsTn) has reinforced the evidence that only serial testing incorporated in running algorithms allows a more accurate diagnosis of acute myocardial infarction. In this report, we consider the available evidence supporting the use of fast track protocols for ruling out and ruling in non-ST elevation myocardial infarction (NSTEMI) and compare it with the content of recently released guideline by the European Society of Cardiology, noting some uncomfortable aspects that need urgent clarification and/or revision...
March 27, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28342713/a-laboratory-score-at-presentation-to-rule-out-serious-cardiac-outcomes-or-death-in-patients-presenting-with-symptoms-suggestive-of-acute-coronary-syndrome
#3
Peter A Kavsak, Colleen Shortt, Jinhui Ma, Natasha Clayton, Jonathan Sherbino, Stephen A Hill, Matthew McQueen, Shamir R Mehta, P J Devereaux, Andrew Worster
BACKGROUND: We evaluated whether a low high-sensitivity cardiac troponin (hs-cTn) cutoff combined with glucose, red cell distribution width (RDW), and the estimated glomerular filtration rate (eGFR) can be used to rule-out a serious cardiac outcome or death in patients presenting with symptoms suggestive of acute coronary syndrome (ACS). METHODS: This was a prospective observational emergency department (ED) study enrolling consecutive patients presenting with symptoms suggestive of ACS (ClinicalTrials...
March 23, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28341782/predictive-properties-of-biomarkers-gdf-15-ntprobnp-and-hs-tnt-on-morbidity-and-mortality-in-type-2-diabetes-patients-with-nephropathy
#4
Arash Bidadkosh, Sebastiaan P H Lambooy, Hiddo J Heerspink, Michelle J Pena, Robert H Henning, Hendrik Buikema, Leo E Deelman
OBJECTIVE: Although type 2 diabetes (T2D) patients with nephropathy are at high risk for renal and cardiovascular complications, relevant biomarkers have been poorly identified. Because renal impairment may increase biomarker levels, this potentially confounds associations between biomarker levels and risk. To investigate the predictive value of a biomarker in such a setting, we examined baseline levels of growth differentiation factor-15 (GDF-15), N-terminal prohormone of B-type natriuretic peptide (NTproBNP), and high-sensitivity troponin-T (hs-TnT) in relation to renal and cardiovascular risk in T2D patients with nephropathy...
March 24, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28333976/early-diagnosis-of-acute-myocardial-infarction-using-high-sensitivity-troponin-i
#5
Johannes Tobias Neumann, Nils Arne Sörensen, Francisco Ojeda, Thomas Renné, Renate B Schnabel, Tanja Zeller, Mahir Karakas, Stefan Blankenberg, Dirk Westermann
OBJECTIVE: There is a clinical need for early and accurate diagnosis of acute myocardial infarction (AMI). Current European Society of Cardiology (ESC) guidelines recommend diagnosis of non-ST-elevation AMI based on serial troponin measurements. We aimed to challenge the ESC guidelines using 1) a high-sensitivity troponin I (hs-TnI) baseline cutoff, 2) an absolute hs-TnI change after 1 hour and 3) additional application of an ischemic ECG. METHODS: 1,516 patients with suspected AMI presenting to the emergency department were included...
2017: PloS One
https://www.readbyqxmd.com/read/28330668/mental-stress-exercise-and-other%C3%A2-determinants-of-elevation-in-high-sensitivity-troponin-levels-a-call-for-standardization-of-laboratory-protocols
#6
EDITORIAL
Alan Rozanski, Chirag Bavishi
No abstract text is available yet for this article.
March 10, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28330661/association-between-high-sensitivity-cardiac-troponin-levels-and-myocardial-ischemia-during-mental-stress-and-conventional-stress
#7
Muhammad Hammadah, Ibhar Al Mheid, Kobina Wilmot, Ronnie Ramadan, Ayman Alkhoder, Malik Obideen, Naser Abdelhadi, Shuyang Fang, Ijeoma Ibeanu, Pratik Pimple, Heval Mohamed Kelli, Amit J Shah, Brad Pearce, Yan Sun, Ernest V Garcia, Michael Kutner, Qi Long, Laura Ward, J Douglas Bremner, Fabio Esteves, Paolo Raggi, David Sheps, Viola Vaccarino, Arshed A Quyyumi
OBJECTIVES: This study sought to investigate whether patients with mental stress-induced myocardial ischemia will have high resting and post-mental stress high-sensitivity cardiac troponin I (hs-cTnI). BACKGROUND: Hs-cTnI is a marker of myocardial necrosis, and its elevated levels are associated with adverse outcomes. Hs-cTnI levels may increase with exercise in patients with coronary artery disease. Mental stress-induced myocardial ischemia is also linked to adverse outcomes...
March 10, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28329906/-the-fabry-s-disease-cardiomyopathy-as-differential-diagnosis-of%C3%A2-acute-coronary-syndrome
#8
Daniel Oder, Stefan Störk, Christoph Wanner, Georg Ertl, Frank Weidemann, Peter Nordbeck
The progressive cardiomyopathy in patients with Fabry disease is often accompanied by angina pectoris and elevated levels of high-sensitive troponin T (hs-TnT), potentially mimicking acute coronary syndrome. Here, we present to representative cases with focus on clinical, diagnostic and therapeutic settings. An overview on the cardiomyopathy associated with Fabry disease and its role as differential diagnosis of acute coronary syndrome is provided. Fabry cardiomyopathy might exhibit similar clinical and biochemical constellations as seen in acute coronary syndrome...
March 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28329361/sex-hormones-affect-outcome-in-arrhythmogenic-right-ventricular-cardiomyopathy-dysplasia-from-a-stem-cell-derived-cardiomyocyte-based-model-to-clinical-biomarkers-of-disease-outcome
#9
Deniz Akdis, Ardan M Saguner, Khooshbu Shah, Chuanyu Wei, Argelia Medeiros-Domingo, Arnold von Eckardstein, Thomas F Lüscher, Corinna Brunckhorst, H S Vincent Chen, Firat Duru
Aims: Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is characterized by fibrofatty infiltration of the myocardium and ventricular arrhythmias that may lead to sudden cardiac death. It has been observed that male patients develop the disease earlier and present with more severe phenotypes as compared to females. Thus, we hypothesized that serum levels of sex hormones may contribute to major arrhythmic cardiovascular events (MACE) in patients with ARVC/D. Methods and results: The serum levels of five sex hormones, sex hormone-binding globulin, high sensitivity troponin T, pro-brain natriuretic peptide, cholesterol, triglycerides, insulin, and glucose were measured in 54 ARVC/D patients (72% male)...
February 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28325612/cost-effectiveness-of-high-sensitivity-troponin-compared-to-conventional-troponin-among-patients-presenting-with-undifferentiated-chest-pain-a-trial-based-analysis
#10
Billingsley Kaambwa, Julie Ratcliffe, Matthew Horsfall, Carolyn Astley, Jonathan Karnon, Penelope Coates, Margaret Arstall, Christopher Zeitz, Matthew Worthley, John Beltrame, Derek P Chew
BACKGROUND: Patients with low and intermediate risk chest pain features comprise the greatest proportion presenting to emergency services for evaluation of suspected acute coronary syndromes (ACS). The efficient and timely identification of patients with these features remains a major challenge within clinical practice. Troponin assays are increasingly being used for the determination of risk among patients presenting with chest pain potentially facilitating more appropriate care. To date, no economic evaluation comparing high-sensitivity troponin T (hs-TnT) reporting to standard troponin T (c-TnT) reporting in the routine management of suspected ACS and based on longer-term clinical outcomes has been conducted...
March 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28325070/methotrexate-therapy-in-st-segment-elevation-myocardial-infarctions
#11
Daniel Medeiros Moreira, Maria Emilia Lueneberg, Roberto Leo da Silva, Tammuz Fattah, Carlos Antonio Mascia Gottschall
PURPOSE: Methotrexate is an anti-inflammatory drug that has been shown to have anti-ischemic effects. Our aim was to evaluate if methotrexate could reduce infarct size in patients with ST-segment elevation myocardial infarction (STEMI). METHODS: We randomly assigned patients with STEMI to receive either methotrexate or placebo. Primary outcome was infarct size determined by calculating the area under the curve (AUC) for creatine kinase (CK) release. Secondary outcomes were AUC of CK MB (CK-MB) and AUC of troponin I; peak CK, peak CK-MB, and troponin I; B-type natriuretic peptide (BNP) level, high-sensitivity C-reactive protein (hsCRP) result, and erythrocyte sedimentation rate (ESR); left ventricular ejection fraction (LVEF); thrombolysis in myocardial infarction (TIMI) frame count; Killip score; mortality and reinfarction incidence; and incidence of adverse reactions...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28323905/elevated-plasma-levels-of-cardiac-troponin-i-predict-left-ventricular-systolic-dysfunction-in-patients-with-myotonic-dystrophy-type-1-a-multicentre-cohort-follow-up-study
#12
Mark J Hamilton, Yvonne Robb, Sarah Cumming, Helen Gregory, Alexis Duncan, Monika Rahman, Anne McKeown, Catherine McWilliam, John Dean, Alison Wilcox, Maria E Farrugia, Anneli Cooper, Josephine McGhie, Berit Adam, Richard Petty, Cheryl Longman, Iain Findlay, Alan Japp, Darren G Monckton, Martin A Denvir
OBJECTIVE: High sensitivity plasma cardiac troponin-I (cTnI) is emerging as a strong predictor of cardiac events in a variety of settings. We have explored its utility in patients with myotonic dystrophy type 1 (DM1). METHODS: 117 patients with DM1 were recruited from routine outpatient clinics across three health boards. A single measurement of cTnI was made using the ARCHITECT STAT Troponin I assay. Demographic, ECG, echocardiographic and other clinical data were obtained from electronic medical records...
2017: PloS One
https://www.readbyqxmd.com/read/28315120/prognostic-biomarkers-in-acute-coronary-syndromes-risk-stratification-beyond-cardiac-troponins
#13
REVIEW
K M Eggers, B Lindahl
PURPOSE OF REVIEW: Cardiac troponin (cTn) plays an essential role for assessment of outcome in acute coronary syndrome (ACS). However, the prognostic value of cTn is not absolute. In this mini-review, we summarize the evidence on the utility of established biomarkers of left-ventricular dysfunction, hemodynamic stress, inflammation, and renal dysfunction for risk prediction beyond cTn in ACS. RECENT FINDINGS: Only few biomarkers consistently demonstrate additive prognostic value to cTn levels...
April 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28314836/safe-heart-rationale-and-design-of-a-pilot-study-investigating-cardiac-safety-of-her2-targeted-therapy-in-patients-with-her2-positive-breast-cancer-and-reduced-left-ventricular-function
#14
Filipa Lynce, Ana Barac, Ming T Tan, Federico M Asch, Karen L Smith, Chau Dang, Claudine Isaacs, Sandra M Swain
BACKGROUND: Human epidermal growth receptor 2 (HER2) targeted therapies have survival benefit in adjuvant and metastatic HER2 positive breast cancer but are associated with cardiac dysfunction. Current U.S. Food and Drug Administration recommendations limit the use of HER2 targeted agents to patients with normal left ventricular (LV) systolic function. METHODS: The objective of the SAFE-HEaRt study is to evaluate the cardiac safety of HER2 targeted therapy in patients with HER2 positive breast cancer and mildly reduced left ventricular ejection fraction (LVEF) with optimized cardiac therapy...
March 17, 2017: Oncologist
https://www.readbyqxmd.com/read/28314141/assay-validation-of-the-cardiac-isoform-of-troponin-i-in-double-crested-cormorant-phalacrocorax-auritus-plasma-for-diagnosis-of-cardiac-damage
#15
Melissa Daigneault, Kendal E Harr, Karen M Dean, Steven J Bursian
Cardiac abnormalities, initially found in Deepwater Horizon weathered MC252 crude oil exposed Double Crested Cormorants (DCCOs) upon gross necropsy, were further investigated using echocardiography. Clinical and statistically significant changes including decreased ventricular myocardial contractility and arrhythmia were elucidated by echocardiography and interpreted by boarded cardiologists as potentially life threatening. The objective of this investigation was to initiate development of an antemortem, sensitive blood screening test for cardiac damage due to oil exposure of avian species...
March 14, 2017: Ecotoxicology and Environmental Safety
https://www.readbyqxmd.com/read/28302319/high-sensitivity-cardiac-troponin-t-and-systemic-right-ventricular-function-in-adults-with-congenitally-corrected-transposition-of-the-great-arteries
#16
Ewa Kowalik, Anna Klisiewicz, Justyna Rybicka, Elżbieta K Biernacka, Piotr Hoffman
BACKGROUND: High sensitive troponin T (hsTnT), a marker of myocardial injury, appears to be a promising diagnostic tool in patients with congenital heart disease. However, little is known about its distribution among adults with systemic right ventricle (sRV). We aimed to assess the distribution of hsTnT concentrations in patients with congenitally corrected transposition of the great arteries (ccTGA) and to evaluate its relationship with sRV function and NT-proBNP. METHODS: A cross-sectional study of adults with ccTGA was conducted...
March 11, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28299447/markers-of-physiological-stress-during-exercise-under-conditions-of-normoxia-normobaric-hypoxia-hypobaric-hypoxia-and-genuine-high-altitude
#17
David Richard Woods, John Paul O'Hara, Christopher John Boos, Peter David Hodkinson, Costas Tsakirides, Neil Edward Hill, Darren Jose, Amanda Hawkins, Kelly Phillipson, Antonia Hazlerigg, Nicola Arjomandkhah, Liam Gallagher, David Holdsworth, Mark Cooke, Nicholas Donald Charles Green, Adrian Mellor
PURPOSE: To investigate whether there is a differential response at rest and following exercise to conditions of genuine high altitude (GHA), normobaric hypoxia (NH), hypobaric hypoxia (HH), and normobaric normoxia (NN). METHOD: Markers of sympathoadrenal and adrenocortical function [plasma normetanephrine (PNORMET), metanephrine (PMET), cortisol], myocardial injury [highly sensitive cardiac troponin T (hscTnT)], and function [N-terminal brain natriuretic peptide (NT-proBNP)] were evaluated at rest and with exercise under NN, at 3375 m in the Alps (GHA) and at equivalent simulated altitude under NH and HH...
March 15, 2017: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/28298397/predictors-of-obstructive-sleep-apnoea-in-patients-admitted-for-acute-coronary-syndrome
#18
Jordi de Batlle, Cecilia Turino, Alicia Sánchez-de-la-Torre, Jorge Abad, Joaquín Duran-Cantolla, R Douglas McEvoy, Nick A Antic, Olga Mediano, Valentín Cabriada, Maria José Masdeu, Joaquín Teran, Joan Valls, Ferran Barbé, Manuel Sánchez-de-la-Torre
Identifying undiagnosed obstructive sleep apnoea (OSA) patients in cardiovascular clinics could improve their management. Aiming to build an OSA predictive model, a broad analysis of clinical variables was performed in a cohort of acute coronary syndrome (ACS) patients.Sociodemographic, anthropometric, life-style and pharmacological variables were recorded. Clinical measures included blood pressure, electrocardiography, echocardiography, blood count, troponin levels and a metabolic panel. OSA was diagnosed using respiratory polygraphy...
March 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28292587/diagnosis-of-perioperative-myocardial-infarction-after-heart-valve-surgery-with-new-cut-off-point-of-high-sensitivity-troponin-t-and-new-electrocardiogram-or-echocardiogram-changes
#19
Héctor Cubero-Gallego, Mario Lorenzo, María Heredia, Itziar Gómez, Eduardo Tamayo
OBJECTIVE: Criteria for diagnosing myocardial infarction (MI) after heart valve surgery are not collected in the Third Universal Definition of MI. We aimed to define cut-offs for high-sensitivity cardiac troponin T (hs-cTnT) and creatine kinase-MB (CK-MB) for the diagnosis of perioperative MI after heart valve surgery according to perioperative MI determined by new alterations in electrocardiogram (ECG) and/or transthoracic echocardiogram (TTE). Secondary endpoints were incidence of perioperative MI, postoperative complications, 30-day mortality, and 2-year survival...
February 14, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28283847/increased-plasma-concentrations-of-soluble-st2-independently-predict-mortality-but-not-cardiovascular-events-in-stable-coronary-heart-disease-patients-13-year-follow-up-of-the-karola-study
#20
Vanessa Pfetsch, Veronika Sanin, Andrea Jaensch, Dhayana Dallmeier, Ute Mons, Hermann Brenner, Wolfgang Koenig, Dietrich Rothenbacher
PURPOSE: sST2 (soluble suppression of tumorigenicity 2), a member of the interleukin-1 family, has been suggested to play a role in cardiac remodeling and inflammatory signaling. We assessed the association between sST2 in patients with stable coronary heart disease (CHD) with multiple cardiovascular outcomes and total mortality, simultaneously controlling for a large number of potential confounders. METHODS: Plasma concentrations of sST2 (ELISA, Critical Diagnostics) were measured at baseline in a cohort of 1081 patients...
March 10, 2017: Cardiovascular Drugs and Therapy
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