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https://www.readbyqxmd.com/read/28923845/high-sensitivity-cardiac-troponin-i-as-a-gatekeeper-for-coronary-computed-tomography-angiography-and-stress-testing-in-patients-with-acute-chest-pain
#1
Maros Ferencik, Thomas Mayrhofer, Michael T Lu, Pamela K Woodard, Quynh A Truong, W Frank Peacock, Fabian Bamberg, Benjamin C Sun, Jerome L Fleg, John T Nagurney, James E Udelson, Wolfgang Koenig, James L Januzzi, Udo Hoffmann
BACKGROUND: Most patients presenting to the emergency department (ED) with suspected acute coronary syndrome (ACS) undergo noninvasive cardiac testing with a low diagnostic yield. We determined whether a combination of high-sensitivity cardiac troponin I (hs-cTnI) and cardiovascular risk factors might improve selection of patients for cardiac testing. METHODS: We included patients from the Rule Out Myocardial Infarction/Ischemia Using Computer Assisted Tomography (ROMICAT) I and II trials who presented to the ED with acute chest pain and were referred for cardiac testing...
September 18, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28920468/annals-express-macrocomplexes-and-discordant-high-sensitivity-cardiac-troponin-concentrations
#2
Pete Kavsak, Chantele Roy, Paul Malinowski, Ching-Tong Mark, Terry Scott, Lorna Clark, Shana Lamers, Craig Ainsworth
BACKGROUND: Analytical comparisons between different high-sensitivity cardiac troponin (hs-cTn) assays are important for reassurance of results performed with different methodologies and to identify potential interferences or confounders to result interpretation. Our objective in the present study was to compare Beckman Coulter's latest hs-cTnI assay to Abbott's hs-cTnI assay and to assess agreement between results. METHODS: Two hundred EDTA plasma samples that had clinically reported hs-cTnI results from the Abbott ARCHITECTi2000 that spanned the analytical range were stored (median=4h), re-centrifuged and retested for hs-cTnI on the Abbott ARCHITECTi1000 and Beckman Coulter Access2 analyzers...
January 1, 2017: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/28904053/cardiovascular-biomarkers-in-hypertensive-patients-with-medical-treatment-results-from-the-randomized-teamsta-protect-i-trial
#3
Annika Jagodzinski, Johannes Tobias Neumann, Francisco Ojeda, Nils Arne Sörensen, Philipp Wild, Thomas Münzel, Tanja Zeller, Dirk Westermann, Stefan Blankenberg
BACKGROUND: High blood pressure (BP) is associated with an increased rate of cardiovascular events and mortality. Cardiovascular biomarkers are able to predict long-term risk in the general population, particularly in diseased cohorts. We undertook an investigation of the effect of 2 different antihypertensive treatments on cardiovascular biomarkers in a randomized trial. METHODS: The TEAMSTA study included 481 hypertensive patients. They were randomized to either 80-mg telmisartan + 5-mg amlodipine (TA) or 40-mg olmesartan + 12...
September 13, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28864718/assessment-of-the-2016-national-institute-for-health-and-care-excellence-high-sensitivity-troponin-rule-out-strategy
#4
Edward Watts Carlton, John William Pickering, Jaimi Greenslade, Louise Cullen, Martin Than, Jason Kendall, Richard Body, William A Parsonage, Ahmed Khattab, Kim Greaves
OBJECTIVE: We aimed to evaluate the limit of detection of high-sensitivity troponin (hs-cTn) and Thrombolysis In Myocardial Infarction (TIMI) score combination rule-out strategy suggested within the 2016 National Institute for Health and Care Excellence (NICE) Chest Pain of Recent Onset guidelines and establish the optimal TIMI score threshold for clinical use. METHODS: A pooled analysis of adult patients presenting to the emergency department with chest pain and a non-ischaemic ECG, recruited into six prospective studies, from Australia, New Zealand and the UK...
September 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28841229/effect-of-vitamin-d-in-the-prevention-of-myocardial-injury-following-elective-percutaneous-coronary-intervention-a-pilot-randomized-clinical-trial
#5
Naser Aslanabadi, Iraj Jafaripor, Selda Sadeghi, Hadi Hamishehkar, Samad Ghaffari, Mehdi Toluey, Hanieh Azizi, Taher Entezari-Maleki
Myocardial injury following elective percutaneous coronary intervention (PCI) occurs in about one-third of patients and is associated with mortality. Platelet aggregation, thrombosis formation, and inflammation are the main causes of cardiac injury during PCI. Vitamin D plays a key role in the cardiovascular system by exerting antiplatelet, anticoagulant, and anti-inflammatory properties. There is no published study that investigated the effect of vitamin D in the prevention of cardiac injury following elective PCI...
August 25, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28826900/identification-of-periprocedural-myocardial-infarction-using-a-high-sensitivity-troponin-i-assay-in-patients-who-underwent-transcatheter-aortic-valve-implantation
#6
Christoph Liebetrau, Won K Kim, Alexander Meyer, Mani Arsalan, Luise Gaede, Johannes M Blumenstein, Ulrich Fischer-Rasokat, Jan S Wolter, Oliver Dörr, Sandra Schillinger, Christian Troidl, Holger M Nef, Christian W Hamm, Thomas Walther, Helge Möllmann
Periprocedural myocardial infarction (MI), a rare complication after transcatheter aortic valve implantation (TAVI), is associated with worse outcome. According to the Valve Academic Research Consortium (VARC-2), MI is defined by an increase in cardiac troponin (cTn) and creatine kinase MB (CK-MB) levels; however, many patients show periprocedurally elevated cTn without clinical evidence of MI. The aims of this study were to establish reference values of cardiac troponin I measured with a high-sensitivity assay (hs-cTnI) and to assess the periprocedural diagnostic value of this biomarker in patients who underwent TAVI...
October 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28808078/relationship-of-kidney-injury-biomarkers-with-long-term-cardiovascular-outcomes-after-cardiac-surgery
#7
Chirag R Parikh, Jeremy Puthumana, Michael G Shlipak, Jay L Koyner, Heather Thiessen-Philbrook, Eric McArthur, Kathleen Kerr, Peter Kavsak, Richard P Whitlock, Amit X Garg, Steven G Coca
Clinical AKI, measured by serum creatinine elevation, is associated with long-term risks of adverse cardiovascular (CV) events and mortality in patients after cardiac surgery. To evaluate the relative contributions of urine kidney injury biomarkers and plasma cardiac injury biomarkers in adverse events, we conducted a multicenter prospective cohort study of 968 adults undergoing cardiac surgery. On postoperative days 1-3, we measured five urine biomarkers of kidney injury (IL-18, NGAL, KIM-1, L-FABP, and albumin) and five plasma biomarkers of cardiac injury (NT-proBNP, H-FABP, hs-cTnT, cTnI, and CK-MB)...
August 14, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28761671/predictors-and-clinical-implication-of-high-sensitivity-cardiac-troponin-i-elevation-following-diagnostic-cardiac-catheterisations
#8
Rikuta Hamaya, Taishi Yonetsu, Tadashi Murai, Yoshihisa Kanaji, Eisuke Usui, Junji Matsuda, Masahiro Hoshino, Makoto Araki, Masahiro Hada, Takayuki Niida, Sadamitsu Ichijo, Yoshinori Kanno, Tsunekazu Kakuta
OBJECTIVES: Although diagnostic coronary angiography (CAG) is performed worldwide, procedure-related myocardial necrosis (PMN) following diagnostic catheter-based procedures has not been well investigated. The aim of this study was to determine clinical and procedural factors associated with PMN, using a high-sensitivity cardiac troponin I (hs-cTnI) assay, and to investigate the clinical implications of PMN. METHODS: Among 697 patients undergoing elective CAG and pre- and post-procedural hs-cTnI (pre-TnI, post-TnI, respectively) measurements, a total of 538 patients (124 female) were evaluated, with 2...
2017: Open Heart
https://www.readbyqxmd.com/read/28757119/low-plasma-testosterone-is-associated-with-elevated-cardiovascular-disease-biomarkers
#9
Alexander W Pastuszak, Taylor P Kohn, Joel Estis, Larry I Lipshultz
BACKGROUND: The relation between testosterone (T) plasma concentration and cardiovascular (CV) risk is unclear, with evidence supporting increased risk in men with low and high T levels. Few studies have assessed CV risk as a function of plasma T levels using objective biomarkers. AIM: To determine the relation between T levels and high-sensitivity CV risk biomarkers. METHODS: Ten thousand forty-one male patients were identified in the database of a commercial clinical laboratory performing biomarker testing...
September 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/28750699/high-sensitivity-cardiac-troponin-concentration-and-risk-of-first-ever%C3%A2-cardiovascular-outcomes-in%C3%A2-154-052-participants
#10
REVIEW
Peter Willeit, Paul Welsh, Jonathan D W Evans, Lena Tschiderer, Charles Boachie, J Wouter Jukema, Ian Ford, Stella Trompet, David J Stott, Patricia M Kearney, Simon P Mooijaart, Stefan Kiechl, Emanuele Di Angelantonio, Naveed Sattar
BACKGROUND: High-sensitivity assays can quantify cardiac troponins I and T (hs-cTnI, hs-cTnT) in individuals with no clinically manifest myocardial injury. OBJECTIVES: The goal of this study was to assess associations of cardiac troponin concentration with cardiovascular disease (CVD) outcomes in primary prevention studies. METHODS: A search was conducted of PubMed, Web of Science, and EMBASE for prospective studies published up to September 2016, reporting on associations of cardiac troponin concentration with first-ever CVD outcomes (i...
August 1, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28747765/troponin-i-and-t-in-relation-to-cardiac-injury-detected-with-electrocardiography-in-a-population-based-cohort-the-maastricht-study
#11
Dorien M Kimenai, Remy J H Martens, Jeroen P Kooman, Coen D A Stehouwer, Frans E S Tan, Nicolaas C Schaper, Pieter C Dagnelie, Miranda T Schram, Carla J H van der Kallen, Simone J S Sep, Jeroen D E van Suijlen, Abraham A Kroon, Otto Bekers, Marja P van Dieijen-Visser, Ronald M A Henry, Steven J R Meex
Interest in high-sensitivity cardiac troponin I(hs-cTnI) and T(hs-cTnT) has expanded from acute cardiac care to cardiovascular disease(CVD) risk stratification. Whether hs-cTnI and hs-cTnT are interchangeable in the ambulant setting is largely unexplored. Cardiac injury is a mechanism that may underlie the associations between troponin levels and mortality in the general population. In the population-based Maastricht Study, we assessed the correlation and concordance between hs-cTnI and hs-cTnT. Multiple regression analyses were conducted to assess the association of hs-cTnI and hs-cTnT with electrocardiographic (ECG) changes indicative of cardiac abnormalities...
July 26, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28739197/type-1-and-2-myocardial-infarction-and-myocardial-injury-clinical-transition-to-high-sensitivity-cardiac-troponin-i
#12
Yader Sandoval, Stephen W Smith, Anne Sexter, Sarah E Thordsen, Charles A Bruen, Michelle D Carlson, Kenneth W Dodd, Brian E Driver, Yan Hu, Katherine Jacoby, Benjamin K Johnson, Sara A Love, Johanna C Moore, Karen Schulz, Nathaniel L Scott, Fred S Apple
BACKGROUND: Studies addressing patients with type 2 myocardial infarction and myocardial injury, including the impact of using high-sensitivity (hs) cardiac troponin (cTn) assays on their incidence are needed. METHODS: Ours is a prospective, observational US cohort study. Consecutive emergency department patients with serial cTnI measurements were studied. Outcomes included 180-day mortality and major adverse cardiac events, including 2-year follow-up for those with myonecrosis...
July 21, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28714526/different-postconditioning-cycles-affect-prognosis-of-aged-patients-undergoing-primary-percutaneous-coronary-intervention
#13
Jie Zhang, Xin Zhang, Yuqi Cui, Misbahul Ferdous, Lianqun Cui, Peng Zhao
BACKGROUND: Postconditioning can affect the infarct size in acute myocardial infarction (AMI). However, few studies show an effect of different postconditioning cycles on AMI aged patients. This study sought to assess the effect of different postconditioning cycles on prognosis in aged patients with AMI who underwent primary percutaneous coronary intervention (PCI). METHODS: 74 aged patients were randomly assigned to three groups. Control group; PC-1 group accepted postconditioning 4 cycles of 30 s inflation and 30 s deflation; PC-2 group accepted postconditioning 4 cycles of 60 s...
July 17, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28701316/diagnostic-performance-of-high-sensitivity-compared-with-contemporary-cardiac-troponin-i-for-the-diagnosis-of-acute-myocardial-infarction
#14
Yader Sandoval, Stephen W Smith, Sarah E Thordsen, Charles A Bruen, Michelle D Carlson, Kenneth W Dodd, Brian E Driver, Katherine Jacoby, Benjamin K Johnson, Sara A Love, Johanna C Moore, Anne Sexter, Karen Schulz, Nathaniel L Scott, Jennifer Nicholson, Fred S Apple
BACKGROUND: We examined the diagnostic performance of high-sensitivity cardiac troponin I (hs-cTnI) vs contemporary cTnI with use of the 99th percentile alone and with a normal electrocardiogram (ECG) to rule out acute myocardial infarction (MI) and serial changes (deltas) to rule in MI. METHODS: We included consecutive patients presenting to a US emergency department with serial cTnI on clinical indication (NCT02060760). Diagnostic performance for acute MI, including MI subtypes, and 30-day outcomes were examined...
July 12, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28668141/high-sensitivity-cardiac-troponin-risk-cutoffs-for-acute-cardiac-outcomes-at-emergency-department-presentation
#15
MULTICENTER STUDY
Peter A Kavsak, Andrew Worster, Jinhui Ma, Colleen Shortt, Natasha Clayton, Jonathan Sherbino, Stephen A Hill, Matthew McQueen, Shamir R Mehta, Philip J Devereaux
The optimal high-sensitivity cardiac troponin (hs-cTn) cutoffs for determining risk in patients who present with acute coronary syndrome symptoms are unknown. In 1137 emergency department patients we calculated adjusted relative risks for a composite outcome (myocardial infarction, unstable angina, heart failure, ventricular arrhythmia, or cardiovascular death) within 7 days for the presentation of hs-cTnT (Roche) and hs-cTnI (Abbott) assay concentrations on the basis of literature cutoffs. Patients with hs-cTn concentrations ≥ 14 ng/L had an adjusted relative risk of 4...
July 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28650717/heart-type-fatty-acid-binding-protein-is-a-sensitive-biomarker-for-early-ami-detection-in-troponin-negative-patients-a-pilot-study
#16
Luisa Agnello, Giulia Bivona, Giuseppina Novo, Concetta Scazzone, Roberto Muratore, Piero Levantino, Chiara Bellia, Bruna Lo Sasso, Marcello Ciaccio
BACKGROUND: Early detecting AMI in individuals presenting to the ED with chest pain continues to be a challenge. cTn is the gold standard for AMI diagnosis but early presenters (<1 hours from symptom onset) maybe cTn negative on admission. We analysed the diagnostic value of h-FABP and hs-TnI in patients presenting to ED with chest pain and no cTnI elevations. METHODS: 28 AMI and 28 no-AMI individuals both presented to ED within one hour from pain onset were included...
June 26, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28626102/-effects-of-dexmedetomidine-on-perioperative-cardiac-adverse-events-in-elderly-patients-with-%C3%A2-coronary-heart-disease
#17
Junmei Shen, Yanjiang Sun, Ding Han, Kangsheng Zhu, Wei Zhao
To investigate the effects of dexmedetomidine on perioperative cardiac adverse events in elderly patients with coronary heart disease.
 Methods: Sixty elderly patients, who were diagnosed as coronary heart disease and underwent gastric cancer operation, were randomly divided into 2 groups (n=30): the dexmedetomidine group (Dex group) and the control group. In the Dex group, dexmedetomidine was administered intravenously at 0.5 μg/(kg·h) after a bolus infusion at 0.5 μg/kg for 10 min before anesthesia induction...
May 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28593872/establishing-consensus-based-assay-specific-99th-percentile-upper-reference-limits-to-facilitate-proper-utilization-of-cardiac-troponin-measurements
#18
Dina N Greene, Jillian R Tate
Implementation of the 99th percentile as the upper reference limit for cardiac troponin (cTn) assays is a seemingly lucid recommendation, but, in reality, is incredibly complex. Lack of harmonization between cTn assays diminishes the ability to have a single medical decision point across manufacturer assay/instruments. Moreover, even within a single cTn assay there are several published values corresponding to the "99th percentile". Variability in the determined value is primarily a function of population selection including: sample size, age, sex, exclusion criteria, and statistical methods...
April 13, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28542299/preoperative-cardiac-troponin-level-is-associated-with-all-cause-mortality-of-liver-transplantation-recipients
#19
Jungchan Park, Seung Hwa Lee, Sangbin Han, Hyun Sook Jee, Suk-Koo Lee, Gyu-Seong Choi, Gaab Soo Kim
This study was aimed to evaluate the association between preoperative high-sensitivity cardiac troponin I (hs-cTnI) level and mortality in patients undergoing liver transplantation (LT). From January 2011 to May 2016, preoperative hs-cTnI level was measured in consecutive 487 patients scheduled for LT. Patients with elevated preoperative hs-cTnI were compared with those who had normal level. The primary outcome was all-cause death in follow-up period of 30 days to 1 year after operation. Of the 487 patients, 58 (11...
2017: PloS One
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
#20
MULTICENTER STUDY
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 W 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)...
July 2017: Clinical Chemistry
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