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Peter A Kavsak, Paul Malinowski, Chantele Roy, Lorna Clark, Shana Lamers
BACKGROUND: Analytical evaluation of high-sensitivity cardiac troponin (hs-cTn) assays, with particular attention to imprecision, interferences and matrix effects, at normal cTn concentrations, is of utmost importance as many different clinical algorithms use concentration cutoffs <10 ng/L for decision-making. The objective for the present analytical study was to compare the new Beckman Coulter hs-cTnI assay (Access hsTnI) to Abbott's hs-cTnI assay in different matrices and for different interferences, with a focus on concentrations <10 ng/L...
March 13, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
Ásthildur Árnadóttir, Kirstine Roll Vestergaard, Jannik Pallisgaard, György Sölétormos, Rolf Steffensen, Jens P Goetze, Kasper Iversen
BACKGROUND: Differences in prevalence and prognostic information of cardiac troponin T (cTnT) and I (cTnI) concentrations in patients without acute coronary syndrome (ACS) are insufficiently investigated. High-sensitivity assays (hs-cTn) have led to an increased interest in hs-cTn for risk stratification. Here, we compare hs-cTnT and hs-cTnI in prediction of mortality patients without ACS. METHOD AND RESULTS: Patients aged >18 years, consecutively admitted to an emergency department (ED) were included...
February 4, 2018: International Journal of Cardiology
Kasper Glerup Lauridsen, Anders Sjørslev Schmidt, Kasper Adelborg, Leif Bach, Nete Hornung, Simon Munkesø Jepsen, Charles D Deakin, Hans Rickers, Bo Løfgren
Oxygen has long been assumed beneficial for all ill and injured patients. However, hyperoxia may be harmful and aggravate myocardial injury such as that caused by myocardial infarction. We aimed to investigate if hyperoxia increases myocardial injury following direct current cardioversion compared with room air. METHODS: Patients undergoing elective biphasic cardioversion for atrial fibrillation or atrial flutter were randomized to receive room air or oxygen (10-15 L/min) during the procedure...
February 2018: American Heart Journal
Jaimi Greenslade, Elizabeth Cho, Christopher Van Hise, Tracey Hawkins, William Parsonage, Jacobus Ungerer, Jillian Tate, Carel Pretorius, Martin Than, Louise Cullen
BACKGROUND: Low concentrations of cardiac troponin (cTn) have been recommended for rapid rule-out of acute myocardial infarction (AMI). We examined the Beckman Coulter Access high-sensitivity cardiac troponin I (hs-cTnI) assay to identify a single test threshold that can safely rule out AMI. METHODS: This analysis used stored samples collected in 2 prospective observational studies. In all, 1871 patients presenting to a tertiary emergency department with symptoms of acute coronary syndrome had blood taken for measurement of cTnI on presentation...
February 1, 2018: Clinical Chemistry
Hyun Suk Yang, Mina Hur, Ahram Yi, Hanah Kim, Jayoun Kim
BACKGROUND: The prognostic utility of cardiac biomarkers, high-sensitivity cardiac troponin I (hs-cTnI) and soluble suppression of tumorigenicity-2 (sST2), in non-cardiac surgery is not well-defined. We evaluated hs-cTnI and sST2 as predictors of 30-day major adverse cardiac events (MACE) in patients admitted to the surgical intensive care unit (SICU) following major non-cardiac surgery. METHODS: hs-cTnI and sST2 concentrations were measured in 175 SICU patients immediately following surgery and for three days postoperatively...
May 2018: Annals of Laboratory Medicine
Anne R Bass, Jackie D Szymonifka, Matthew T Rondina, Margaret Bogardus, Mitchell G Scott, Scott C Woller, Scott M Stevens, Charles Eby, Kerri Merritt, Alejandro Gonzalez Della Valle, Gerard Moskowitz, Eva Flores, Brian F Gage
Background: Orthopedic patients are at risk for adverse postoperative cardiovascular outcomes. Questions/Purposes: This pilot randomized controlled trial (RCT) of atorvastatin vs. placebo in orthopedic surgery patients was performed in order to assess: (1) the prevalence of perioperative myocardial injury; (2) the effect of atorvastatin on perioperative inflammation; and (3) the feasibility of performing a large RCT of statin therapy in orthopedic patients. Methods: Hip fracture (hip Fx) and total hip and knee replacement (THR and TKR) patients were randomized 1:1 to atorvastatin 40 mg daily vs...
February 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Jos F Frencken, Dirk W Donker, Cristian Spitoni, Marlies E Koster-Brouwer, Ivo W Soliman, David S Y Ong, Janneke Horn, Tom van der Poll, Wilton A van Klei, Marc J M Bonten, Olaf L Cremer
BACKGROUND: Sepsis is frequently complicated by the release of cardiac troponin, but the clinical significance of this myocardial injury remains unclear. We studied the associations between troponin release during sepsis and 1-year outcomes. METHODS AND RESULTS: We enrolled consecutive patients with sepsis in 2 Dutch intensive care units between 2011 and 2013. Subjects with a clinically apparent cause of troponin release were excluded. High-sensitivity cardiac troponin I (hs-cTnI) concentration in plasma was measured daily during the first 4 intensive care unit days, and multivariable Cox regression analysis was used to model its association with 1-year mortality while adjusting for confounding...
February 2018: Circulation. Cardiovascular Quality and Outcomes
Tomonori Sugiura, Yasuaki Dohi, Hiroyuki Takase, Atsushi Ito, Satoshi Fujii, Nobuyuki Ohte
BACKGROUND AND AIMS: Severe cardiac load increases circulating concentrations of high-sensitivity cardiac troponin I (hs-cTnI) through non-ischemic mechanisms. The present study was designed to investigate the effect of central blood pressure (BP), which reflects cardiac load rather than peripheral BP, on serum concentrations of hs-cTnI in subjects with or without increased arterial stiffness. METHODS: We enrolled 1210 participants taking part in a yearly health checkup program...
January 16, 2018: Atherosclerosis
Peter A Kavsak, Andrew Worster, Colleen Shortt, Jinhui Ma, Natasha Clayton, Jonathan Sherbino, Stephen A Hill, Matthew McQueen, Lauren E Griffith, Shamir R Mehta, Andrew D McRae, P J Devereaux
BACKGROUND: Clinicians regularly observe increased high-sensitivity cardiac troponin (hs-cTn) concentrations in patients with low estimated glomerular filtration rate (eGFR). The challenge is to differentiate acute coronary syndrome (ACS) from increased hs-cTn results across a range of eGFR. We determined the optimal hs-cTn concentrations for acute myocardial infarction (MI) and a composite cardiovascular outcome across different eGFR ranges and to assess the utility of a low hs-cTn cutoff to rule-out events...
January 20, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
Øyvind Skadberg, Øyunn Kleiven, Stein Ørn, Magnus F Bjørkavoll-Bergseth, Tor H Melberg, Torbjørn Omland, Kristin M Aakre
BACKGROUND: The aim of this study was to investigate troponin (cTn) dynamics for both genders, compared the different release patterns to the gender specific 99th percentile and to current biomarker criteria for diagnosing myocardial infarction (MI). METHODS: Serum was collected from 97 recreational cyclists 24 h before and immediately, 3 and 24 h following a 91-km bike race. hs-cTnI (Abbott) and hs-cTnT (Roche) were measured. Conventional or CT coronary angiography was performed in the 13 participants with the highest hs-cTnI (>140 ng/L)...
January 20, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
Patrick Badertscher, Jasper Boeddinghaus, Thomas Nestelberger, Raphael Twerenbold, Karin Wildi, Zaid Sabti, Christian Puelacher, Maria Rubini Giménez, Julian Pfäffli, Dayana Flores, Jeanne du Fay de Lavallaz, Òscar Miró, F Javier Martin-Sanchez, Beata Morawiec, Jens Lohrmann, Andreas Buser, Dagmar I Keller, Nicolas Geigy, Tobias Reichlin, Christian Mueller
BACKGROUND: There is concern that high-sensitivity cardiac troponin (hs-cTn) may have low diagnostic accuracy in patients with low acute coronary syndrome (ACS) probability. METHODS: We prospectively stratified patients presenting with acute chest discomfort to the emergency department (ED) into 3 groups according to their probability for ACS as assessed by the treating ED physician using a visual analog scale-≤10%, 11% to 79%, and ≥80%-reviewing all information available at 90 min...
January 17, 2018: Clinical Chemistry
Jonathan D W Evans, Stephen J H Dobbin, Stephen J Pettit, Emanuele Di Angelantonio, Peter Willeit
OBJECTIVES: The aim of this study was to systematically collate and appraise the available evidence regarding the association between high-sensitivity cardiac troponin (hs-cTn) and incident heart failure (HF) and the added value of hs-cTn in HF prediction. BACKGROUND: Identification of subjects at high risk for HF and early risk factor modification with medications such as angiotensin-converting enzyme inhibitors may delay the onset of HF. Hs-cTn has been suggested as a prognostic marker for the incidence of first-ever HF in asymptomatic subjects...
January 3, 2018: JACC. Heart Failure
Luciano Consuegra-Sánchez, Juan José Martínez-Díaz, Luis García de Guadiana-Romualdo, Samantha Wasniewski, Patricia Esteban-Torrella, Francisco Guillermo Clavel-Ruipérez, Alfredo Bardají, Juan Antonio Castillo-Moreno, Juan Carlos Kaski
BACKGROUND: The distinction of type 1 and type 2 myocardial infarction (MI) is of major clinical importance. Our aim was to evaluate the diagnostic ability of absolute and relative conventional cardiac troponin I (cTnI) and high-sensitivity cardiac troponin T (hs-cTnT) in the distinction between type 1 and type 2 MI in patients presenting at the emergency department with non-ST-segment elevation acute chest pain within the first 12 h. METHODS: We measured cTnI (Dimension Vista) and hs-cTnT (Cobas e601) concentrations at presentation and after 4 h in 200 patients presenting with suspected acute MI...
January 5, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
Jungchan Park, Seung Hwa Lee, Sangbin Han, Ki Yoon Kim, Go Eun Kim, Myungsoo Park, Suk-Koo Lee, Gyu-Seong Choi, Soohyun Ahn, Hyeon Seon Ahn, Gaab Soo Kim
BACKGROUND: This study aimed to evaluate risk factors and postoperative clinical outcome associated with myocardial injury detected by an elevated high-sensitivity cardiac troponin I (hs-cTnI) immediately after living donor liver transplantation (LDLT). METHODS: Between January 2011 and December 2016, 313 adult recipients undergoing LDLT, with normal preoperative hs-cTnI were selected. Hs-cTnI level above 0.04 ng/mL according to 99th percentile reference limit was defined as myocardial injury...
January 2, 2018: Transplantation
Qiang Su, Lang Li, Jinmin Zhao, Yuhan Sun, Huafeng Yang
Objective: Post-percutaneous coronary intervention (PCI) myocardial injury is related to the CD4+ T lymphocyte-mediated inflammatory response. microRNA-21 expression is associated with CD4+ T lymphocyte activation. The pre-PCI use of trimetazidine prevents periprocedural myocardial injury and reduces inflammatory cytokine levels. This study aimed to assess the effects of trimetazidine on periprocedural microRNA-21 expression by CD4+ T lymphocytes in patients with unstable angina pectoris...
December 1, 2017: Oncotarget
Shirjel R Alam, Colin Stirrat, Nick Spath, Vipin Zamvar, Renzo Pessotto, Marc R Dweck, Colin Moore, Scott Semple, Ahmed El-Medany, Divya Manoharan, Nicholas L Mills, Anoop Shah, Saeed Mirsadraee, David E Newby, Peter A Henriksen
BACKGROUND: Myocardial inflammation and injury occur during coronary artery bypass graft (CABG) surgery. We aimed to characterise these processes during routine CABG surgery to inform the diagnosis of type 5 myocardial infarction. METHODS: We assessed 87 patients with stable coronary artery disease who underwent elective CABG surgery. Myocardial inflammation, injury and infarction were assessed using plasma inflammatory biomarkers, high-sensitivity cardiac troponin I (hs-cTnI) and cardiac magnetic resonance imaging (CMR) using both late gadolinium enhancement (LGE) and ultrasmall superparamagnetic particles of iron oxide (USPIO)...
December 16, 2017: Journal of Cardiothoracic Surgery
Jaimi H Greenslade, Kimberly Chung, William A Parsonage, Tracey Hawkins, Martin Than, John W Pickering, Louise Cullen
OBJECTIVE: To develop a modified Thrombolysis in Myocardial Infarction (TIMI) score to effectively risk stratify patients presenting to the ED with chest pain. METHODS: A prospective observational study was conducted at two metropolitan EDs. Data were obtained during patient interview. The primary outcome was major adverse cardiovascular events (MACE) within 30 days of presentation. Two separate modifications of the TIMI score were developed. These scores were compared to the original TIMI in terms of the area under the receiver operating characteristic curve and diagnostic accuracy statistics (sensitivity, specificity, positive and negative predictive values)...
February 2018: Emergency Medicine Australasia: EMA
Aitor Alquézar-Arbé, Alessandro Sionis, Jorge Ordoñez-Llanos
Twenty-five years ago, non-isotopic immunoassays for measuring the cardiac specific isoforms of troponin I (cTnI) and T (cTnT) were developed. Both biomarkers radically changed the diagnosis, prognosis, and therapy indication of acute coronary syndromes (ACS) and, particularly, of myocardial infarction (MI). However, cardiac troponins (cTn) rapidly demonstrated their usefulness in other cardiac and non-cardiac conditions, a part of the ischemic coronary diseases. Consequently, the number of patients to be tested for cTn and the number of tests requested to clinical laboratories sharply increased...
November 2017: Critical Reviews in Clinical Laboratory Sciences
Margot Egger, Benjamin Dieplinger, Thomas Mueller
BACKGROUND: We assessed the long-term in vitro stability of cardiac troponins and galectin-3 under different storage conditions. METHODS: We used high-sensitivity cardiac troponin I (hs-cTnI) and galectin-3 assays from Abbott and a high-sensitivity cardiac troponin T (hs-cTnT) assay from Roche. The analyte concentrations of 30 patients were measured in heparin-treated plasma, EDTA-treated plasma and serum samples after the following storage conditions: 1) samples used immediately after blood collection for baseline measurements; 2) samples stored for 0...
January 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
Henning Jansen, Andrea Jänsch, Lutz P Breitling, Liesa Hoppe, Dhayana Dallmeier, Roman Schmucker, Hermann Brenner, Wolfgang Koenig, Dietrich Rothenbacher
BACKGROUND: High-sensitivity Troponins (hs-cTnT and hs-cTnI) are established biomarkers to identify patients with an acute myocardial infarction. However, data comparing the capacity of these two subtypes in predicting recurrent cardiovascular disease (CVD) events in a population with stable coronary heart disease (CHD) after adjustment for several other modern biomarkers are lacking. METHODS: We measured both troponins at baseline in 1068 CHD patients, followed them for 13years, assessed a combined CVD endpoint, and adjusted for multiple traditional and novel risk factors...
January 1, 2018: International Journal of Cardiology
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