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https://www.readbyqxmd.com/read/28626102/-effects-of-dexmedetomidine-on-perioperative-cardiac-adverse-events-in-elderly-patients-with-%C3%A2-coronary-heart-disease
#1
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
#2
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
#3
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
#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/28457177/high-sensitivity-cardiac-troponin-assays-from-improved-analytical-performance-to-enhanced-risk-stratification
#5
Marek Kozinski, Magdalena Krintus, Jacek Kubica, Grazyna Sypniewska
Implementation of cardiac troponin (cTn) assays has revolutionized the diagnosis, risk stratification, triage and management of patients with suspected myocardial infarction (MI). The Universal Definition of MI brought about a shift in the diagnostics of MI, from an approach primarily based on electrocardiography (ECG) to one primarily based on biomarkers. Currently, detection of a rise and/or fall in concentration or activity of myocardial necrosis biomarkers, preferentially cTns, with at least one value above the 99th percentile upper reference limit (URL), is the essential component for the diagnosis of MI...
May 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/28397478/point-of-care-cardiac-troponin-assay-analytical-performances-for-their-use-in-clinical-routine
#6
Anne M Dupuy, Solenne Baillet, Richard Dumont, Isabelle Giraud, Stephanie Badiou, Anne S Bargnoux, Nils Kuster, Francois Roubille, Jean Paul Cristol
BACKGROUND: We report the analytical and clinical performances of the Alere Triage Cardiac3© Panel on the Triage MeterPro© instrument, comparing concordance with hs-cTnT results from central laboratory above the respective 99th percentiles and determining the clinical sensitivity within the framework of AMI. METHODS: The concordance was obtained with these two methods among unselected patients admitted to both the emergency and cardiology departments. RESULTS: The LoD of the assay is 0...
April 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28392226/the-relationship-of-plasma-creatinine-as-egfr-and-high-sensitivity-cardiac-troponin-and-nt-probnp-concentrations-in-a-hospital-and-community-outpatient-population
#7
Julia M Potter, Aaron J Simpson, Jennifer Kerrigan, Emma Southcott, Marie M Salib, Gus Koerbin, Peter E Hickman
OBJECTIVES: While persons with overt renal failure have a well-described rise in troponin and NT-proBNP, it is less well described what the relationship is between cardiac markers and persons with impaired renal function, not requiring dialysis. DESIGN & METHODS: We have collected ALL samples referred to our pathology practice over a 24h period and measured hs-cTnI, hs-cTnT, NT-proBNP, calculated the eGFR, and related our measurements to clinical outcomes. RESULTS: For both men and women, for all of hs-cTnI, hs-cTnT and NT-proBNP, there was a graded response, as renal function worsened, the concentration of the cardiac marker increased...
April 6, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28383401/establishment-of-a-reference-interval-for-high-sensitivity-cardiac-troponin-i-in-healthy-adults-from-the-sichuan-area
#8
Shunjun Li, Yue Zuo, Wenfang Huang
High-sensitivity cardiac troponin I (hs-cTnI) has been used in the diagnosis and risk stratification of acute myocardial infarction. However, there is no common consensus on an hs-cTnI reference interval for the Chinese population. The aim of this study was to describe the distribution of hs-TnI and establish the 99th percentile reference interval for hs-cTnI in healthy adults from the Sichuan area.Serum specimens were collected from 1485 healthy adults (731 men and 754 women ranging in age from 18 to 85 years) in Sichuan Provincial People's Hospital...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28347675/equal-clinical-performance-of-a-novel-point-of-care-cardiac-troponin-i-ctni-assay-with-a-commonly-used-high-sensitivity-ctni-assay
#9
Per Venge, Lian van Lippen, Sabine Blaschke, Michael Christ, Felicitas Geier, Evangelos Giannitsis, Emil Hagström, Pierre Hausfater, Mehdi Khellaf, Johannes Mair, David Pariente, Volkher Scharnhorst, Veronique Semjonow
BACKGROUND: Efficient rule-out of acute myocardial infarction (MI) facilitates early disposition of chest pain patients in emergency departments (ED). Point-of-care (POC) cardiac troponin (cTn) may improve patient throughput. We compared the diagnostic accuracy of a novel cTnI test (Minicare cTnI, Philips), with current POC cTnI (I-Stat, Abbott) and high-sensitivity central laboratory cTnI (hs-cTnI; Architect, Abbott) assays. METHODS: The clinical performance of the assays were compared in samples from 450 patients from a previous clinical evaluation of Minicare cTnI...
March 25, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28344141/single-high-sensitivity-cardiac-troponin-i-to-rule-out-acute-myocardial-infarction
#10
Yader Sandoval, Stephen W Smith, Sara A Love, Anne Sexter, Karen Schulz, Fred S Apple
BACKGROUND: This study examined the performance of single high-sensitivity cardiac troponin I (hs-cTnI) measurement strategies to rule out acute myocardial infarction. METHODS: This was a prospective, observational study of consecutive patients presenting to the emergency department (n = 1631) in whom cTnI measurements were obtained using an investigational hs-cTnI assay. The goals of the study were to determine 1) negative predictive value (NPV) and sensitivity for the diagnosis of acute myocardial infarction, type 1 myocardial infarction, and type 2 myocardial infarction; and 2) safety outcome of acute myocardial infarction or cardiac death at 30 days using hs-cTnI less than the limit of detection (LoD) (<1...
March 24, 2017: American Journal of Medicine
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
#11
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...
June 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28330661/association-between-high-sensitivity-cardiac-troponin-levels-and-myocardial-ischemia-during-mental-stress-and-conventional-stress
#12
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/28283497/direct-comparison-of-four-very-early-rule-out-strategies-for-acute-myocardial-infarction-using-high-sensitivity-cardiac-troponin-i
#13
Jasper Boeddinghaus, Thomas Nestelberger, Raphael Twerenbold, Karin Wildi, Patrick Badertscher, Janosch Cupa, Tobias Bürge, Patrick Mächler, Sydney Corbière, Karin Grimm, Maria Rubini Giménez, Christian Puelacher, Samyut Shrestha, Dayana Flores Widmer, Jakob Fuhrmann, Petra Hillinger, Zaid Sabti, Ursina Honegger, Nicolas Schaerli, Nikola Kozhuharov, Katharina Rentsch, Òscar Miró, Beatriz López Barbeito, F Javier Martin-Sanchez, Esther Rodriguez-Adrada, Beata Morawiec, Damian Kawecki, Eva Ganovská, Jiri Parenica, Jens Lohrmann, Wanda Kloos, Andreas Buser, Nicolas Geigy, Dagmar I Keller, Stefan Osswald, Tobias Reichlin, Christian Müller
Background -Four strategies for very early rule-out of acute myocardial infarction (AMI) using high-sensitivity cardiac troponin I (hs-cTnI) have been identified. It remains unclear which strategy is most attractive for clinical application. Methods -We prospectively enrolled unselected patients presenting to the emergency department (ED) with symptoms suggestive of AMI. The final diagnosis was adjudicated by two independent cardiologists. Hs-cTnI levels were measured at presentation and after 1h in a blinded fashion...
March 10, 2017: Circulation
https://www.readbyqxmd.com/read/28263716/statistical-considerations-for-determining-high-sensitivity-cardiac-troponin-reference-intervals
#14
Peter E Hickman, Gus Koerbin, Julia M Potter, Walter P Abhayaratna
The troponin 99th percentile is used as the laboratory decision point in the diagnosis of acute myocardial infarction. A recent publication has shown that the statistical treatment for outlier removal may dramatically change the calculated troponin 99th percentile. We have used our large database from the previously reported Canberra Heart Study to independently assess the effect of various methods for removing outliers on the calculated 99th percentile. We have performed the same exercise using the troponin 97...
June 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28213568/estimated-glomerular-filtration-rate-and-albuminuria-are-associated-with-biomarkers-of-cardiac-injury-in-a-population-based-cohort-study-the-maastricht-study
#15
Remy J H Martens, Dorien M Kimenai, Jeroen P Kooman, Coen D A Stehouwer, Frans E S Tan, Otto Bekers, Pieter C Dagnelie, Carla J H van der Kallen, Abraham A Kroon, Karel M L Leunissen, Frank M van der Sande, Nicolaas C Schaper, Simone J S Sep, Miranda T Schram, Jeroen D van Suijlen, Marja P van Dieijen-Visser, Steven J R Meex, Ronald M A Henry
BACKGROUND: Chronic kidney disease (CKD) is associated with an increased cardiovascular disease mortality risk. It is, however, less clear at what point in the course from normal kidney function to CKD the association with cardiovascular disease appears. Studying the associations of estimated glomerular filtration rate (eGFR) and albuminuria with biomarkers of (subclinical) cardiac injury in a population without substantial CKD may clarify this issue. METHODS: We examined the cross-sectional associations of eGFR and urinary albumin excretion (UAE) with high-sensitivity cardiac troponin (hs-cTn) T, hs-cTnI, and N-terminal probrain natriuretic-peptide (NT-proBNP) in 3103 individuals from a population-based diabetes-enriched cohort study...
April 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28150185/early-diagnosis-of-acute-myocardial-infarction-in-patients-with-mild-elevations-of-cardiac-troponin
#16
Jasper Boeddinghaus, Tobias Reichlin, Thomas Nestelberger, Raphael Twerenbold, Yvette Meili, Karin Wildi, Petra Hillinger, Maria Rubini Giménez, Janosch Cupa, Lukas Schumacher, Marie Schubera, Patrick Badertscher, Sydney Corbière, Karin Grimm, Christian Puelacher, Zaid Sabti, Dayana Flores Widmer, Nicolas Schaerli, Nikola Kozhuharov, Samyut Shrestha, Tobias Bürge, Patrick Mächler, Michael Büchi, Katharina Rentsch, Òscar Miró, Beatriz López, F Javier Martin-Sanchez, Esther Rodriguez-Adrada, Beata Morawiec, Damian Kawecki, Eva Ganovská, Jiri Parenica, Jens Lohrmann, Andreas Buser, Dagmar I Keller, Stefan Osswald, Christian Mueller
BACKGROUND: The early diagnosis of acute myocardial infarction (AMI) in patients with mild elevations of high-sensitivity cardiac troponin (hs-cTn) is a challenge. It is unclear whether copeptin, a marker of endogenous stress, or 1h-hs-cTn changes are better suited to address this important unmet clinical need. METHODS: We prospectively enrolled patients presenting with symptoms suggestive of AMI to the emergency department (ED). Two independent cardiologists adjudicated the final diagnosis...
February 1, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28087371/use-of-the-heart-pathway-with-high-sensitivity-cardiac-troponins-a-secondary-analysis
#17
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/28062631/rule-in-and-rule-out-of-myocardial-infarction-using-cardiac-troponin-and-glycemic-biomarkers-in-patients-with-symptoms-suggestive-of-acute-coronary-syndrome
#18
MULTICENTER STUDY
Colleen Shortt, Jinhui Ma, Natasha Clayton, Jonathan Sherbino, Richard Whitlock, Guillaume Pare, Stephen A Hill, Matthew McQueen, Shamir R Mehta, P J Devereaux, Andrew Worster, Peter A Kavsak
BACKGROUND: Early rule-in/rule-out of myocardial infarction (MI) in patients presenting to the emergency department (ED) is important for patient care and resource allocation. Given that dysglycemia is a strong risk factor for MI, we sought to explore and compare different combinations of cardiac troponin (cTn) cutoffs with glycemic markers for the early rule-in/rule-out of MI. METHODS: We included ED patients (n = 1137) with symptoms suggestive of acute coronary syndrome (ACS) who had cTnI, high-sensitivity cTnI (hs-cTnI), hs-cTnT, glucose, and hemoglobin A1c (Hb A1c) measurements...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28062627/association-of-repeatedly-measured-high-sensitivity-assayed-troponin-i-with-cardiovascular-disease-events-in-a-general-population-from-the-morgam-biomarcare-study
#19
Maria F Hughes, Francisco Ojeda, Olli Saarela, Torben Jørgensen, Tanja Zeller, Tarja Palosaari, Mark G O'Doherty, Anders Borglykke, Kari Kuulasmaa, Stefan Blankenberg, Frank Kee
BACKGROUND: High-sensitivity troponin I (hs-cTnI) concentrations reflect myocardial stress. The role of hs-cTnI in predicting long-term changes in the risk of cardiovascular disease (CVD) in general populations is not clearly defined. METHODS: We investigated whether the change in 3 repeated measures of hs-cTnI collected 5 years apart in a prospective Danish study (3875 participants, initially aged 30-60 years, 51% female, disease free at baseline) improves 10-year prediction of incident CVD compared to using a single most recent hs-cTnI measurement...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28062612/cardiac-troponin-assays-guide-to-understanding-analytical-characteristics-and-their-impact-on-clinical-care
#20
REVIEW
Fred S Apple, Yader Sandoval, Allan S Jaffe, Jordi Ordonez-Llanos
BACKGROUND: Cardiac troponin I (cTnI) and cardiac troponin T (cTnT) determinations are fixtures in clinical practice and research. Cardiac troponin testing has been the standard of practice for the diagnosis of acute myocardial infarction (AMI), early rule-out, risk stratification, and outcomes assessment in patients presenting with acute coronary syndrome (ACS) and non-ACS myocardial injury. We recognize from reading the literature over the past several years how poorly understood the analytical characteristics are for cTnI and cTnT assays by laboratorians, clinicians, and scientists who use these assays...
January 2017: Clinical Chemistry
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