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Troponin Sensitive Diagnosis

Mehrshad Vafaie, Evangelos Giannitsis, Matthias Mueller-Hennessen, Moritz Biener, Elena Makarenko, Buelent Yueksel, Hugo A Katus, Kiril M Stoyanov
AIMS: Elevated levels of high-sensitivity cardiac troponin T (hsTnT) are associated with adverse outcomes in numerous patient populations. Their value in prediction of stroke risk in patients with atrial fibrillation (AF) is in debate. METHODS: The study population included 2898 consecutive patients presenting with AF to the emergency department of the Department of Cardiology, Heidelberg University Hospital. Associations between hsTnT and stroke risk were assessed using multivariable Cox regression...
2019: PloS One
James McCord, Lindsey Aurora, Bertil Lindahl, Evangelos Giannitsis, Carlos Calle-Muller, Richard Nowak, Richard Body, Michael Christ, Christopher R deFilippi, Robert H Christenson, Gordon Jacobsen, Aitor Alquezar, Mauro Panteghini, Dina Melki, Mario Plebani, Franck Verschuren, John French, Garnet Bendig, Silvia Weiser, Christian Mueller
The TRAPID-AMI (High Sensitivity Cardiac Troponin T assay for rapid Rule-out of Acute Myocardial Infarction) study evaluated a rapid "rule-out" acute myocardial infarction (AMI). We evaluated what symptoms were associated with AMI as part of a substudy of TRAPID-AMI. There were 1282 patients evaluated from 12 centers in Europe, the United States of America, and Australia from 2011 to 2013. Multiple symptom variables were prospectively obtained and evaluated for association with the final diagnosis of AMI...
March 2019: Critical Pathways in Cardiology
Carolyn S P Lam, Rafael Castillo, Dung Thuong Ho, Ravi R Kasliwal, Rohit Khurana, Sudhir Naik, Torbjørn Omland, William Anthony Parsonage, Arintaya Phrommintikul, Daniel Tobing, Kelvin Kai Hang Yiu
Cardiac troponin is a sensitive and specific biomarker for acute myocardial injury and has been used in the diagnosis of acute coronary syndromes, and has emerged as a tool for identifying high risk individuals for primary preventive therapy. Recent evidence has emerged indicating that high-sensitivity cardiac troponin assays, which allow robust detection of very low troponin concentrations, could detect subclinical injury in asymptomatic patients. On 24 March 2018, a group of cardiologists from the Asia Pacific region convened to review the data and discuss the potential utility of high-sensitivity troponin I (hsTnI) in the risk assessment of cardiovascular disease in the general population...
February 1, 2019: International Journal of Cardiology
S Baroni, E Troiani, C Santonocito, G Moretti, C De Luca, M Antenucci, A Urbani
We report a case of a heterophile antibodies interference in a new high-sensitivity troponin commercial immunoassay (cTNIH Siemens), observed in a patient with possible acute coronary syndrome (ACS). The analytical interference was investigated with standard laboratories procedures. The false positive result was found with different troponin methods and kits. We also investigated the protein sequence of cTnl and no sequence variants were detected. The discordance between clinical pictures and high concentration of cTnl, together with the collaboration between clinicians and laboratory staff avoided possible erroneous diagnosis and further invasive investigations to the patient...
February 6, 2019: Clinical Biochemistry
Mir Mohammad Taghi Mortazavi, Jafar Ganjpour Sales, Masoud Nouri-Vaskeh, Masoud Parish, Salar Abdolhosseynzadeh
Background: Cardiac injury is one of the significant perioperative complications in major orthopedic surgeries and its early diagnosis is useful in the reduction of postoperative comorbidity. The cardiac troponin is a sensitive and specific biomarker for detecting this damage. Objectives: The aim of this study was to evaluate the levels of perioperative cardiac troponin I (cTnI) before and after arthroplasty in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA)...
December 2018: Anesthesiology and Pain Medicine
Ithiel J Frame, Parag H Joshi, Caroline Mwangi, Ian Gunsolus, James A De Lemos, Sandeep R Das, Ravi Sarode, Jyoti Balani, Fred S Apple, Alagarraju Muthukumar
Objectives: To investigate biotin interference on three cardiac troponin (cTn) assays and demonstrate a method to overcome biotin interference. Methods: cTn levels were measured in (1) plasma from healthy volunteers on 10-mg daily biotin supplementation mixed with a plasma with known elevated troponin, (2) plasmas with known elevated cTn after mixing in reagent biotin to simulate supplementation, and (3) biotin-spiked plasma specimens pretreated with streptavidin-agarose beads...
February 2, 2019: American Journal of Clinical Pathology
Fangfang Chen, Qiong Wu, Daqian Song, Xinghua Wang, Pinyi Ma, Ying Sun
This work reports immunomagnetic separation technology-assisted surface plasmon resonance (SPR) biosensing for human cardiac troponin-I (cTnI), a well-known diagnostic marker for myocardial damage. Au film modified by Au nanoparticles (AuNPs) and polydopamine (PDA) was employed as the platforms for immobilizing capture antibody (cAb) and SPR sensing. Magnetic immune probe was prepared by attaching detection antibody (dAb) on the surface of Fe3 O4 nanoparticles (Fe3 O4 NPs) coated by PDA for precise capture, magnetic separation and enrichment of target analyte (cTnI) from samples...
January 28, 2019: Colloids and Surfaces. B, Biointerfaces
Martina Di Pietro, Mariella Dipalo, Marco Bruno Luigi Rocchi, Roberta Musa, Paola Avanzini, Cecilia Gnocchi, Maria Chiara Anelli, Rosalia Aloe
BACKGROUND: The detection of an increase and/or decrease of cardiac troponin (cTnI) values, with at least one value above the 99th percentile of the upper reference limit (URL) have a central role in acute myocardial infarction (AMI) diagnosis. The employment of sex specific 99th percentile URLs and High-sensitivity (Hs) assays are recommended. We assessed sex specific 99th percentile URL for Access Hs-cTnI and AccuTnI3+ (Beckman Coulter) using European donor reference population following recent International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) recommendations...
January 31, 2019: Clinica Chimica Acta; International Journal of Clinical Chemistry
Danielle Hof, Arnold von Eckardstein
Nowadays, measurement of cardiac troponins (cTn) in patient plasma is central for diagnosis of patients with acute coronary syndrome (ACS). High-sensitivity (hs) immunoassays have been developed that can very precisely record slightly elevated and rising plasma concentrations of cTn very early after onset of clinical symptoms. Algorithms integrate measurements of hs-cTn at onset of clinical symptoms of acute myocardial infarction (AMI), and 1 or 3 h after onset, to rule-in and rule-out AMI patients. More and more point-of-care (POC) cTn assays conquer the diagnostic market, but thorough clinical validation studies are required before potential implementation of such POC tests into hospital settings...
2019: Methods in Molecular Biology
V N Protasov, O Yu Narusov, A A Skvortsov, D E Protasova, T V Kuznetsova, A A Petrukhina, V P Masenko, S N Tereshchenko
PURPOSE: to study prognostic value of various biomarkers and their combinations in patients who survived decompensation of chronic heart failure. MATERIALS AND METHODS: Patients (n=159) who were hospitalized with diagnosis of heart failure (HF) decompensation were included in a prospective single-center study. Examination on admission and the day of hospital discharge, included measurement of concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity troponin T (hsTnT), copeptin, soluble suppression of tumorigenicity 2 (sST2), kopetin, neutrophil gelatinase-associated lipocalin (NGAL), and galectin-3...
January 31, 2019: Kardiologiia
Lars Michel, Tienush Rassaf, Matthias Totzeck
Progress in cancer therapy over the past decades improved long-term survival but increased cancer therapy-related cardiotoxicity. Many novel treatment options have been implemented with yet incompletely characterized cardiovascular side effects including heart failure, coronary artery disease, arrhythmias, valvular disease, venous thromboembolism and myocarditis. Diagnosis of potential cardiotoxic side effects is essential for an optimal treatment but remains challenging. Cardiac biomarkers troponin and brain natriuretic peptide/N-terminal proBNP (BNP/NT-proBNP) have been extensively studied in heart failure and acute coronary syndromes...
December 2018: Journal of Thoracic Disease
Jong Yoon Kim, Kye Hun Kim, Jae Yeong Cho, Doo Sun Sim, Hyun Ju Yoon, Nam Sik Yoon, Young Joon Hong, Hyung Wook Park, Ju Han Kim, Youngkeun Ahn, Myung Ho Jeong, Jeong Gwan Cho, Jong Chun Park
Background/Aims: The aim of this study was to investigate useful cardiac biomarkers in the differential diagnosis of acute pulmonary embolism (APE) with troponin elevation from acute non-ST elevation myocardial infarction (NSTEMI). Methods: A total of 771 consecutive NSTEMI patients with D-dimer measurements and 90 patients with troponin-I (TnI) elevation out of 233 APE patients were enrolled, and cardiac biomarkers were compared. Results: D-dimer elevation was noted in 382 patients with NSTEMI (49...
January 28, 2019: Korean Journal of Internal Medicine
Wei Yin Lim, T Malathi Thevarajah, Boon Tong Goh, Sook Mei Khor
The early detection of acute myocardial infarction (AMI) upon the onset of chest pain symptoms is crucial for patient survival. However, this detection is challenging, particularly without a persistent elevation of ST-segment reflected in an electrocardiogram or in blood tests. A majority of the available point-of-care testing devices allow accurate and rapid diagnosis of AMI. However, AMI diagnosis is reliable only at intermediate and later stages, with myocardial injury (> 6 h) and MI, based on the expression of specific cardiac biomarkers including troponin I or T (cTnI or cTnT), creatine kinase-MB (CK-MB), and myoglobin...
March 1, 2019: Biosensors & Bioelectronics
Shanshan Wang, Yangyang Zhao, Minmin Wang, Haijuan Li, Muhammad Saqib, Chunhua Ge, Xiangdong Zhang, Yongdong Jin
Electrochemiluminescence (ECL) has been emerged as one of the most important methods for in vitro diagnosis and detec-tion, but it is still limited in sensitivity for ultrasensitive bio-detections. While fast and ultrasensitive detection of biomolecules is critical, especially for the clinical detection of cardiac troponin I (cTnI) for cardiac infarction diagnosis. In this study, an effective tactic was developed to enhance ECL efficiency of the luminol system, by combined use of Co2+-based metal or-ganic frameworks (MOF), zeolitic imidazolate frameworks (ZIF-67) and luminol-capped Ag nanoparticles (luminol-AgNPs)...
January 25, 2019: Analytical Chemistry
S Blankenberg, T Wittlinger, B Nowak, H-J Rupprecht
Elevation of cardiac troponins above the 99th percentile of a healthy reference population is established as a marker for myocardial cell damage and is crucial for the diagnosis of myocardial infarction. In addition, corresponding clinical evidence of acute myocardial ischemia i.e. symptoms, changes in the electrocardiogram (ECG), wall motion abnormalities or suggestive angiographic findings are required for the diagnosis of myocardial infarction. Using modern highly sensitive assays myocardial infarction can be detected more frequently and earlier...
January 24, 2019: Herz
Xiuli Fu, Yunqing Wang, Yongming Liu, Huitao Liu, Longwen Fu, Jiahui Wen, Jingwen Li, Peihai Wei, Lingxin Chen
Cardiac troponin I (cTnI) was considered as the "gold standard" for acute myocardial infarction (AMI) diagnosis owing to its superior cardiac specificity for cardiac damage and showing little or no changes in patients with a skeletal muscle disease or trauma. Herein, a new signal amplification surface-enhanced Raman scattering (SERS) platform was developed for recognition and detection of cTnI by using gold nanoparticles (AuNPs), graphene oxide (GO) and magnetic beads (MB). Here, antibody/Raman reporter labeled AuNP-functionalized GO were employed as both SERS nanotags and signal amplification carriers...
January 22, 2019: Analyst
Muhammad Imran, Louis Wang, Jane McCrohon, Chung Yu, Cameron Holloway, James Otton, Justyn Huang, Christian Stehning, Kirsten Jane Moffat, Joanne Ross, Valentina O Puntmann, Vassilios S Vassiliou, Sanjay Prasad, Eugene Kotlyar, Anne Keogh, Christopher Hayward, Peter Macdonald, Andrew Jabbour
OBJECTIVES: This study aimed to determine the role of T1 mapping in identifying cardiac allograft rejection. BACKGROUND: Endomyocardial biopsy (EMBx), the current gold standard to diagnose cardiac allograft rejection, is associated with potentially serious complications. Cardiac magnetic resonance (CMR)-based T1 mapping detects interstitial edema and fibrosis, which are important markers of acute and chronic rejection. Therefore, T1 mapping can potentially diagnose cardiac allograft rejection noninvasively...
January 9, 2019: JACC. Cardiovascular Imaging
Alina Bisoc, Daniel Ciurescu, Mariana Rădoi, Monica M Tântu, Liliana Rogozea, Alexander J Sweidan, Daniela A Bota
BACKGROUND: Anthracyclines remain the cornerstone of the treatment in many cancers including lymphomas, leukemia and sarcomas, and breast cancer. The cardiomyopathy that develops from anthracyclines can lead to heart failure and decreased survival. Multiple mechanisms are involved in the pathophysiology of anthracycline-induced heart failure. STUDY QUESTION: We hypothesize that anthracycline-induced cardiac (AIC) pathology can be monitored using a panel of blood biomarkers including high-sensitive cardiac troponin T (hs-cTnT) for myocyte necrosis and N-terminal prohormone brain natriuretic peptide (NT-proBNP) for parietal stress...
January 3, 2019: American Journal of Therapeutics
Richard Body, Malak Almashali, Niall Morris, Phil Moss, Heather Jarman, Andrew Appelboam, Richard Parris, Louisa Chan, Alison Walker, Mark Harrison, Andrea Wootten, Garry McDowell
OBJECTIVES: The rapid turnaround time of point-of-care (POC) cardiac troponin (cTn) assays is highly attractive for crowded emergency departments (EDs). We evaluated the diagnostic accuracy of the Troponin-only Manchester Acute Coronary Syndromes (T-MACS) decision aid with a POC cTn assay. METHODS: In a prospective diagnostic accuracy study at eight EDs, we included patients with suspected acute coronary syndromes (ACS). Blood drawn on arrival and 3 hours later was analysed for POC cTnI (i-Stat, Abbott Point of Care)...
January 12, 2019: Heart: Official Journal of the British Cardiac Society
James Cranley, Unni Krishnan, Katharine Tweed, Rudolf Martin Duehmke
A 51-year-old woman with known primary antiphospholipid syndrome presented with a 4-day history of chest and abdominal pain, inferior ST-segment elevation on a 12-lead ECG and a subtherapeutic international normalised ratio. In view of a significantly raised high-sensitivity troponin I assay, inferior wall hypokinesis on transthoracic echocardiography and despite unobstructed epicardial vessels on emergency coronary angiography, a diagnosis of myocardial infarction was made. Furthermore, the patient also developed both bilateral adrenal haemorrhages leading to acute adrenal insufficiency and microvascular thrombotic renal disease concurrently...
January 10, 2019: BMJ Case Reports
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