scholarly journals High-sensitivity cardiac troponin T in young, healthy adults undergoing non-cardiac surgery

2018 ◽  
Vol 120 (2) ◽  
pp. 291-298 ◽  
Author(s):  
A. Duma ◽  
C. Wagner ◽  
M. Titz ◽  
M. Maleczek ◽  
M. Hüpfl ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Healthy Adults ◽  
Cardiac Troponin T

scholarly journals Direct comparison of the accuracy of preoperative high-sensitivity cardiac troponin T to predict mortality, acute heart failure and perioperative myocardial infarction/injury after non-cardiac surgery

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Gualandro ◽  
C Puelacher ◽  
M Liffert ◽  
K Arslani ◽  
R Meister ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Surgery ◽  
Cardiac Troponin ◽  
Good Accuracy ◽  
Independent Predictor ◽  
Troponin T ◽  
High Sensitivity ◽  
Funding Source ◽  
Cardiac Troponin T ◽  
Perioperative Myocardial Infarction

Abstract Background Death, acute heart failure (AHF) and perioperative myocardial infarction/injury (PMI) are the most relevant cardiovascular complications following non-cardiac surgery. Unfortunately, the incidence of these complications are higher than expected. Currently available tools to predict these complications have only modest accuracy. Purpose To determine the accuracy of preoperative high-sensitivity cardiac troponin T (hs-cTnT) concentrations for prediction of mortality, AHF and PMI after non-cardiac surgery. Methods We prospectively included 4,709 patients at high cardiovascular risk undergoing non-cardiac surgery. Hs-cTnT concentrations were measured before surgery and, daily after surgery, for two days. PMI was defined as an absolute increase of 14ng/L (the 99th percentile of the assay used) from hs-cTnT baseline values. The primary endpoint was the diagnostic accuracy of preoperative hs-cTnT concentration to predict death, AHF and PMI within 30 days, as quantified by the area under the receiving-operating curve (AUC). Multivariate logistic regression analysis was performed to test the association between preoperative hs-cTnT and each endpoint. Results All-cause mortality occurred in 133 (3%), AHF in 84 (2%) and PMI in 742 (16%) patients. Preoperative hs-cTnT concentrations had good accuracy for prediction of death, AHF and PMI (AUC = 0.75 [95% CI, 0.71–0.79], 0.72 [95% CI, 0.67–0.77] and 0.73 [95% CI, 0.71–0.75], respectively). After adjusting for confounders, hs-cTnT remained an independent predictor for death with an adjusted odds ratio (aOR) of 2.1 (95% CI, 1.7–2.7, P<0.001) and for PMI (aOR 2.2, 95% CI, 1.9–2.4, P<0.001), but not for AHF (aOR 1.0, 95% CI, 0.7–1.4, P=0.99). An hs-cTnT concentration below 5ng/L was found in 526 (11%) patients, and this cut-off yielded a negative predictive value of 99.6% for the occurrence of death, 99.2% for AHF and 95.6% for PMI. Conclusion The preoperative hs-cTnT concentration has a good accuracy to predict mortality, AHF and PMI after non-cardiac surgery, but is an independent predictor only for mortality and PMI. A cut-off value of 5ng/L identifies a subgroup of patients at low risk for these complications. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Swiss National Foundation, Swiss Herat Foundation

scholarly journals The association between fibrinogen reactivity to mental stress and high-sensitivity cardiac troponin T in healthy adults

2015 ◽  
Vol 59 ◽  
pp. 37-48 ◽  
Author(s):  
Antonio Ivan Lazzarino ◽  
Mark Hamer ◽  
David Gaze ◽  
Paul Collinson ◽  
Ann Rumley ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Mental Stress ◽  
Troponin T ◽  
High Sensitivity ◽  
Healthy Adults ◽  
Cardiac Troponin T

Evaluation of the 0 h/1 h high-sensitivity cardiac troponin T algorithm in diagnosis of non-ST-segment elevation myocardial infarction (NSTEMI) in Han population

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Chen Dongxu ◽  
Zhou Yannan ◽  
Yang Yilin ◽  
Yao Chenling ◽  
Gu Guorong ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
Chinese Han ◽  
Han Population ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Rule Out

Abstract Objectives A rapid 0 h/1 h algorithm using high-sensitivity cardiac troponin T (hs-cTnT) for rule-out and rule-in of non-ST-segment elevation myocardial infarction (NSTEMI) is recommended by the European Society of Cardiology. We aim to prospectively evaluate the diagnostic performance of the algorithm in Chinese Han patients with suspected NSTEMI. Methods In this prospective diagnostic cohort study, 577 patients presenting to the emergency department with suspected NSTEMI and recent (<12 h) onset of symptoms were enrolled. The levels of serum hs-cTnT were measured on admission, 1 h later and 4–14 h later. All patients underwent the initial clinical assessment and were triaged into three groups (rule-out, rule-in and observe) according to the 0 h/1 h algorithm. The major cardiovascular events (MACE) were evaluated at the 7-day and 30-day follow-ups. Results Among 577 enrolled patients, NSTEMI was the final diagnosis for 106 (18.4%) patients. Based on the hs-cTnT 0 h/1 h algorithm, 148 patients (25.6%) were classified as rule-out, 278 patients (48.2%) as rule-in and 151 patients (26.2%) were assigned to the observe group. The rule-out approach resulted in a sensitivity of 100% and negative predictive value of 100%. The rule-in approach resulted in a specificity of 62.9% [95% CI (58.5–67.2%)] and positive predictive value of 37.1% [95%CI (31.3–42.8%)]. No MACE was observed in the rule-out group within 30-day follow-up. Conclusions The hs-cTnT 0 h/1 h algorithm is a safe tool for early rule-out of NSTEMI, while probably not an effective strategy for accurate rule-in of NSTEMI in Chinese Han population.

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