Two-hour diagnostic algorithms for early assessment of patients with acute chest pain — Implications of lowering the cardiac troponin I cut-off to the 97.5th percentile

2015 ◽  
Vol 445 ◽  
pp. 19-24 ◽  
Author(s):  
Kai M. Eggers ◽  
Sally Aldous ◽  
Jaimi H. Greenslade ◽  
Nina Johnston ◽  
Bertil Lindahl ◽  
...  
Keyword(s):  
Chest Pain ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Acute Chest Pain ◽  
Cardiac Troponin I ◽  
Early Assessment ◽  
Diagnostic Algorithms

Emergency department triage of patients with acute chest pain: definition of cardiac troponin I decisional value to manage patients without electrocardiographic evidence of ischemia

2004 ◽  
Vol 42 (5) ◽  
Author(s):  
Pascale Beyne ◽  
Erik Bouvier ◽  
Patrick Werner ◽  
Pierre Bourgoin ◽  
Damien Logeart ◽  
...  
Keyword(s):  
Chest Pain ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Acute Chest Pain ◽  
Final Diagnosis ◽  
Cardiac Troponin I ◽  
Reference Limit ◽  
Coronary Syndrome ◽  
Definition Of ◽  
Upper Reference Limit

AbstractThe aim of this study was to define the use of a new cardiac troponin I (cTnI) assay for emergency patients with chest pain and no specific electrocardiographic changes consistent with the presence of ischemia. Patients (n=106) admitted in Emergency/Cardiology Departments for chest pain and suspicion of acute coronary syndrome (ACS) were randomized into two diagnosis groups (ACS or non-ACS) by two independent cardiologists. cTnI measurements were performed at admission, and 6 hours and 12 hours later with a new generation assay (Access AccuTnI, Beckman Coulter). Using an upper reference limit of 0.04 μg/l, 27 patients had a cTnI elevation not related to the final diagnosis of ischemia; the positive predictive value (PPV) was 67% with specificity 48%. The decisional value was re-defined and set at 0.16 μg/l, a concentration corresponding to the 99th percentile of the non-ACS patient group. Precision (coefficient of variation) was 8% at this level, PPV 97% and specificity 98%. This new decisional value is now used in our institution and could be included in standard care guidelines to improve the management of patients presenting chest pain in emergency departments.

Cardiac Troponin I and T Concentrations in Patients with Cocaine-Associated Chest Pain

1996 ◽  
Vol 33 (3) ◽  
pp. 183-186 ◽  
Author(s):  
Mary McLaurin ◽  
Fred S Apple ◽  
Timothy D Henry ◽  
Scott W Sharkey
Keyword(s):  
Skeletal Muscle ◽  
Chest Pain ◽  
Cardiac Troponin ◽  
Muscle Injury ◽  
Troponin I ◽  
Troponin T ◽  
Acute Chest Pain ◽  
Cardiac Troponin I ◽  
Skeletal Muscle Injury ◽  
Rule Out

Patients with cocaine-related chest pain with electrocardiographic (ECG) abnormalities are often admitted to rule out acute myocardial infarction (AMI). Cardiac troponin I and T should be superior to measurement of creatine kinase (CK)—MB for detecting cardiac injury in patients with coexisting skeletal muscle injury. We prospectively evaluated 19 consecutive patients with acute chest pain related to cocaine use who were hospitalized to rule out AMI. The admission ECG was abnormal in 16 of 19 patients. Total CK and CK—MB were elevated during the hospital course in 14 and 3 patients, respectively. Cardiac troponin I and cardiac troponin T levels were within normal limits in all patients demonstrating that recent myocardial injury did not occur. Clinically, no patient had an AMI. Cocaine-induced thoracic skeletal muscle injury or transient cocaine-induced coronary vasospasm should be considered as alternative sources of chest pain in these patients.

scholarly journals Implication of different cardiac troponin I levels for clinical outcomes and prognosis of acute chest pain patients

2004 ◽  
Vol 43 (6) ◽  
pp. 958-965 ◽  
Author(s):  
Michael C Kontos ◽  
Rakesh Shah ◽  
Lucie M Fritz ◽  
F.Philip Anderson ◽  
James L Tatum ◽  
...  
Keyword(s):  
Chest Pain ◽  
Clinical Outcomes ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Acute Chest Pain ◽  
Cardiac Troponin I ◽  
Pain Patients

scholarly journals Study of Cardiac Troponin I level in Acute Coronary Syndrome and its correlation with Left Ventricular Systolic Function

2019 ◽  
Vol 12 (1) ◽  
pp. 24-29
Author(s):  
Mohammad Jakir Hossain ◽  
Khondoker Asaduzzaman ◽  
Solaiman Hossain ◽  
Muhammad Badrul Alam ◽  
Nur Hossain
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Systolic Function ◽  
Left Ventricular ◽  
Cardiac Troponin I ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Coronary Syndrome

Background: In the diagnosis of acute coronary syndrome, cardiac troponin I is highly reliable and widely available biomarker. Serum level of cardiac troponin I is related to amount of myocardial damage and also closely relates to infarct size. Our aim of the study is to find out the relationship between cardiac troponin I and left ventricular systolic function after acute coronary syndrome. Methods: Total of 132 acute coronary syndrome patients were included in this study after admission in coronary care unit of Sir Salimullah Medical College, Mitford Hospital. Troponin I level was measured at admission and left ventricular ejection fraction (LVEF) was measured by echocardiography between 12-48 hours of onset of chest pain. Results: There was negative correlation between Troponin I at 12 to 48 hours of chest pain with LVEF in these study patients. With a cutoff value of troponin I e”6.8 ng/ml in STEMI patients there is a significant negative relation between 12 to 48 hrs troponin I and LVEF (p<0.001). Sensitivity of troponin I e” 6.8 ng/ml between 12 to 48 hours of chest pain in predicting LVEF <50% in STEMI was 93.75% and specificity was 77.78%. In NSTEMI sensitivity of troponin I e” 4.5 ng/ml between 12 to 48 hours of chest pain in predicting LVEF <50% was 65% and specificity was 54.05%. Conclusion: Serum troponin I level had a strong negative correlation with left ventricular ejection fraction after acute coronary syndrome and hence can be used to predict the LVEF in this setting. Cardiovasc. j. 2019; 12(1): 24-29

scholarly journals Comparison of Myocardial Perfusion Imaging and Cardiac Troponin I in Patients Admitted to the Emergency Department With Chest Pain

Circulation ◽  
1999 ◽  
Vol 99 (16) ◽  
pp. 2073-2078 ◽  
Author(s):  
Michael C. Kontos ◽  
Robert L. Jesse ◽  
F. Philip Anderson ◽  
Kristin L. Schmidt ◽  
Joseph P. Ornato ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Myocardial Perfusion Imaging ◽  
Myocardial Perfusion ◽  
Perfusion Imaging ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Troponin I

scholarly journals eComment: Is early assessment of cardiac troponin I a valuable predictor of mortality after cardiac surgery?

2010 ◽  
Vol 10 (3) ◽  
pp. 416-417 ◽  
Author(s):  
Petros Tzimas ◽  
Nikolaos G. Baikoussis ◽  
Kallirroi Kalantzi ◽  
Georgios Papadopoulos
Keyword(s):  
Cardiac Surgery ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Troponin I ◽  
Early Assessment ◽  
Valuable Predictor

scholarly journals Predictive Role of Cardiac Troponin I, Creatine Kinase-Mb and Electrocardiogram in Early Assessment of Acute Cardiotoxicity in Patients Poisoned by Cardiotoxic Drugs and Toxins

2020 ◽  
pp. 18-30
Author(s):  
Maha A. Hilal ◽  
Sharaf E. D. Mahmoud ◽  
Meray M. Shokry ◽  
Ahmed M. Said
Keyword(s):  
Creatine Kinase ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Troponin I ◽  
Early Assessment ◽  
Roc Curve Analysis ◽  
Creatine Kinase Mb ◽  
Significant Difference ◽  
Acute Cardiotoxicity

Background: In spite speedy development of clinical toxicology researches and protocols cardiovascular failure in severe acute intoxication remains a leading cause of death. Early cardiovascular risk assessment in acutely intoxicated patients is a must nowadays. This study aims to evaluate the role of ECG, serum cardiac troponin I (cTnI) and creatine kinase myocardial band (CK-MB) for early detection of cardio-toxicity in acutely poisoned patients. Methods: Prospective study was carried on100 patients with acute cardiotoxicity by drugs and toxins known to cause cardiac injury admitted to Sohag University hospitals, informed written consent has been obtained from each patient; ECG and biochemical analysis of serum cTnI and CK-MB were estimated in all studied patients. Results: (90%) of studied patients had complete free recovery, (4%) discharged with complications and (6%) of patients died. ECG test can be used as a predictor of mortality and had sensitivity 100%, specificity 46.8% and negative predictive value (NPV) 100%. Serum cTnI was highly significantly increased with death hence could be used as predictors of outcome. While serum CK-MB couldn't be used as an outcome predictor. ROC curve analysis to assess serum cTnI as a predictor of mortality of acute cardiovascular toxicity with cut off > 1.0 ng/ml had sensitivity 100%, specificity 89.4% and NPV 100% with excellent diagnostic characteristic (accuracy rate 96.4%). There is no significant difference of serum CK-MB and serum cTnI among cardiac drugs toxicity patients and non-cardiac toxins patients. Conclusion: the study concluded that ECG and serum cTnI can be used as a predictor of mortality. Also, the protocol of management will be same in acute cardiotoxicity by cardiac drugs and non-cardiac drugs and toxins. Recommendation: the study recommends combining of ECG changes and serum cTnI as they can early detect acute cardiovascular effects in acutely poisoned patients.

scholarly journals Combination of Goldman Risk and Initial Cardiac Troponin I for Emergency Department Chest Pain Patient Risk Stratification

2001 ◽  
Vol 8 (7) ◽  
pp. 696-702 ◽  
Author(s):  
Alex Limkakeng ◽  
W. Brian Gibler ◽  
Charles Pollack ◽  
James W. Hoekstra ◽  
Frank Sites ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Risk Stratification ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Troponin I ◽  
Pain Patient ◽  
Patient Risk ◽  
Chest Pain Patient
Sign in / Sign up

Export Citation Format

Share Document