scholarly journals Cardiac Troponin Levels in the Elderly—Time to Re-think Threshold Levels?

2012 ◽  
Vol 21 ◽  
pp. S31
Author(s):  
I. Webb ◽  
S. Yam ◽  
R. Cooke ◽  
A. Aitkin ◽  
P. Larsen ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
The Elderly ◽  
Threshold Levels

Elevated Baseline Cardiac Troponin Levels in the Elderly – Another Variable to Consider?

2015 ◽  
Vol 24 (2) ◽  
pp. 142-148 ◽  
Author(s):  
Ian G. Webb ◽  
S.T. Yam ◽  
Russel Cooke ◽  
Andrew Aitken ◽  
Peter D. Larsen ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
The Elderly

Abstract 219: Histidine Substituted Cardiac Troponin I (a164h) Improves Survival And Protects Cardiac Contractility During Acute Hypoxia In The Aged Murine Heart.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Nathan Palpant ◽  
Sharlene Day ◽  
Kimber Converso ◽  
Joseph Metzger
Keyword(s):  
Cardiac Troponin ◽  
Troponin I ◽  
Acute Hypoxia ◽  
Cardiac Contractility ◽  
Systolic Pressure ◽  
Calcium Sensitivity ◽  
The Elderly ◽  
Cardiac Troponin I ◽  
Pump Failure ◽  
Myofilament Calcium Sensitivity

Contractile dysfunction associated with ischemia is a significant cause of morbidity and mortality particularly in the elderly. Strategies designed to protect the aged heart from ischemia-mediated pump failure are needed. We have generated transgenic (Tg) mice expressing a modified form of adult cardiac troponin I, the Ca ++ -activated molecular switch of the myofilament. Consonant with the fetal isoform, this transgene encodes a histidine substitution (A164H) in the critical switch domain of TnI thus increasing myofilament calcium sensitivity in a pH-dependent manner. We hypothesized that aged mice (24 months), intrinsically susceptible to myocardial dysfunction, would retain improved cardiac contractility at baseline and during an acute hypoxic challenge by means of myofilament-mediated calcium sensitization. Methods/Results: At baseline, by echocardiography, Tg hearts had increased systolic function, with a 26% higher mean ejection fraction compared to nontransgenic (Ntg) mice: 75 ± 3% [Tg: n = 13] vs. 63 ± 4% [Ntg: n = 12], P < 0.05, with no differences in diastolic function between the groups. To study the effects of acute hypoxia on cardiac hemodynamics mice underwent microconductance Millar catheterization while ventilated with 12% oxygen. Aged Tg mice had improved survival compared to Ntg mice: time to pump failure (65% of baseline peak systolic pressure) 11.59 ± 1.25 min. [Tg: n = 3] vs. 4.11 ± 1.90 min. [Ntg: n = 3], P < 0.05. After four minutes of hypoxia, Tg mice had markedly improved cardiac contractility compared to Ntg mice with increased stroke volume (30.05 ± 4.49 uL [Tg] vs. 13.23 ± 3.21 uL [Ntg], P < 0.05), end systolic pressure (106.09 ± 11.81 mmHg [Tg] vs. 64.49 ± 4.05 mmHg [Ntg], P < 0.05) and rate of positive left ventricular pressure development (12958.66 ± 2544.68 mmHg/sec [Tg] vs. 5717.00 ± 745.67 mmHg/sec [Ntg], P = 0.05). Conclusion: An alteration in myofilament calcium sensitivity via a pH-responsive histidine button in cardiac troponin I augments baseline heart function in Tg mice over their lifetime. During acute hypoxia, cTnI A164H improves survival in aged mice by maintaining cardiac contractility, and thus holds promise for the design of gene therapeutics to treat pump failure associated with acute ischemic events in the elderly.

Elevated Baseline Cardiac Troponin Levels in the Elderly—Another Variable to Consider?

2012 ◽  
Vol 21 (8) ◽  
pp. 520-521
Author(s):  
I.G. Webb ◽  
S.T. Yam ◽  
R. Cooke ◽  
A. Aitken ◽  
P.D. Larsen ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
The Elderly

High-sensitivity cardiac troponin T for diagnosis of NSTEMI in the elderly emergency department patient: a clinical cohort study

Biomarkers ◽  
2018 ◽  
Vol 23 (6) ◽  
pp. 551-557 ◽  
Author(s):  
Dorothee Riedlinger ◽  
Martin Möckel ◽  
Christian Müller ◽  
Fabian Holert ◽  
Julia Searle ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Emergency Department Patient ◽  
The Elderly ◽  
Cardiac Troponin T ◽  
Clinical Cohort

scholarly journals Early diagnosis of acute myocardial infarction in the elderly using more sensitive cardiac troponin assays

2011 ◽  
Vol 32 (11) ◽  
pp. 1379-1389 ◽  
Author(s):  
Miriam Reiter ◽  
Raphael Twerenbold ◽  
Tobias Reichlin ◽  
Philip Haaf ◽  
Frederico Peter ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Early Diagnosis ◽  
Cardiac Troponin ◽  
The Elderly

scholarly journals Could cardiac troponin I levels predict mortality in the elderly?

2018 ◽  
Vol 31 (3) ◽  
pp. 435-435 ◽  
Author(s):  
Gozde Sengul Aycicek ◽  
Pelın Unsal ◽  
Mert Esme ◽  
Cafer Balci ◽  
Burcu Balam Yavuz ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Troponin I ◽  
The Elderly ◽  
Cardiac Troponin I

Presenting characteristics of patients undergoing cardiac troponin measurements in the emergency department

CJEM ◽  
2015 ◽  
Vol 17 (1) ◽  
pp. 62-66 ◽  
Author(s):  
Daniel A. Goodman ◽  
Peter A. Kavsak ◽  
Stephen A. Hill ◽  
Andrew Worster
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Elderly Patients ◽  
Cardiac Troponin ◽  
Patient Characteristics ◽  
The Elderly ◽  
Primary Objective ◽  
Shortness Of Breath ◽  
Coronary Syndrome ◽  
Secondary Objective

AbstractIntroductionNot all patients with suspected acute coronary syndrome (ACS) receiving cardiac troponin (cTn) testing present to the emergency department (ED) with cardiac chest pain. Since elderly patients (age ≥70) have increased morbidity and mortality associated with ACS, complaints other than cardiac chest pain may justify cTn testing. Our primary objective was to characterize the population of ED patients who receive cTn testing. The secondary objective was to determine if elderly patients underwent cTn testing for different presenting complaints than their younger counterparts.MethodsWe created an electronic database including Canadian Emergency Department Information Systems (CEDIS) presenting complaints, age, sex, disposition, and Canadian Triage Acuity Scale (CTAS) score, for patients who received cTn testing in three Canadian EDs during 2011. We analyzed the data for patient characteristics and sorted by age (<70 and ≥70) for further analysis.ResultsIn the 15,824 included patients, the average age was 66 (51%<70; 51% female). The most common presenting complaints were cardiac chest pain (n=3,267) and shortness of breath (n=2,266). The elderly underwent cTn testing for significantly (p<0.0001) different complaints than their younger counterparts. They more commonly presented with generalized weakness (n=898), whereas younger patients more frequently had abdominal pain (n=576).ConclusionsCardiac chest pain and shortness of breath are presenting complaints in one-third of patients undergoing ED cTn testing. The majority of patients undergoing cTn testing did not have typical ACS symptoms. Half of all cTn testing in the ED is on the elderly, who present with different complaints than their younger counterparts.

Ultrasensitive cardiac troponin assay and atrial fibrillation in the elderly population

2012 ◽  
Vol 3 ◽  
pp. S98
Author(s):  
F. Attanasio ◽  
V. Giantin ◽  
A. Franchin ◽  
A. Rossi ◽  
M.M. Mion ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Troponin ◽  
Elderly Population ◽  
The Elderly

Estimation of age- and comorbidities-adjusted percentiles of high-sensitivity cardiac troponin T levels in the elderly

2015 ◽  
Vol 53 (5) ◽  
Author(s):  
Nils Kuster ◽  
Karine Monnier ◽  
Gregory Baptista ◽  
Anne-Marie Dupuy ◽  
Stéphanie Badiou ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Rating Scale ◽  
Troponin T ◽  
High Sensitivity ◽  
The Elderly ◽  
Elderly Subjects ◽  
Reference Limit ◽  
Reactive Protein ◽  
Ctnt Level ◽  
Upper Reference Limit

AbstractCardiac troponin level measured by high-sensitivity assays (hs-cTn) in the elderly is frequently found higher than the 99th percentile upper reference limit, making the diagnosis of acute coronary syndromes (ACS) difficult. This study aimed at: 1) identifying determinants of hs-cTnT levels in an unselected population of elderly subjects; and 2) assessing the prognosis value of increased hs-cTnT in elderly people free of ACS.Hs-cTnT was measured in 591 individuals aged over 65 years without suspicion of ACS. Comorbidities were assessed using the Cumulative Illness Rating Scale for Geriatrics (CIRS-G). C-reactive protein, αAge, gender, cardiac CIRS-G, estimated glomerular filtration rate (p<0.001 for all), albumin (p<0.028) and αHs-cTnT level is associated with inflammation and renal function in the elderly. Independently of comorbidities, hs-cTnT concentration increases exponentially with age after 65 years. Decision limits adapted to age and sex may be useful to patient management.

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