High-sensitivity Troponin T Assay in Asymptomatic High Cardiovascular Risk Patients. The TUSARC Registry

2017 ◽  
Vol 70 (4) ◽  
pp. 261-266
Author(s):  
Isabel Álvarez ◽  
Luis Hernández ◽  
Héctor García ◽  
Vicente Villamandos ◽  
María Gracia López ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Troponin T ◽  
High Sensitivity ◽  
High Cardiovascular Risk ◽  
High Sensitivity Troponin ◽  
Risk Patients ◽  
High Sensitivity Troponin T

Abstract 16576: The Role of Undetectable Cardiac High Sensitivity Troponin T and Copeptin for Prediction of 90 Day Outcomes in Low- to Intermediate-Risk Patients With Suspected ACS: A BIC-8 Biomarker Substudy

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Mehrshad Vafaie ◽  
Anna Slagman ◽  
Julia Searle ◽  
Christian Hamm ◽  
Kurt Huber ◽  
...  
Keyword(s):  
Limit Of Detection ◽  
Troponin T ◽  
High Sensitivity ◽  
Original Study ◽  
Intermediate Risk ◽  
Entire Study ◽  
High Sensitivity Troponin ◽  
Risk Patients ◽  
Study Population ◽  
High Sensitivity Troponin T

Introduction: The international randomized multicentre BIC-8 trial demonstrated that patients with suspected ACS and a negative baseline troponin, who also tested negative for copeptin, could safely be discharged and did not experience a higher rate of MACE within 30 days compared to patients managed according to current guidelines. Objective: This BIC8-substudy evaluates the usefulness of copeptin in patients with undetectable (below limit of detection (LOD)), compared to detectable (at or above LOD) high sensitivity troponin T (hsTnT) at presentation. Methods: In the original study, patients (n=902) were randomized 1:1 into standard and experimental arm. In the experimental arm, further patient care was based on copeptin levels at admission. After 30 and 90 days, a telephone follow-up was performed. Since hsTnT at LOD was evaluated in a post-randomization cohort, all analyses were executed on the entire study population. For the hsTnT assay (Elecsys, Roche), LOD was defined as a value below 5 ng/l. Copeptin values were determined using the BRAHMS Copeptin us Kryptor assay (Thermo Scientific). Results: Of all patients enrolled in the original study (n=902), hsTnT at admission was available in 893 patients (99.0%). The majority of patients had detectable hsTnT values (65.4%, n=584). 34.6% (n=309) had no detectable hsTnT-values. In these patients, no myocardial infarctions (MIs) or deaths occurred within 90 days. In patients with detectable hsTnT-values, in 3.3% the combined endpoint of death or MI occurred within 90 days (table 1). In the subgroup of patients with a copeptin value ≥10 pmol/l the event-rate was 8.2% (10/122) and in patients below this value 2.0% (9/441), (RR = 4.02, p=0.003). Conclusion: In low-to-intermediate risk patients with suspected ACS, undetectable hsTnT values at admission allow a safe discharge without occurrence of death or MI within 90 days. In patients with detectable hsTnT, Copeptin is useful to stratify patients at higher risk for death/MI.

Detection of High-sensitivity Troponin T in Patients With Cardiovascular Risk

2017 ◽  
Vol 70 (7) ◽  
pp. 615
Author(s):  
Joaquín Velilla Moliner ◽  
Daniel Lahoz Rodríguez ◽  
Antonio Giménez Valverde ◽  
Eduardo Bustamante Rodríguez
Keyword(s):  
Cardiovascular Risk ◽  
Troponin T ◽  
High Sensitivity ◽  
High Sensitivity Troponin ◽  
High Sensitivity Troponin T

scholarly journals Efficacy of High-Sensitivity Troponin T in Identifying Very-Low-Risk Patients With Possible Acute Coronary Syndrome

2018 ◽  
Vol 3 (2) ◽  
pp. 104 ◽  
Author(s):  
W. Frank Peacock ◽  
Brigette M. Baumann ◽  
Deborah Bruton ◽  
Thomas E. Davis ◽  
Beverly Handy ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Troponin T ◽  
High Sensitivity ◽  
Low Risk ◽  
Coronary Syndrome ◽  
High Sensitivity Troponin ◽  
Risk Patients ◽  
High Sensitivity Troponin T

scholarly journals Growth Differentiation Factor‐15 Predicts Death and Stroke Event in Outpatients With Cardiovascular Risk Factors: The J‐HOP Study

2021 ◽  
Author(s):  
Keita Negishi ◽  
Satoshi Hoshide ◽  
Masahisa Shimpo ◽  
Hiroshi Kanegae ◽  
Kazuomi Kario
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Events ◽  
Growth Differentiation Factor 15 ◽  
High Sensitivity Troponin ◽  
High Sensitivity Troponin T

Background Growth differentiation factor‐15 (GDF‐15) has emerged as a novel biomarker to predict all‐cause death in community‐dwelling individuals and patients with cardiovascular disease. We evaluated the prognostic value of GDF‐15 in outpatients with cardiovascular risk factors. Methods and Results GDF‐15 levels were measured in 3562 outpatients with cardiovascular risk factors in the J‐HOP (Japan Morning Surge‐Home Blood Pressure) study, a nationwide prospective study. Participants were stratified according to tertiles of GDF‐15 and followed up for all‐cause death and cardiovascular disease. During a mean follow‐up period of 6.6 years, there were 155 all‐cause deaths, 81 stroke events including cerebral infarction and intracranial hemorrhage, and 141 cardiac events including cardiac artery disease and heart failure. Patients with higher GDF‐15 levels were associated with risks of all‐cause death and stroke events (except for cardiac events) after adjustment for traditional risk factors and other prognostic biomarkers (NT‐proBNP [N‐terminal pro‐B‐type natriuretic peptide], high‐sensitivity troponin T; all‐cause death, hazard ratio, 2.38; 95% CI, 1.26–4.48; P =0.007; stroke events, hazard ratio, 2.93; 95% CI, 1.31–6.56, P =0.009; compared with the lowest tertile). Furthermore, incorporating GDF‐15 to the predictive models for all‐cause death improved discrimination and reclassification significantly. For stroke events, GDF‐15 showed similar diagnostic accuracy to NT‐proBNP and high‐sensitivity troponin T. Conclusions In Japanese outpatients with cardiovascular risk factors, GDF‐15 improves risk stratification for all‐cause death when compared with NT‐proBNP and high‐sensitivity troponin T. GDF‐15 was associated with increased risks of stroke events beyond conventional risk factors and other prognostic markers; however, the predictive ability for stroke events was equivalent to NT‐proBNP and high‐sensitivity troponin T. Registration URL: http://www.umin.ac.jp/ctr .; Unique identifier: UMIN000000894.

Increased serum level of high sensitivity troponin T even prior to surgery can predict adverse events during carotid endarterectomy

Vascular ◽  
2021 ◽  
pp. 170853812098629
Author(s):  
Bálint Nagy ◽  
Elettra Engblom ◽  
Marijana Matas ◽  
Péter Maróti ◽  
Tamás Kőszegi ◽  
...  
Keyword(s):  
Plasma Concentration ◽  
Matrix Metalloproteinase ◽  
Carotid Endarterectomy ◽  
Troponin T ◽  
High Sensitivity ◽  
Matrix Metalloproteinase 9 ◽  
Tissue Inhibitor Of Metalloproteinase ◽  
High Sensitivity Troponin ◽  
High Sensitivity Troponin T ◽  
Metalloproteinase 9

Objectives Perioperative stress affects the outcome of carotid endarterectomy performed under regional anesthesia. Here we aimed to explore the temporal profile of the stress marker cortisol and its relationship to high-sensitivity troponin-T, matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1, and S100B as an indicator of blood–brain barrier alteration in the systemic circulation. Methods Prospective part of the study: a total of 31 patients with significant carotid stenosis scheduled for carotid endarterectomy in regional anesthesia were enrolled. Follow-up part of the study and retrospective analysis of the outcome: each patient was followed up to five years and morbidity as well as mortality data were collected from an electronic database. Blood samples from each patient were serially taken; prior to surgery (T1), at the time of reperfusion (T2), 24 h (T3) and 72 h later postoperatively (T4), then the plasma concentration of each biomarker was measured. Besides, the clinical and surgical factors and perioperative adverse events were recorded. Results More positive correlations were found between: the early change of S100B (T2–T1) and late change in plasma cortisol level (T4–T3) (r = 0.403; p < 0.05); the early change of cortisol (T2–T1) and the early postoperative change of plasma matrix metalloproteinase-9 level (T3–T2) (r = 0.432; p = 0.01); the plasma concentration of tissue inhibitor of metalloproteinase-1 at 24 postoperative hours and the late change in plasma high-sensitivity troponin-T level (T4–T3) (r = 0.705; p < 0.001). Five patients needed an intraoperative shunt in whom the high-sensitivity troponin-T was elevated even prior to surgery, but definitive stroke never occurred. Plasma matrix metalloproteinase-9 concentration at reperfusion independently predicted the five-year mortality with a cut-off value of 456 ng/ml (sensitivity: 86%, specificity: 84%, area 0.887, p = 0.002). Conclusions A higher intraoperative change in S100B level reflecting carotid endarterectomy induced acute silent brain ischemia was associated with more pronounced post-operative change of cortisol. An early elevation of cortisol was found to be associated with a delayed increase of matrix metalloproteinase-9. Importantly, an increased high-sensitivity troponin-T even prior to carotid endarterectomy may predict clamp intolerance, and elevated matrix metalloproteinase-9 at reperfusion suggests a poor outcome.

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