scholarly journals HIGH-SENSITIVITY CARDIAC TROPONIN T FOR THE DETECTION OF MYOCARDIAL INJURY AND RISK STRATIFICATION IN COVID-19

2021 ◽  
Vol 77 (18) ◽  
pp. 3145
Author(s):  
Laura De Michieli ◽  
Olatunde Ola ◽  
Jonathan Knott ◽  
Ashok Akula ◽  
Ramila Mehta ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Cardiac Troponin ◽  
Myocardial Injury ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T

scholarly journals High-Sensitivity Cardiac Troponin T for Risk Stratification in Patients With Embolic Stroke of Undetermined Source

Stroke ◽  
2020 ◽  
Vol 51 (8) ◽  
pp. 2386-2394 ◽  
Author(s):  
Jan F. Scheitz ◽  
Guillaume Pare ◽  
Lesly A. Pearce ◽  
Hardi Mundl ◽  
W. Frank Peacock ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Risk Stratification ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Embolic Stroke ◽  
Cardiac Troponin T ◽  
Reference Limit ◽  
End Point ◽  
Upper Reference Limit

Background and Purpose: Optimal secondary prevention for patients with embolic stroke of undetermined source (ESUS) remains unknown. We aimed to assess whether high-sensitivity cardiac troponin T (hs-cTnT) levels are associated with major vascular events and whether hs-cTnT may identify patients who benefit from anticoagulation following ESUS. Methods: Data were obtained from the biomarker substudy of the NAVIGATE ESUS trial, a randomized controlled trial testing the efficacy of rivaroxaban versus aspirin for secondary stroke prevention in ESUS. Patients were dichotomized at the hs-cTnT upper reference limit (14 ng/L, Gen V, Roche Diagnostics). Cox proportional hazard models were computed to explore the association between hs-cTnT, the combined cardiovascular end point (recurrent stroke, myocardial infarction, systemic embolism, cardiovascular death), and recurrent ischemic stroke. Results: Among 1337 patients enrolled at 111 participating centers in 18 countries (mean age 67±9 years, 61% male), hs-cTnT was detectable in 95% and at/above the upper reference limit in 21%. During a median follow-up of 11 months, the combined cardiovascular end point occurred in 68 patients (5.0%/y, rivaroxaban 28 events, aspirin 40 events; hazard ratio, 0.67 [95% CI, 0.41–1.1]), and recurrent ischemic stroke occurred in 50 patients (4.0%/y, rivaroxaban 16 events, aspirin 34 events, hazard ratio 0.45 [95% CI, 0.25–0.81]). Annualized combined cardiovascular end point rates were 8.2% (9.5% rivaroxaban, 7.0% aspirin) for those above hs-cTnT upper reference limit and 4.8% (3.1% rivaroxaban, 6.6% aspirin) below with a significant treatment modification ( P =0.04). Annualized ischemic stroke rates were 4.7% above hs-cTnT upper reference limit and 3.9% below, with no suggestion of an interaction between hs-cTnT and treatment ( P =0.3). Conclusions: In patients with ESUS, hs-cTnT was associated with increased cardiovascular event rates. While fewer recurrent strokes occurred in patients receiving rivaroxaban, outcomes were not stratified by hs-cTn results. Our findings support using hs-cTnT for cardiovascular risk stratification but not for decision-making regarding anticoagulation therapy in patients with ESUS. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT02313909.

scholarly journals Risk Stratification Using High-Sensitivity Cardiac Troponin T in Patients With Suspected Acute Coronary Syndrome

2020 ◽  
Vol 75 (8) ◽  
pp. 985-987 ◽  
Author(s):  
Andrew R. Chapman ◽  
Dennis Sandeman ◽  
Amy V. Ferry ◽  
Stacey Stewart ◽  
Fiona E. Strachan ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Risk Stratification ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
Coronary Syndrome

Coronary angiography-related myocardial injury as detected by high-sensitivity cardiac troponin T assay

2016 ◽  
Vol 12 (3) ◽  
pp. 337-344 ◽  
Author(s):  
Haitham Abu Sharar ◽  
Daniel Wohlleben ◽  
Mehrshad Vafaie ◽  
Arnt V. Kristen ◽  
H. Christian Volz ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Cardiac Troponin ◽  
Myocardial Injury ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T

scholarly journals Troponin T Measurements by High-Sensitivity vs Conventional Assays for Risk Stratification in Acute Dyspnea

2012 ◽  
Vol 58 (1) ◽  
pp. 284-292 ◽  
Author(s):  
Sandra van Wijk ◽  
Leo Jacobs ◽  
Luc W Eurlings ◽  
Roland van Kimmenade ◽  
Roosmarijn Lemmers ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Risk Stratification ◽  
Cardiac Troponin ◽  
Prognostic Value ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
Acute Dyspnea ◽  
Prognostic Information ◽  
Term Outcome

Abstract BACKGROUND Cardiac troponin T measured by a high-sensitivity assay (hs-cTnT) recently proved to be of prognostic value in several populations. The hs-cTnT assay may also improve risk stratification in acute dyspnea. METHODS We prospectively studied the prognostic value of hs-cTnT in 678 consecutive patients presenting to the emergency department with acute dyspnea. On the basis of conventional cardiac troponin T assay (cTnT) and hs-cTnT assay measurements, patients were divided into 3 categories: (1) neither assay increased (cTnT <0.03 μg/L, hs-cTnT <0.016 μg/L), (2) only hs-cTnT increased ≥0.016 μg/L (cTnT <0.03 μg/L), and (3) both assays increased (cTnT ≥0.03 μg/L, hs-cTnT ≥0.016 μg/L). Moreover, the prognostic value of hs-cTnT was investigated if cTnT was not detectable (<0.01). RESULTS One hundred seventy-two patients were in the lowest, 282 patients in the middle, and 223 patients in the highest troponin category. Patients in the second and third categories had significantly higher mortality compared to those in the first category (90-day mortality rate 2%, 10%, and 26% in groups 1, 2, and 3, respectively, P < 0.001; 1-year mortality rate 9%, 21%, and 39%, P < 0.001). Importantly, in patients with undetectable cTnT (n = 347, 51%), increased hs-cTnT indicated worse outcome [90-day mortality, odds ratio 4.26 (95% CI 1.19–15.21); 1-year mortality, hazard ratio 2.27 (1.19–4.36), P = 0.013], whereas N-terminal pro–brain-type natriuretic peptide (NT-proBNP) was not predictive of short-term outcome. CONCLUSIONS hs-cTnT is associated with mortality in patients presenting with acute dyspnea. hs-cTnT concentrations provide additional prognostic information to cTnT and NT-proBNP testing in patients with cTnT concentrations below the detection limit. In particular, the hs-cTnT cutoff of 0.016 μg/L enables identification of low-risk patients.

scholarly journals High-Sensitivity Cardiac Troponin T: Risk Stratification Tool in Patients with Symptoms of Chest Discomfort

PLoS ONE ◽  
2012 ◽  
Vol 7 (4) ◽  
pp. e35059 ◽  
Author(s):  
Alma M. Mingels ◽  
Ivo A. Joosen ◽  
Mathijs O. Versteylen ◽  
Eduard M. Laufer ◽  
Mark H. Winkens ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
Chest Discomfort ◽  
Risk Stratification Tool

scholarly journals High-Sensitivity Troponin as a Predictor of Cardiac Events and Mortality in the Stable Dialysis Population

2014 ◽  
Vol 60 (2) ◽  
pp. 389-398 ◽  
Author(s):  
Hicham Cheikh Hassan ◽  
Kenneth Howlin ◽  
Andrew Jefferys ◽  
Stephen T Spicer ◽  
Ananthakrishnapuram N Aravindan ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Cardiac Event ◽  
Clinical Utility ◽  
Myocardial Injury ◽  
Prospective Observational Study ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
Cardiac Events ◽  
Over Time

Abstract BACKGROUND High-sensitivity cardiac troponin T (hs-cTnT) is a biomarker used in diagnosing myocardial injury. The clinical utility and the variation of this biomarker over time remain unclear in hemodialysis (HD) and peritoneal dialysis (PD) patients. We sought to determine whether hs-cTnT concentrations were predictive of myocardial infarction (MI) and death and to examine hs-cTnT variability over a 1-year period. METHODS A total of 393 nonacute HD and PD patients (70% HD and 30% PD) were followed in a prospective observational study for new MI and death. RESULTS Median hs-cTnT was 57 ng/L (interquartile range, 36–101 ng/L) with no observed difference between HD and PD patients (P = 0.11). Incremental increases in mortality (P = 0.024) and MI (P = 0.001) were observed with increasing hs-cTnT quartiles. MI incidence increased significantly across quartiles in both HD and PD patients (P = 0.012 and P = 0.025, respectively), whereas mortality increased only in HD patients (P = 0.015). For every increase of 25 ng/L in hs-cTnT, the unadjusted hazard ratio (HR) was 1.10 for mortality in the whole group (95% CI, 1.04–1.16, P = 0.001) and 1.16 for MI (95% CI, 1.08–1.23, P < 0.001). Adjusted HR for mortality was 1.07 (95% CI, 1.01–1.15, P = 0.04) and 1.14 for MI (95% CI, 1.06–1.22, P < 0.001). Changes in hs-cTnT from baseline concentrations after 1 year were minimal (55 ng/L vs 53 ng/L, P = 0.22) even in patients who had an MI (P = 0.53). CONCLUSIONS hs-cTnT appears to have a useful role in predicting MI and death in the dialysis population. Over a 1-year period concentrations remained stable even in patients who sustained a new cardiac event.

Sign in / Sign up

Export Citation Format

Share Document