scholarly journals Myocardial Infarction Can Be Safely Excluded by High‐sensitivity Troponin I Testing 3 Hours After Emergency Department Presentation

2020 ◽  
Vol 27 (8) ◽  
pp. 671-680 ◽  
Author(s):  
W. Frank Peacock ◽  
Robert Christenson ◽  
Deborah B. Diercks ◽  
Christian Fromm ◽  
Gary F. Headden ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Emergency Department ◽  
Troponin I ◽  
High Sensitivity ◽  
Emergency Department Presentation ◽  
High Sensitivity Troponin

scholarly journals The utility of presentation and 4-hour high sensitivity troponin I to rule-out acute myocardial infarction in the emergency department

2015 ◽  
Vol 48 (18) ◽  
pp. 1219-1224 ◽  
Author(s):  
John W. Pickering ◽  
Joanna M. Young ◽  
Peter George ◽  
Sally Aldous ◽  
Louise Cullen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Emergency Department ◽  
Troponin I ◽  
High Sensitivity ◽  
High Sensitivity Troponin ◽  
Rule Out

scholarly journals Comparison Between Soluble ST2 and High-Sensitivity Troponin I in Predicting Short-Term Mortality for Patients Presenting to the Emergency Department With Chest Pain

2017 ◽  
Vol 37 (2) ◽  
pp. 137-146 ◽  
Author(s):  
Rossella Marino ◽  
Laura Magrini ◽  
Francesca Orsini ◽  
Veronica Russo ◽  
Patrizia Cardelli ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Troponin I ◽  
High Sensitivity ◽  
Short Term ◽  
Soluble St2 ◽  
High Sensitivity Troponin ◽  
Short Term Mortality

scholarly journals High-Sensitivity Troponin T Testing: Consequences on Daily Clinical Practice and Effects on Diagnosis of Myocardial Infarction

2020 ◽  
Vol 9 (3) ◽  
pp. 775 ◽  
Author(s):  
Christian Frédéric Zachoval ◽  
Ramona Dolscheid-Pommerich ◽  
Ingo Graeff ◽  
Bernd Goldschmidt ◽  
Andreas Grigull ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Resource Utilization ◽  
Troponin I ◽  
Troponin T ◽  
High Sensitivity ◽  
Coronary Intervention ◽  
International Classification Of Diseases ◽  
High Sensitivity Troponin ◽  
Classification Of Diseases ◽  
High Sensitivity Troponin T

It remains unclear how introduction of high-sensitivity troponin T testing, as opposed to conventional troponin testing, has affected the diagnosis of acute myocardial infarction (AMI) and resource utilization in unselected hospitalized patients. In this retrospective analysis, we include all consecutive cases from our center during two corresponding time frames (10/2016–04/2017 and 10/2017–04/2018) for which different troponin tests were performed: conventional troponin I (cTnI) and high-sensitivity troponin T (hs-TnT) assays. Testing was performed in 18,025 cases. The incidence of troponin levels above the 99th percentile was significantly higher in cases tested using hs-TnT. This was not associated with increased utilization of echocardiography, coronary angiography, or percutaneous coronary intervention. Although there were no changes in local standard operating procedures, study site personnel, or national coding guidelines, the number of coded AMI significantly decreased after introduction of hs-TnT. In this single-center retrospective study comprising 18,025 mixed medical and surgical cases with troponin testing, the introduction of hs-TnT was not associated with changes in resource utilization among the general cohort, but instead, led to a decrease in the international classification of diseases (ICD)-10 coded diagnosis of AMI.

scholarly journals Immediate Rule-Out of Acute Myocardial Infarction Using Electrocardiogram and Baseline High-Sensitivity Troponin I

2017 ◽  
Vol 63 (1) ◽  
pp. 394-402 ◽  
Author(s):  
Johannes Tobias Neumann ◽  
Nils Arne Sörensen ◽  
Francisco Ojeda ◽  
Tjark Schwemer ◽  
Jonas Lehmacher ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Troponin I ◽  
High Sensitivity ◽  
Low Risk ◽  
High Sensitivity Troponin ◽  
Testing Trial ◽  
Pain Symptoms ◽  
Electrocardiogram Ecg ◽  
Rule Out

Abstract AIMS Serial measurements of high-sensitivity troponin are used to rule out acute myocardial infarction (AMI) with an assay specific cutoff at the 99th percentile. Here, we evaluated the performance of a single admission troponin with a lower cutoff combined with a low risk electrocardiogram (ECG) to rule out AMI. METHODS Troponin I measured with a high-sensitivity assay (hs-TnI) was determined at admission in 1040 patients presenting with suspected AMI (BACC study). To rule out AMI we calculated the negative predictive value (NPV) utilizing the optimal hs-TnI cutoff combined with a low risk ECG. The results were validated in 3566 patients with suspected AMI [2-h Accelerated Diagnostic Protocol to Assess Patients With Chest Pain Symptoms Using Contemporary Troponins as the Only Biomarker (ADAPT) studies]. Patients were followed for 6 or 12 months. RESULTS 184 of all patients were diagnosed with AMI. An hs-TnI cutoff of 3 ng/L resulted in a NPV of 99.3% (CI 97.3–100.0), ruling out 35% of all non-AMI patients. Adding the information of a low risk ECG resulted in a 100% (CI 97.5–100.0) NPV (28% ruled out). The 2 validation cohorts replicated the high NPV of this approach. The follow-up mortality in the ruled out population was low (0 deaths in BACC and Stenocardia, 1 death in ADAPT). CONCLUSIONS A single hs-TnI measurement on admission combined with a low risk ECG appears to rule out AMI safely without need for serial troponin testing. Trial Registration: www.clinicaltrials.gov (NCT02355457).

Differences in measurement of high-sensitivity troponin in an on-demand and batch-wise setting

2020 ◽  
pp. 204887262092419
Author(s):  
Nils Arne Sörensen ◽  
Johannes Tobias Neumann ◽  
Francisco Ojeda ◽  
Thomas Renné ◽  
Mahir Karakas ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Troponin I ◽  
Troponin T ◽  
High Sensitivity ◽  
Clinical Routine ◽  
Blood Samples ◽  
Diagnostic Algorithms ◽  
On Demand ◽  
High Sensitivity Troponin ◽  
High Sensitivity Troponin T

Background Most studies assessing the diagnostic value of high-sensitivity troponin in the diagnosis of myocardial infarction used batch-wise analyses of frozen samples for high-sensitivity troponin measurements. Whether the accuracy of these batch-wise high-sensitivity troponin measurements described in diagnostic studies is comparable to clinical routine is unknown. Methods We enrolled 937 patients presenting with suspected myocardial infarction in this prospective cohort study. Measurements of high-sensitivity troponin I (Abbott Architect) and high-sensitivity troponin T (Roche) were performed in two settings: (a) on-demand in clinical routine using fresh blood samples; and (b) in batches using frozen blood samples from the same individuals at three timepoints (0 hours, 1 hour and 3 hours after presentation). Results Median troponin levels were not different between on-demand and batch-wise measurements. Troponin levels in the range of 0 to 40 ng/L showed a very high correlation between the on-demand and batch setting (Pearson correlation coefficient ( r) was 0.92–0.95 for high-sensitivity troponin I and 0.96 for high-sensitivity troponin T). However, at very low troponin levels (0 to 10 ng/L) correlation between the two settings was moderate ( r for high-sensitivity troponin I 0.59–0.66 and 0.65–0.69 for high-sensitivity troponin T). Application of guideline-recommended rapid diagnostic algorithms showed similar diagnostic performance with both methods. Conclusions Overall on-demand and batch-wise measurements of high-sensitivity troponin provided similar results, but their correlation was moderate, when focusing on very low troponin levels. The application of rapid diagnostic algorithms was safe in both settings. Trial Registration: www.clinicaltrials.gov (NCT02355457)

scholarly journals P6395Prognostic effect of high-sensitivity troponin I in patients with suspected myocardial infarction

2018 ◽  
Vol 39 (suppl_1) ◽  
Author(s):  
J T Neumann ◽  
N Soerensen ◽  
N Ruebsamen ◽  
F Ojeda ◽  
T Keller ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Troponin I ◽  
High Sensitivity ◽  
High Sensitivity Troponin
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