Cardiac magnetic resonance in patients with elevated troponin and normal coronary angiography

Heart ◽  
2019 ◽  
Vol 105 (16) ◽  
pp. 1231-1236 ◽  
Author(s):  
Subir Bhatia ◽  
Christopher Anstine ◽  
Allan S Jaffe ◽  
Bernard J Gersh ◽  
Krishnaswamy Chandrasekaran ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Small Area ◽  
Troponin T ◽  
Arterial Disease ◽  
Stress Cardiomyopathy ◽  
Cardiac Biomarkers ◽  
Elevated Troponin ◽  
Coronary Arterial Disease ◽  
Ischaemic Cardiomyopathy ◽  
Single Centre Study

BackgroundInvasive angiography in the setting of cardiac troponin elevation may reveal non-obstructive coronary arteries leading to uncertainty in diagnosis. Cardiac MR (CMR) may aid in diagnosis, however, the spectrum of diagnostic findings in the patient presenting with symptoms of cardiac ischaemia, elevated cardiac biomarkers and a negative invasive coronary angiogram is yet to be completely described.MethodsWe queried the Mayo Clinic, Rochester inpatient record from 1 January 2000 to 31 December 2016 to identify patients who: (1) had an elevated troponin T during admission, (2) underwent coronary angiography within 30 days of troponin T elevation which was considered negative for obstructive coronary arterial disease and (3) underwent CMR within 30 days of troponin T elevation. CMR diagnoses were classified as either (1) myocarditis, (2) small area myocardial infarction, (3) stress cardiomyopathy, (4) non-ischaemic cardiomyopathy or (5) normal.ResultsOf 215 patients, the spectrum of disease seen on CMR was myocarditis (32%), small area infarction (22%), non-ischaemic cardiomyopathy (20%) and stress cardiomyopathy (9.3%).ConclusionIn the largest single-centre study assessing the role of CMR in patients admitted with elevated troponin T with a non-obstructive coronary disease on an angiogram, small area infarction was seen in 22% of patients.

scholarly journals CT-Coronary Angiography

2019 ◽  
Vol 10 (SPL1) ◽  
Author(s):  
Yussri Jemenin
Keyword(s):  
Chest Pain ◽  
Coronary Angiography ◽  
Large Body ◽  
Invasive Procedure ◽  
Arterial Disease ◽  
Ct Coronary Angiography ◽  
Conventional Coronary Angiography ◽  
Conventional Angiography ◽  
Coronary Arterial Disease ◽  
Non Invasive

A large body of literature has demonstrated the ability of coronary computed tomographic (CT) angiography to rule out significant stenosis. This test is a non-invasive alternative to conventional cardiac angiography in the work-up of patients suspected of having coronary artery disease (CAD) and increasingly as an option for the people. A multi-slices Computed Tomography (CT) is able to perform coronary angiography with very fast scanning time within a few seconds. It is an imaging test tool to detect cardiovascular disease in the arteries that supply blood to the heart. It can be used to diagnose the cause of chest pain or other symptoms. Chest pain can be caused by myocardial infarction that may need immediate investigation and accurate diagnosis before any treatment. The procedure can be done as out-patient, convenient, and with very minimal contrast media (Dye) injection. A CT coronary angiography relies on a powerful X-ray machine with multi-detectors and special computer software to produce 2D and 3D images of the heart and its blood vessels. A conventional coronary angiography is an invasive procedure that requires a flexible tube (catheter) to be threaded through the groin or arm to the heart or coronary arteries. CT coronary angiography is an advantage, non-invasive, and the option for the patient who have contraindicated for conventional angiography. But clinically conventional angiography is still the gold standard for detecting coronary arterial disease.

scholarly journals Role of Hyperinsulinemia in Atherosclerotic Coronary Arterial Disease. Studies of Semi-quantitative Coronary Angiography.

1999 ◽  
Vol 38 (9) ◽  
pp. 691-697 ◽  
Author(s):  
Kazufumi TSUCHIHASHI ◽  
Nobuichi HIKITA ◽  
Mamoru HASE ◽  
Jun AGATA ◽  
Shigeyuki SAITOH ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Quantitative Coronary Angiography ◽  
Arterial Disease ◽  
Coronary Arterial Disease

scholarly journals The Role of RIPC in Preventing Organ Damage, Inflammation, and Oxidative Stress during Lower Limb DSA: A Randomised Controlled Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Karl Kuusik ◽  
Teele Kasepalu ◽  
Mihkel Zilmer ◽  
Jaan Eha ◽  
Mare Vähi ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Sham Group ◽  
Troponin T ◽  
Controlled Trial ◽  
Arterial Disease ◽  
Organ Damage ◽  
Cardiac Biomarkers ◽  
Endovascular Procedure ◽  
Significant Difference ◽  
Sham Intervention

Objective. Diagnostic digital subtraction angiography (DSA) and DSA with percutaneous transluminal angioplasty (DSA-PTA) are common procedures for diagnosing and treating symptomatic lower extremity arterial disease (LEAD). However, organ damage following DSA and DSA-PTA is often underrecognised and hence undiagnosed. To reduce the risk induced by invasive procedures in symptomatic LEAD patients, the method of remote ischemic preconditioning (RIPC) has been suggested. The aim of the current study was to assess the effect of RIPC intervention on the organ damage markers profile, oxidative stress, and inflammation biomarkers in LEAD patients undergoing DSA and DSA-PTA procedure. Methods. The RIPC intervention was performed by inflating a standard blood pressure cuff on the patient’s upper arm to 200 mmHg for 5 minutes four times with 5-minute perfusion between each cycle. The sham intervention was performed similarly, but the cuff was inflated to 20 mmHg. Changes in the cardiac and renal damage biomarkers’ profile, oxidative stress, and inflammation biomarkers were recorded before and 24 hours after DSA or DSA-PTA. Results. A total of 111 (RIPC 54, sham 57) patients with symptomatic LEAD scheduled for endovascular procedure were randomised, and 102 patients (RIPC 47, sham 55) completed the study protocol. RIPC significantly limited the increase of adiponectine levels after DSA and DSA-PTA, compared to sham intervention ( p = 0.020 ), but CK-MB levels were markedly lower in the sham group ( p = 0.047 ) after procedure. There was no significant difference between the RIPC and the sham group in mean changes in hs-troponin-T ( p = 0.25 ), NT-proBNP ( p = 0.24 ), creatinine ( p = 0.76 ), eGFR ( p = 0.61 ), urea ( p = 0.95 ), beta-2-microglobuline ( p = 0.34 ), or cystatine C ( p = 0.24 ) levels. Conclusion. In this controlled clinical study, RIPC failed to improve the profile of renal and cardiac biomarkers in patients with LEAD periprocedurally. RIPC significantly limits the rise in adiponectin levels and may influence the decrease of CK-MB levels 24 hours after endovascular procedure.

scholarly journals The significance of elevated troponin T in patients with nondialysis-dependent renal insufficiency: A validation with coronary angiography

2005 ◽  
Vol 28 (7) ◽  
pp. 333-336 ◽  
Author(s):  
John F. Heitner ◽  
Jeptha P. Curtis ◽  
Salman A. Haq ◽  
G. Ralph Corey ◽  
L. Kristin Newby ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Renal Insufficiency ◽  
Troponin T ◽  
Elevated Troponin

scholarly journals Gender-Related Differences in Patients Presenting with Suspected Acute Coronary Syndromes: Clinical Presentation, Biomarkers and Diagnosis

Cardiology ◽  
2015 ◽  
Vol 132 (3) ◽  
pp. 189-198 ◽  
Author(s):  
B.E. Stähli ◽  
C. Gebhard ◽  
K. Yonekawa ◽  
C.E. Gebhard ◽  
L.A. Altwegg ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Acute Coronary Syndromes ◽  
Troponin T ◽  
Protein A ◽  
Female Gender ◽  
Cardiac Biomarkers ◽  
Coronary Syndromes ◽  
Male Patients ◽  
Clinical Profiles ◽  
Timi Risk Score

Objectives: Gender differences in patients presenting with suspected acute coronary syndromes (ACS) have not yet been fully characterized. The aim of this study was to assess gender-related disparities in clinical profiles, biomarkers and diagnoses of patients with suspected ACS. Methods: This single-centre, prospective cohort study included 377 consecutive patients presenting with suspected ACS to the emergency department. Suspected ACS was defined as a request for conventional troponin T (c-cTnT) measurements on clinical grounds. Results: Women were older than men (p = 0.004), and had a lower prevalence of known coronary artery and peripheral vascular disease (p < 0.05). c-cTnT was positive in 8% of female and in 14% of male patients (p = 0.16), TIMI risk score and cardiac biomarkers including c-cTnT, hs-cTnT, myoglobin, creatine kinase, N-terminal pro-brain natriuretic peptide, myeloid-related protein 8/14 and pregnancy-associated plasma protein A were lower in women (p < 0.05). Women were less frequently diagnosed with ACS (30 vs. 51%), and were not referred for urgent coronary angiography as often as men (p < 0.001). In multivariate analysis, female gender was associated with a lower referral for coronary angiography (HR 0.41, 95% CI 0.23-0.78, p = 0.006). Conclusions: In patients with suspected ACS, women presented with different biomarker profiles, and were less often diagnosed with ACS and referred to coronary angiography.

Coronary arterial disease associated with arteriosclerosis in lower extremity: angiographic analysis

1993 ◽  
Vol 29 (6) ◽  
pp. 1163
Author(s):  
Ji Hye Kim ◽  
Jin Wook Chung ◽  
Seon Kyu Lee ◽  
Joon Koo Han ◽  
Jae Hyung Park ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Arterial Disease ◽  
Coronary Arterial Disease

scholarly journals Urinary fatty acid binding protein 3 (uFABP3) is a potential biomarker for peripheral arterial disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Abdelrahman Zamzam ◽  
Muzammil H. Syed ◽  
John Harlock ◽  
John Eikelboom ◽  
Krishna K. Singh ◽  
...  
Keyword(s):  
Fatty Acid ◽  
Fatty Acid Binding Protein ◽  
Binding Protein ◽  
Arterial Disease ◽  
Prior History ◽  
P Value ◽  
Fatty Acid Binding ◽  
Coronary Arterial Disease ◽  
Acid Binding Protein ◽  
Potential Biomarker

AbstractPlasma levels of fatty acid binding protein 3 (pFABP3) are elevated in patients with peripheral artery disease (PAD). Since the kidney filters FABP3 from circulation, we investigated whether urinary fatty acid binding protein 3 (uFABP3) is associated with PAD, and also explored its potential as a diagnostic biomarker for this disease state. A total of 130 patients were recruited from outpatient clinics at St. Michael’s Hospital, comprising of 65 patients with PAD and 65 patients without PAD (non-PAD). Levels of uFABP3 normalized for urine creatinine (uFABP3/uCr) were 1.7-folds higher in patients with PAD [median (IQR) 4.41 (2.79–8.08)] compared with non-PAD controls [median (IQR) 2.49 (1.78–3.12), p-value = 0.001]. Subgroup analysis demonstrated no significant effect of cardiovascular risk factors (age, sex, hypertension, hypercholesteremia, diabetes and smoking) on uFABP3/uCr in both PAD and non-PAD patients. Spearmen correlation studies demonstrated a significant negative correlation between uFABP3/uCr and ABI (ρ = − 0.436; p-value = 0.001). Regression analysis demonstrated that uFABP3/Cr levels were associated with PAD independently of age, sex, hypercholesterolemia, smoking, prior history of coronary arterial disease and Estimated Glomerular Filtration rate (eGFR) [odds ratio: 2.34 (95% confidence interval: 1.47–3.75) p-value < 0.001]. Lastly, receiver operator curve (ROC) analysis demonstrated unadjusted area under the curve (AUC) for uFABP3/Cr of 0.79, which improved to 0.86 after adjusting for eGFR, age, hypercholesteremia, smoking and diabetes. In conclusion, our results demonstrate a strong association between uFABP3/Cr and PAD and suggest the potential of uFABP3/Cr in identifying patients with PAD.

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