Abstract 19569: High-sensitive Troponin T Cut-off Value for Myocardial Infarction After Vascular Surgery

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Danielle M Gualandro ◽  
Gisela B Llobet ◽  
Pai C Yu ◽  
Daniela Calderaro ◽  
Andre C Marques ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Vascular Surgery ◽  
Roc Curve ◽  
Troponin T ◽  
Curve Analysis ◽  
Operating Characteristics ◽  
Roc Curve Analysis ◽  
Cutoff Value ◽  
Coronary Syndrome ◽  
High Sensitive Troponin

Introduction: Isolated high sensitive cardiac troponin T (hsTnT) elevations after vascular surgery are frequent and may lead to over diagnosis of myocardial infarction (MI). The aim of our study was to determine the accuracy of the current hsTnT cut-off value in the setting of acute coronary syndrome (ACS) after vascular surgery. Methods: Between August 2012 and March 2014, we included 337 consecutive patients submitted to arterial vascular surgery for which cardiac perioperative evaluation was requested. Perioperative surveillance included 12-lead electrocardiogram and hsTnT measurements on the three days following surgery. Patients were followed-up by cardiologists until hospital discharge and monitored for ACS. A receiver operating characteristics (ROC) curve analysis was performed to determine the hsTnT cut-off value with better accuracy for the diagnosis of perioperative ACS. Results: Of the 337 patients included, 240 (71.2%) presented hsTnT elevation above the manufacturer-provided cut-off value (0.014 ng/ml), whereas 22 (6.5%) fulfilled criteria for ACS. Median post-operative peak hsTnT of ACS patients were 0.215 ng/ml (IQR 0.043-0.493 ng/ml), versus 0.02 ng/ml (IQR 0.012-0.038 ng/ml) in patients that did not have events (P<0.001). After performing a ROC curve analysis (AUC = 0.876), we found that the manufacture-provided cutoff hsTnT value yielded a sensitivity of 100% and specificity of only 35% for diagnosis of perioperative ACS. A new hsTnT cutoff value of 0.0415 ng/ml was obtained with 86.4% sensitivity and 77% specificity for the diagnosis of perioperative ACS. Ninety-two patients (27.3%) had hsTnT elevations above the proposed new cutoff. Conclusion: A different hsTnT cutoff value of 0.0415 ng/ml is proposed and could be more useful for the diagnosis of perioperative ACS.

scholarly journals Immature platelet fraction is a strong predictor of adverse cardiovascular events in patients with acute coronary syndrome. Results of the ISAR-REACT 5 reticulated platelet substudy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Bongiovanni ◽  
K Mayer ◽  
N Schreiner ◽  
V Karschin ◽  
I Wustrow ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Primary Endpoint ◽  
Roc Curve ◽  
Cardiovascular Events ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Cox Regression Analysis ◽  
Coronary Syndrome ◽  
Immature Platelet Fraction

Abstract Introduction Reticulated or immature Platelets are pro-thrombotic RNA-rich young platelets, which have been reported to correlate with adverse events in several pathological settings including coronary artery disease. However, the predictive value of this subgroup of platelets in patients with acute coronary syndrome treated with the potent novel P2Y12 inhibitors prasugrel or ticagrelor has not been investigated yet. Moreover, their role as predictors of major bleeding is unclear. Purpose The primary aim of this prespecified reticulated platelet ISAR-REACT-5 substudy was to evaluate the immature platelet fraction (IPF%) in peripheral blood as a predictor of the composite primary endpoint consisting of death, myocardial infarction, or stroke at one year after randomization in patients with acute coronary syndrome. Methods IPF was assessed in the first 24h after randomization using a fully automated system and correlated to the incidence of the primary endpoint. All patients with available IPF values were included. The Sysmex system uses two fluorescent dyes to stain platelet RNA and a computer algorithm (Sysmex IPF Master) discriminates immature from mature platelets by the intensity of forward scattered light and fluorescence. The immature platelet fraction is displayed as percentage of the total optical platelet count (IPF%). Results IPF values within the first 24h after randomization were available in a total of 506 randomized patients. Baseline characteristics and IPF (median [IQR]) values did not differ between the 2 study groups (IPF: prasugrel 3.9% [2.7–5.8] ticagrelor 3.4% [2.5–5.6] p=0.56). Significantly higher IPF values were observed in patients reaching the primary endpoint (n=55 of 506) independent from the study group (p for interaction= 0.28). ROC-curve analysis revealed a cut-of value of IPF 3.6% for the prediction of death, myocardial infarction or stroke with a Hazard ratio (HR) according to cox-regression analysis of 1.98 (95% CI, 1.15–3.44), P=0.01 (Figure 1A). Interestingly, we also detected a trend for higher major bleedings (BARC 3–5) in patients with elevated IPF values above IPF&gt;4.8% according to ROC-curve analysis (Figure 1B). Conclusion IPF was significantly associated with the primary endpoint in the ISAR-REACT 5 substudy independent from the treatment group and therefore is a promising novel biomarker for the prediction of adverse cardiovascular events in patients with acute coronary syndrome. Figure 1 Funding Acknowledgement Type of funding source: None

scholarly journals Right choice of a method for determination of cut-off values: A statistical tool for a diagnostic test

2014 ◽  
Vol 5 (3) ◽  
pp. 30-34 ◽  
Author(s):  
Balkishan Sharma ◽  
Ravikant Jain
Keyword(s):  
Logistic Regression ◽  
Discriminant Analysis ◽  
Diagnostic Test ◽  
Roc Curve ◽  
Traditional Method ◽  
Statistical Technique ◽  
Curve Analysis ◽  
Operating Characteristics ◽  
Roc Curve Analysis

Objective: The clinical diagnostic tests are generally used to identify the presence of a disease. The cutoff value of a diagnostic test should be chosen to maximize the advantage that accrues from testing a population of human and others. When a diagnostic test is to be used in a clinical condition, there may be an opportunity to improve the test by changing the cutoff value. To enhance the accuracy of diagnosis is to develop new tests by using a proper statistical technique with optimum sensitivity and specificity. Method: Mean±2SD method, Logistic Regression Analysis, Receivers Operating Characteristics (ROC) curve analysis and Discriminant Analysis (DA) have been discussed with their respective applications. Results: The study highlighted some important methods to determine the cutoff points for a diagnostic test. The traditional method is to identify the cut-off values is Mean±2SD method. Logistic Regression Analysis, Receivers Operating Characteristics (ROC) curve analysis and Discriminant Analysis (DA) have been proved to be beneficial statistical tools for determination of cut-off points.Conclusion: There may be an opportunity to improve the test by changing the cut-off value with the help of a correctly identified statistical technique in a clinical condition when a diagnostic test is to be used. The traditional method is to identify the cut-off values is Mean ± 2SD method. It was evidenced in certain conditions that logistic regression is found to be a good predictor and the validity of the same can be confirmed by identifying the area under the ROC curve. Abbreviations: ROC-Receiver operating characteristics and DA-Discriminant Analysis. Asian Journal of Medical Science, Volume-5(3) 2014: 30-34 http://dx.doi.org/10.3126/ajms.v5i3.9296      

scholarly journals Ascitic pseudouridine discriminates between hepatocarcinoma-derived ascites and cirrhotic ascites

1996 ◽  
Vol 42 (11) ◽  
pp. 1843-1846 ◽  
Author(s):  
G Castaldo ◽  
M Intrieri ◽  
G Calcagno ◽  
L Cimino ◽  
G Budillon ◽  
...  
Keyword(s):  
Liver Biopsy ◽  
Roc Curve ◽  
Curve Analysis ◽  
Diagnostic Sensitivity ◽  
Serum Concentrations ◽  
Diagnostic Specificity ◽  
Roc Curve Analysis ◽  
Neoplastic Cells ◽  
Cutoff Value ◽  
Cirrhotic Patients

Abstract Various biochemical indexes discriminate neoplastic from nonneoplastic ascites. However, within the latter group, the distinction between cirrhotic ascites and ascites caused by hepatocarcinoma (HC) is usually based on liver biopsy or cytology. HC-derived ascites is included in the group of nonneoplastic ascites because it is not associated with peritoneal spreading of neoplastic cells. In 54 cases of cirrhotic ascites and 17 cases of HC ascites, all histologically diagnosed, ascitic pseudouridine concentrations discriminated cirrhotic from HC ascites. For example, using the cutoff value of 4.25 mumol/L (obtained by ROC curve analysis) resulted in a diagnostic sensitivity of 88.2% and a diagnostic specificity of 90.8%. Moreover, in cirrhosis, the ascitic concentrations of pseudouridine were lower than serum concentrations, and the two sets of values were correlated; in HC, however, ascitic pseudouridine concentrations were higher than serum concentrations, and the two were unrelated. These findings strongly suggest that in cirrhotic patients ascitic pseudouridine derives from serum by diffusion, whereas in HC patients the mechanism appears to be more complex.

scholarly journals A Novel Inflammation-Based Prognostic Score: The Fibrinogen/Albumin Ratio Predicts Prognoses of Patients after Curative Resection for Hepatocellular Carcinoma

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Qiaodong Xu ◽  
Yongcong Yan ◽  
Songgang Gu ◽  
Kai Mao ◽  
Jianlong Zhang ◽  
...  
Keyword(s):  
Roc Curve ◽  
Prognostic Value ◽  
Curative Resection ◽  
Operating Characteristic ◽  
Curve Analysis ◽  
Prognostic Scores ◽  
Roc Curve Analysis ◽  
Optimal Cutoff ◽  
Albumin Ratio ◽  
Cutoff Value

Background. Inflammation is an important hallmark of cancer. Fibrinogen and albumin are both vital factors in systemic inflammation. This study investigated the prognostic value of the fibrinogen/albumin ratio in HCC patients who underwent curative resection. Methods. HCC patients (n=151) who underwent curative resection were evaluated retrospectively. The optimal cutoff value for the fibrinogen/albumin ratio was selected by receiver operating characteristic (ROC) curve analysis. Correlations between preoperative fibrinogen/albumin ratios and clinicopathologic characteristics were analyzed by χ2 test. The area under the receiver operating characteristic curve (AUC) was calculated to compare the prognostic value of the fibrinogen/albumin ratio with other prognostic scores (neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and albumin-bilirubin (ALBI) score). The overall survival (OS) and time to recurrence (TTR) were assessed by the log-rank test and the Cox proportional hazard regression model. Results. An optimal cutoff value of the preoperative fibrinogen/albumin ratio (0.062) was determined for 151 patients who underwent curative resection for HCC via a ROC curve analysis. Fibrinogen/albumin ratio > 0.062 was significantly associated with microvascular invasion, an advanced BCLC stage, and ALBI grade. Multivariate analyses revealed that fibrinogen/albumin ratio was an independent predictor for OS (P=0.003) and TTR (P=0.035). The prognostic ability of fibrinogen/albumin ratio was comparable to other prognostic scores (NLR, PLR, and ALBI score) by AUC analysis. Patients with a fibrinogen/albumin ratio > 0.062 had lower 1-, 3-, and 5-year OS rates (66.0%, 41.8%, and 28.2% versus 81.9%, 69.3%, and 56.1%, resp., P<0.001) and higher 1-, 3-, and 5-year recurrence rates (60.9%, 79.2%, and 90.5% versus 49.5%, 69.1%, and 77.1%, resp., P=0.008) compared with patients with fibrinogen/albumin ratio ≤ 0.062. Conclusion. The preoperative fibrinogen/albumin ratio is an effective prognostic factor for HCC patients who underwent curative resection. An elevated fibrinogen/albumin ratio significantly correlates with poorer survival and a higher risk of recurrence in HCC patients.

scholarly journals Combine preoperative estimation of serum thyroglobulin and ACR-thyroid imaging reporting and data system scoring could accurately define malignant thyroid nodules

2020 ◽  
Vol 8 (1) ◽  
pp. 32
Author(s):  
Waseem A. Shoda
Keyword(s):  
Roc Curve ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Curve Analysis ◽  
Data System ◽  
Operating Characteristics ◽  
Roc Curve Analysis ◽  
Serum Thyroglobulin ◽  
Thyroid Imaging ◽  
Significant Difference

Background: Evaluation of diagnostic ability of preoperative estimation of serum thyroglobulin (TG) to detect malignant thyroid nodules (TN) in comparison to the American College of Radiology, Thyroid imaging reporting and data system (ACR-TIRADS), fine needle aspiration cytology (FNAC) and intraoperative frozen section (IO-FS).Methods: 34 patients with ACR-TIRADS 2-4 TN were evaluated preoperatively for identification of malignancy and all underwent total thyroidectomy with bilateral neck block dissection if indicated. Results of preoperative investigations were statistically analyzed using the Receiver operating characteristics (ROC) curve analysis as predictors for malignancy in comparison to postoperative paraffin sections.Results: Preoperative serum TG levels had 100% sensitivity and negative predictive value, while ACR-TIRADS scoring had 100% specificity and positive predictive value with accuracy rates of 95.35% and 97.67% for TG and TIRADS, respectively. ROC curve analysis defined preoperative ACR-TIRADS class and serum TG as highly diagnostic than FNAC for defining malignancy with non-significant difference between areas under curve for TIRADS and TG. For cases had intermediate risk of malignancy on TIRADS, IO-FS had missed 3, FNAC missed 4, while serum TG levels were very high in the 13 cases and were defined by ROC curve as the only significant predictor for malignancy.Conclusions: Preoperative estimation of serum TG showed higher diagnostic validity than FNAC, high predictability of cancer and ability to verify the intermediate findings on TIRADS. Combined preoperative TIRADS and TG estimation could accurately discriminate malignant TN with high accuracy and spare the need for preoperative FNAC or IO-FS. 

scholarly journals DEFINING TROCHLEAR DYSPLASIA VIA THE LATERAL TROCHLEAR INCLINATION ANGLE

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0017
Author(s):  
Christopher Cheng ◽  
Jon Hedgecock ◽  
Matthew Solomito ◽  
Sheeba Joseph ◽  
J. Lee Pace
Keyword(s):  
Measurement Technique ◽  
Roc Curve ◽  
Patellar Instability ◽  
Clinical Decision Making ◽  
Trochlear Dysplasia ◽  
Curve Analysis ◽  
Threshold Values ◽  
Roc Curve Analysis ◽  
Good Discrimination ◽  
Cutoff Value

Background: Trochlear dysplasia (TD) is the principle anatomic risk factor for patellar instability (PI). The lateral trochlear inclination (LTI) is a quantitative measure of trochlear morphology on axial magnetic resonance imaging (MRI). Threshold values for patients at risk for PI via LTI measurement have ranged from 11o to 17o. Our group recently described a new technique for characterizing LTI by referencing the fully-formed posterior femoral condyles. This novel measurement technique revealed that the historically-used method was comparable in reliability but significantly underestimated TD. Purpose: The purpose of this study was to define, with high specificity, a LTI value cutoff value consistent with patellar instability using the new LTI measurement technique. Methods: MRI scans of 95 patients aged 9 to 18 years treated for PI at our tertiary referral center were compared with a control cohort of 98 age- and gender- matched patients with knee imaging but no clinical evidence of PI. LTI was measured as the angle formed between a line subtended from the cartilaginous surface of the lateral trochlea at its most proximal extent and a line parallel to the fully-formed posterior condyles. Receiver operator characteristic (ROC) curve analysis was conducted to establish a cutoff value with optimal specificity and sensitivity. Results: Average LTI was significantly lower in the study group (5.9±10.4o) than control (18.9±5.8o) (p<0.001). Area under the ROC curve was 0.86. A proposed 8.9o LTI threshold angle achieves good discrimination between the two groups, with specificity of 0.904 and sensitivity of 0.684. Conclusion: Re-examination of previously described threshold values using ROC curve analysis of LTI measured in reference to the posterior condyles found 8.9o as the optimal threshold value to achieve good discrimination between patients with and without PI. The novel technique has previously been established to have excellent intra- and inter-observer reliability and produced significantly lower LTI values than the historically-used technique. Taken in concert, this new cutoff is valuable to improve future clinical decision making in regards to risk stratification, treatment algorithms and research purposes.

scholarly journals Efficacy of Differential Diagnosis of Thyroid Nodules by Shear Wave Elastography, the Stiffness Map

2021 ◽  
Author(s):  
Myung Hi Yoo ◽  
Hye Jeong Kim ◽  
In Ho Choi ◽  
Suyeon Park ◽  
Sumi Yun ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Shear Wave ◽  
Roc Curve ◽  
Thyroid Nodules ◽  
Shear Wave Elastography ◽  
Curve Analysis ◽  
Follicular Neoplasm ◽  
Roc Curve Analysis ◽  
Cutoff Value ◽  
Benign Pathology

Abstract Background Fine-needle aspiration is the gold standard, but malignancy rate of the indeterminate cytology is reported as 20-50 %. We aimed to evaluate the efficacy of shear wave elastography (SWE) added to ultrasonogram in the differential diagnosis of thyroid nodules. Methods We retrospectively reviewed the medical records of 258 consecutive patients. Thyroid nodules were divided in to 4 categoies according to maximum elasticity (EMax) and nodule depth/width (D/W) ratio; Category 1 (EMax ≥42.6 kPa & D/W&lt;0.9), Category 2 (EMax &lt;42.6 kPa & D/W&lt;0.9 ), Category 3 (EMax ≥42.6 kPa & D/W≥ 0.9) and Category 4 (EMax&lt;46.2 kPa & D/W≥ 0.9 ). The cutoff value of EMax was set using ROC curve analysis to predict nodular hyperplasia (NH) from follicular neoplasm (FN). Cutoff value ​​for nodule D/W ratio was set using ROC curve analysis for malignancy. Results NH was the most prevalent pathology group in category 1, FN in category 2 and PTC in category 3. The category 3 demonstrated the highest rate of malignancy (81.8%) and had 55.4% sensitivity and 90% specificity for predicting malignancy. When assessing the benign pathology of NH in follicular patterned lesion, category 1 demonstrated the highest NH prevalence of 88.9% (34/37) and had 73.9% sensitivity and 85.0% specificity. Conclusion The performance for malignancy was highest in category 3 and predictive ability for benign pathology of NH in follicular lesion was highest in category 1. So the information of EMax and nodule D/W ratio was useful to predict the pathology of thyroid nodules

Abstract 13743: Prognostic Values of Ratio of Serum Eicosapentaenoic Acid to Arachidonic Acid on Clinical Outcome after Endovascular Therapy in Patients with Peripheral Artery Disease due to Femoropopliteal Artery Lesions

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Keiichi Hishikari ◽  
Shigeki Kimura ◽  
Yosuke Yamakami ◽  
Keisuke Kojima ◽  
Takatoshi Shigeta ◽  
...  
Keyword(s):  
Arachidonic Acid ◽  
Clinical Outcome ◽  
Endovascular Therapy ◽  
Roc Curve ◽  
Curve Analysis ◽  
Peripheral Artery ◽  
Roc Curve Analysis ◽  
Cutoff Value ◽  
Femoropopliteal Artery ◽  
Artery Disease

Background: Peripheral artery disease (PAD) patients have a substantially increased risk of mortality and cardiovascular morbidity than those without PAD. However, risk prediction tools have not been established among patients with PAD to identify who is likely destined for adverse clinical outcome. Eicosapentaenoic acid to arachidonic acid (EPA/AA) ratio has emerged as predictor of mortality endpoints in vascular diseases, especially, coronary artery disease and cerebrovascular disease. In contrast, the prognostic value of EPA/AA ratios in patients with PAD is unclear. We sought to examine whether assessment of serum ratio of EPA/AA in patients with PAD due to femoropopliteal artery lesions can predict clinical outcome after endovascular therapy (EVT). Methods: We obtained serum EPA/AA ratio in 132 consecutive patients with PAD due to femoropopliteal artery lesions before EVT. We analyzed the incidence of major adverse event (MAE) including major adverse limb event (MALE) and any-cause death. The clinical characteristics and laboratory variables were compared and analyzed between MAE group and non-MAE group. Cox regression analyses were used for survival tests. Receiver operating characteristics (ROC) curve analysis was used to determine an optimal cutoff value for EPA/AA ratio to predict MAE after EVT. Results: At a median follow-up of 17 months, MALE occurred in 39 patients (29.5%) and 10 patients (7.6%) died. Significantly lower level of preprocedural serum EPA/AA ratio was observed in the MAE group than non-MAE group. Multivariable Cox analysis showed critical limb ischemia (hazard ratio, 2.93; 95% confidence interval [CI], 1.59-5.40; P = 0.001) and preprocedural serum EPA/AA ratio (hazard ratio, 0.08; 95% CI, 0.02-0.43; P = 0.003) were independent predictors of MAE after EVT. The cutoff value of EPA/AA ratio via ROC curve analysis was 0.29 (66.3% sensitivity, 73.5% specificity). Conclusions: Our findings suggest that lower serum EPA/AA ratio is associated with a greater risk of MALE and any-cause death after EVT in patients with PAD due to femoropopliteal artery lesions.

Global longitudinal strain and chronic kidney disease prognostic impact on acute coronary syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.R Morgado Gomes ◽  
D Campos ◽  
C Saleiro ◽  
J Gameiro Lopes ◽  
J.P Sousa ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Roc Curve ◽  
Cox Regression ◽  
Left Ventricular ◽  
Curve Analysis ◽  
Left Ventricular Ejection ◽  
Roc Curve Analysis ◽  
Ventricular Ejection Fraction ◽  
Cox Regression Analysis ◽  
Coronary Syndrome

Abstract Background Impaired left ventricular ejection fraction (LVEF) and chronic kidney disease (CKD) have been associated with poorer outcomes in acute coronary syndrome (ACS). Increasing evidence on global left ventricular longitudinal strain (GLS) suggests superiority over left ventricular ejection fraction (LVEF) in risk stratification. Methods This study was based on a retrospective analysis of consecutive patients admitted to a Coronary Care Unit between 2009 and 2016. Baseline characteristics and echocardiographic parameters, including LVEF, were assessed. For each patient, a two-dimensional speckle tracking of the left ventricle was assessed and average GLS was calculated using 2, 3 and 4-chamber views. Blood creatinine was measured during hospital stay and used to estimate glomerular filtration rate (GFR) with Modification of Diet in Renal Disease (MDRD) equation. A cox regression analysis was performed to determine mortality prediction value of average GLS, LVEF and GFR in this population. Receiver operating characteristic (ROC) curve analysis was conducted and area under the curve (AUC) was estimated. Results A total of 85 patients (66.7±12.7 years old; 78.8% males) were enrolled. LVEF mean was 49.4±9.8% and average GLS was −16.0±4.0%. GFR median was 80.0±48.9 ml/min/1.73m2. In cox regression analysis, worse average GLS was associated with greater mortality (HR 0.721; 95% CI 0.599–0.867; P=0.001). GFR was inversely related to death (HR 0.967; 95% CI 0.944–0.991, P=0.008). In cox regression analysis using average GLS and GFR as covariates, both proved to be independent predictors of mortality (for average GLS, HR 0.748; 95% CI 0.610–0.918, P=0.005; for GFR, HR 0.974; 95% CI 0.949–0.999; P=0.044). The AUC of average GLS to predict mortality was 0.78 (P&lt;0.001, sensitivity 50.7% and specificity 100%) and for average GLS and GFR combined was 0.85 (P&lt;0.001, sensitivity 84.0% and specificity 77.8%). Although LVEF proved to be a mortality predictor, the AUC obtained by ROC curve analysis was inferior to average GLS, with statistical significance (P=0.043). Conclusions GLS and CKD proved to be independent predictors of mortality in ACS patients. GLS showed superiority when compared to LVEF in risk stratification and in the future it might replace LVEF. The model combining GLS and GFR emphasized the increased risk of CKD patients and how they should be seen as high-risk patients. ROC curve analysis Funding Acknowledgement Type of funding source: None

scholarly journals PEMERIKSAAN CKMB DAN HS-TROPONIN T PADA PASIEN INFARK JANTUNG DENGAN PENINGKATAN SEGMEN NON-ST

2018 ◽  
Vol 20 (2) ◽  
pp. 160
Author(s):  
AK Salim ◽  
M Suryaatmadja ◽  
DA Hanafi
Keyword(s):  
Myocardial Infarction ◽  
Chest Pain ◽  
Troponin T ◽  
Coronary Insufficiency ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Grade Ii ◽  
High Sensitive Troponin

Acute Coronary Syndrome (ACS)1 is a typical chest pain symptom due to ischemic coronary insufficiency caused by blockage of acoronary artery thrombus. There are three different states: Unstable Angina (UA), Non-ST segment Elevation Myocardial Infarction(NSTEMI) and ST segment Elevation Myocardial Infarction (STEMI).1 Cardiac Troponin (cTn) is a myocardial ischemia marker.6 A clinicalcontext is very important for the interpretation of the value of cTn, the increase of cTn is not always due to Acute Myocardial Infarction(AMI). According to a research, a new cTn examination called ‘high sensitive troponin T’ (hs-cTropT) has a higher sensitivity than theprevious generations for the diagnosis of AMI.7 A 60- year- old female patient entered the ER of Cardiovascular Hospital Harapan Kitasuffering from chest pain since the day before. From the examination it seemed that the patient had a risk factor of dyslipidemia. Thelaboratory results showed normal routine hematology, CKMB , renal function, glucose and electrolytes, however, hs - cTropT and lipidprofile were shown above normal. The differential diagnosis of the symptoms shown was: UA/NSTEMI, with Congestive Heart Failure(CHF) grade II and overweight.

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