scholarly journals High-sensitivity cardiac Troponin T delta concentration after repeat pulmonary vein isolation

2019 ◽  
Vol 29 (2) ◽  
pp. 407-412
Author(s):  
Ivan Zeljkovic ◽  
Sven Knecht ◽  
Christian Sticherling ◽  
Michael Kühne ◽  
Stefan Osswald ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
Cox Regression Analysis ◽  
Prognostic Power ◽  
Af Recurrence

Introduction: Difference between high-sensitivity cardiac troponin T concentrations (hs-cTnT) before and after ablation procedure (delta concentration) reflects the amount of myocardial injury. The aim of the study was to investigate hs-cTnT prognostic power for predicting atrial fibrillation (AF) recurrence after repeat pulmonary vein isolation (PVI) procedure. Materials and methods: Consecutive patients with paroxysmal AF undergoing repeat PVI using a focal radiofrequency catheter were included in the study. Hs-cTnT was measured before and 18-24 hours after the procedure. Standardized 3, 6 and 12-month follow-up was performed. Cox-regression analysis was used to identify predictors of AF recurrence. Results: A total of 105 patients undergoing repeat PVI were analysed (24% female, median age 61 years). Median (interquartile range) hs-cTnT delta after repeat PVI was 283 (127 - 489) ng/L. After a median follow-up of 12 months, AF recurred in 24 (23%) patients. A weak linear relationship between the total radiofrequency energy delivery time and delta hs-cTnT was observed (Pearson R2 = 0.31, P = 0.030). Delta Hs-cTnT was not identified as a significant long-term predictor of AF recurrence after repeated PVI (P = 0.920). Conclusion: This was the first study evaluating the prognostic power of delta hs-cTnT in predicting AF recurrence after repeat PVI. Delta hs-cTnT does not predict AF recurrence after repeat PVI procedures. Systematic measurement of hs-cTnT after repeat PVI does not add information relevant to outcome.

scholarly journals High-sensitive cardiac troponin T as a predictor of efficacy and safety after pulmonary vein isolation using focal radiofrequency, multielectrode radiofrequency and cryoballoon ablation catheter

Open Heart ◽  
2019 ◽  
Vol 6 (1) ◽  
pp. e000949 ◽  
Author(s):  
Ivan Zeljkovic ◽  
Sven Knecht ◽  
Nikola Pavlovic ◽  
Umut Celikyrut ◽  
Florian Spies ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Cardiac Troponin ◽  
Myocardial Injury ◽  
Troponin T ◽  
Cardiac Troponin T ◽  
Cryoballoon Ablation ◽  
Creatine Kinase Mb ◽  
Af Recurrence

IntroductionMyocardial injury markers such as high-sensitive cardiac troponin T (hs-cTnT) and creatine kinase MB (CK-MB) reflects the amount of myocardial injury with ablation. The aim of the study was to identify the value of myocardial injury markers to predict outcomes after pulmonary vein isolation (PVI) using three different ablation technologies.MethodsConsecutive patients undergoing PVI using a standard 3.5 mm irrigated-tip radiofrequency catheter (RF-group), an irrigated multielectrode radiofrequency catheter (IMEA-group) and a second-generation cryoballoon (CB-group) were analysed. Blood samples to measure injury markers were taken before and 18–24 hours after the ablation. Procedural complications were collected and standardised follow-up was performed. Logistic regression was used to identify predictors of recurrence and complications.Results96 patients (RF group: n=40, IMEA-group: n=17, CB-group: n=39) undergoing PVI only were analysed (82% male, age 59±10 years). After a follow-up of 12 months, atrial fibrillation (AF) recurred in 45% in the RF-group, 29% in the IMEA-group and 36% in the CB-group (p=0.492). Symptomatic pericarditis was observed in 20% of patients in the RF-group, 15% in the IMEA-group and 5% in the CB-group (p=0.131). None of the injury markers was predictive of AF recurrence or PV reconnection after a single procedure. However, hs-cTnT was identified as a predictor of symptomatic pericarditis (OR: 1.003 [1.001 to 1.005], p=0.015).ConclusionHs-cTnT and CK-MB were significantly elevated after PVI, irrespective of the ablation technology used. None of the myocardial injury markers were predictive for AF recurrence or PV reconnection, but hs-cTnT release predicts the occurrence of symptomatic pericarditis after PVI.

scholarly journals High-Sensitivity Cardiac Troponin T is A Risk Factor for Major Adverse Cardiovascular Events and All-Cause Mortality: 9.5 Year Follow-up Study

2020 ◽  
Author(s):  
Xiaona Wang ◽  
Ruihua Cao ◽  
Xu Yang ◽  
Wenkai Xiao ◽  
Yun Zhang ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Cardiovascular Events ◽  
Troponin T ◽  
High Sensitivity ◽  
Major Adverse Cardiovascular Events ◽  
Cardiac Troponin T ◽  
Follow Up Study ◽  
All Cause Mortality ◽  
Coronary Events

Abstract Background: The relationship between high-sensitivity cardiac troponin T (hs-cTnT) and different cardiovascular events has been observed in several large community studies, and the results have been controversial. However, there is currently no cross-sectional or longitudinal follow-up study on hs-cTnT in the Chinese population.Methods: We analyzed the association of plasma hs-cTnT levels with major adverse cardiovascular events and all-cause mortality in 1325 subjects from a longitudinal follow-up community-based population in Beijing, China.Results: In the Cox proportional hazards models analysis, the risk of MACE increased with the increase of hs-cTnT levels (HR, 1.223, 95% CI, 1.054–1.418, P = 0.008). Increased hs-cTnT levels were associated with coronary events (HR, 1.391, 95% CI, 1.106–1.749, P = 0.005) in Model 4. Cox proportional risk regression model analysis revealed that increased hs-cTnT levels were associated with an increased risk of mortality (HR, 1.763, 95% CI, 1.224–2.540, P = 0.002), even after adjusting hs-CRP and NT-proBNP. The area under the ROC curve for predicting MACE was 0.559 (95% CI, 0.523–0.595, P = 0.001). The areas under the ROC curve for predicting coronary events and mortality were 0.629 (95% CI, 0.580–0.678, P < 0.001) and 0.644 (95% CI, 0.564–0.725, P < 0.001), respectively.Conclusions: Our findings in the Chinese cohort support that hs-cTnT is a risk factor for major adverse cardiovascular events and all-cause mortality.

scholarly journals High-Sensitivity Cardiac Troponin T Is a Risk Factor for Major Adverse Cardiovascular Events and All-Cause Mortality: A 9.5-Year Follow-Up Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Xiaona Wang ◽  
Peiqi Wang ◽  
Ruihua Cao ◽  
Xu Yang ◽  
Wenkai Xiao ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Cardiovascular Events ◽  
Troponin T ◽  
High Sensitivity ◽  
Major Adverse Cardiovascular Events ◽  
Cardiac Troponin T ◽  
Follow Up Study ◽  
All Cause Mortality ◽  
Coronary Events

Background. The relationship between high-sensitivity cardiac troponin T (hs-cTnT) and different cardiovascular events has been observed in several large community studies, and the results have been controversial. However, there is currently no cross-sectional or longitudinal follow-up study on hs-cTnT in the Chinese population. Methods. We analyzed the association of plasma hs-cTnT levels with major adverse cardiovascular events (MACEs) and all-cause mortality in 1325 subjects from a longitudinal follow-up community-based population in Beijing, China. Results. In the Cox proportional hazards models analysis, the risk of MACEs increased with the increase of hs-cTnT levels (HR, 1.223, 95% CI, 1.054–1.418, P = 0.008 ). Increased hs-cTnT levels were associated with coronary events (HR, 1.391, 95% CI, 1.106–1.749, P = 0.005 ) in Model 4. Cox proportional risk regression model analysis revealed that increased hs-cTnT levels were associated with an increased risk of mortality (HR, 1.763, 95% CI, 1.224–2.540, P = 0.002 ), even after adjusting hs-CRP and NT-proBNP. The area under the ROC curve for predicting MACEs was 0.559 (95% CI, 0.523–0.595, P = 0.001 ). The areas under the ROC curve for predicting coronary events and mortality were 0.629 (95% CI, 0.580–0.678, P < 0.001 ) and 0.644 (95% CI, 0.564–0.725, P < 0.001 ), respectively. Conclusions. Our findings in the Chinese cohort support that hs-cTnT is a risk factor for major adverse cardiovascular events and all-cause mortality.

scholarly journals Markers of Plaque Instability in the Early Diagnosis and Risk Stratification of Acute Myocardial Infarction

2012 ◽  
Vol 58 (1) ◽  
pp. 246-256 ◽  
Author(s):  
Nora Schaub ◽  
Tobias Reichlin ◽  
Christophe Meune ◽  
Raphael Twerenbold ◽  
Philip Haaf ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Risk Stratification ◽  
Cardiac Troponin ◽  
Troponin T ◽  
Acute Chest Pain ◽  
High Sensitivity ◽  
Final Diagnosis ◽  
Cardiac Troponin T ◽  
Plaque Instability

Abstract BACKGROUND Plaque erosion and plaque rupture occur early in the pathophysiology of acute myocardial infarction (AMI). We hypothesized that markers of plaque instability might be useful in the early diagnosis and risk stratification of AMI. METHODS In this multicenter study, we examined 4 markers of plaque instability, myeloperoxidase (MPO), myeloid-related protein 8/14 (MRP-8/14), pregnancy-associated plasma protein-A (PAPP-A), and C-reactive protein (CRP) in 398 consecutive patients presenting to the emergency department with acute chest pain and compared them to normal and high-sensitivity cardiac troponin T (cTnT and hs-cTnT). The final diagnosis was adjudicated by 2 independent cardiologists. Primary prognostic end point was death during a median follow-up of 27 months. RESULTS The adjudicated final diagnosis was AMI in 76 patients (19%). At emergency department presentation, concentrations of all 4 biomarkers of plaque instability were significantly higher in patients with AMI than in patients with other diagnoses. However, their diagnostic accuracy as quantified by the area under the ROC curve (AUC) was low (MPO 0.63, MRP-8/14 0.65, PAPP-A 0.62, CRP 0.59) and inferior to both normal and high-sensitivity cardiac troponin T (cTnT 0.88, hs-cTnT 0.96; P &lt; 0.001 for all comparisons). Thirty-nine patients (10%) died during follow-up. Concentrations of MPO, MRP-8/14, and CRP were higher in nonsurvivors than in survivors and predicted all-cause mortality with moderate accuracy. CONCLUSIONS Biomarkers of plaque instability do not seem helpful in the early diagnosis of AMI but may provide some incremental value in the risk stratification of patients with acute chest pain.

scholarly journals P1289CIRCULATING HIGH SENSITIVITY CARDIAC TROPONIN-T WAS AN IMPORTANT PREDICTIVE MARKER FOR CARDIOVASCULAR EVENTS IN HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Su-Chu Lee ◽  
Ping-Hsun Wu ◽  
Yi-Ting Lin ◽  
Pei-Yu Wu ◽  
Szu-Chia Chen ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Gini Index ◽  
Cox Regression ◽  
Troponin T ◽  
Prognostic Significance ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
Clinical Parameters ◽  
Cox Regression Analysis ◽  
Coronary Syndrome

Abstract Background and Aims High sensitivity cardiac troponin-T (hs-cTnT) are prognostic markers in patients with stable cardiovascular (CV) disease but limited study investigated the CV outcome association in asymptomatic patients receiving hemodialysis (HD). We evaluated the prognostic value of hs-cTnT in predicting CV events in stable HD patients. Method A total of 341 stable HD patients was included in this prospective cohort study. Baseline hs-cTnT was measured by Roche hs-cTnT assays. Patients were followed up for 3 years or until first CV event, which was defined a composite endpoint of acute coronary syndrome, ischemic stroke, or hospitalization for heart failure. Cox proportional hazards model was used to determine independent predictors of CV events. The importance of hs-cTnT compared to other clinical parameters was evaluated by random forests algorithm in Gini index. Results The HD patients enrolled in this study was 59.2 ± 11.5 87 years old, 53.4% male, 42.5% had diabetes, 76.8% had hypertension, 17.6% had coronary artery disease, and 9.1% had cerebrovascular disease. In multivariate Cox regression analysis, the circulating hs-cTnT levels were independent associated with CV events (HR 2.31; 95% CI 1.21-4.40; p-value=0.011) after adjusting for confounders. Multivariable model showed prognostic significance, with the c-statistics of 0.75. The addition of baseline hs-cTnT to established risk factors improved risk prediction of CV events (c-statistics of 0.76; integrated discrimination improvement = 0.02, P = 0.049). Gini index demonstrated hs-cTnT was more important than other clinical parameters for CV events prediction. Conclusion Circulating hs-cTnT levels independently predicted CV events in chronic HD patients. CV risk in HD patients could be stratified according to hs-cTnT levels. The results suggest the useful property of hs-cTnT as an end-organ damage marker reflecting subclinical cardiac injury.

Evaluation of the 0 h/1 h high-sensitivity cardiac troponin T algorithm in diagnosis of non-ST-segment elevation myocardial infarction (NSTEMI) in Han population

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Chen Dongxu ◽  
Zhou Yannan ◽  
Yang Yilin ◽  
Yao Chenling ◽  
Gu Guorong ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
Chinese Han ◽  
Han Population ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Rule Out

Abstract Objectives A rapid 0 h/1 h algorithm using high-sensitivity cardiac troponin T (hs-cTnT) for rule-out and rule-in of non-ST-segment elevation myocardial infarction (NSTEMI) is recommended by the European Society of Cardiology. We aim to prospectively evaluate the diagnostic performance of the algorithm in Chinese Han patients with suspected NSTEMI. Methods In this prospective diagnostic cohort study, 577 patients presenting to the emergency department with suspected NSTEMI and recent (<12 h) onset of symptoms were enrolled. The levels of serum hs-cTnT were measured on admission, 1 h later and 4–14 h later. All patients underwent the initial clinical assessment and were triaged into three groups (rule-out, rule-in and observe) according to the 0 h/1 h algorithm. The major cardiovascular events (MACE) were evaluated at the 7-day and 30-day follow-ups. Results Among 577 enrolled patients, NSTEMI was the final diagnosis for 106 (18.4%) patients. Based on the hs-cTnT 0 h/1 h algorithm, 148 patients (25.6%) were classified as rule-out, 278 patients (48.2%) as rule-in and 151 patients (26.2%) were assigned to the observe group. The rule-out approach resulted in a sensitivity of 100% and negative predictive value of 100%. The rule-in approach resulted in a specificity of 62.9% [95% CI (58.5–67.2%)] and positive predictive value of 37.1% [95%CI (31.3–42.8%)]. No MACE was observed in the rule-out group within 30-day follow-up. Conclusions The hs-cTnT 0 h/1 h algorithm is a safe tool for early rule-out of NSTEMI, while probably not an effective strategy for accurate rule-in of NSTEMI in Chinese Han population.

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