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 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

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 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 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 < 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.

RISK STRATIFICATION USING HIGH-SENSITIVITY CARDIAC TROPONIN T IN PATIENTS WITH SUSPECTED ACUTE CORONARY SYNDROME

2020 ◽  
Vol 75 (11) ◽  
pp. 17
Author(s):  
Andrew R. Chapman ◽  
Dennis Sandeman ◽  
Amy Ferry ◽  
Stacey Stewart ◽  
Fiona E. Strachan ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Risk Stratification ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
Coronary Syndrome

The case for cardiac troponin T: marker for effective risk stratification of patients with acute cardiac ischemia

1996 ◽  
Vol 42 (5) ◽  
pp. 803-808 ◽  
Author(s):  
G L Alonsozana ◽  
R H Christenson
Keyword(s):  
Risk Stratification ◽  
Cardiac Troponin ◽  
Troponin T ◽  
Myocardial Damage ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
Cardiac Events ◽  
Common Procedure ◽  
Rapid Assay ◽  
Lower Specificity

Abstract Availability of markers such as cardiac troponin T (cTnT) has brought new insights into ischemic heart disease (IHD). cTnT is a distinct protein that differs from other markers in biological function, molecular mass, and cytosolic pool. cTnT has been utilized for diagnosis of acute myocardial infarction (AMI) and risk stratification of patients with IHD. For AMI diagnosis, cTnT showed high sensitivity (94-100%) but generally lower specificity (46-99%), possibly because of increases in non-AMI patients with minor myocardial damage. Outcome studies have demonstrated that IHD patients with increased cTnT are at significantly greater risk for cardiac events; revascularization in patients with increased cTnT may improve outcome. Estimated costs for batched ES 300 cTnT results and for a cTnT rapid assay run "on demand" were $17.48 and $21.65, respectively. cTnT currently has no specific common procedure test code; expected reimbursement is $18.32 for the ES 300 and is not established for the rapid assay.

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