scholarly journals High-Sensitivity Troponin as a Predictor of Cardiac Events and Mortality in the Stable Dialysis Population

2014 ◽  
Vol 60 (2) ◽  
pp. 389-398 ◽  
Author(s):  
Hicham Cheikh Hassan ◽  
Kenneth Howlin ◽  
Andrew Jefferys ◽  
Stephen T Spicer ◽  
Ananthakrishnapuram N Aravindan ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Cardiac Event ◽  
Clinical Utility ◽  
Myocardial Injury ◽  
Prospective Observational Study ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
Cardiac Events ◽  
Over Time

Abstract BACKGROUND High-sensitivity cardiac troponin T (hs-cTnT) is a biomarker used in diagnosing myocardial injury. The clinical utility and the variation of this biomarker over time remain unclear in hemodialysis (HD) and peritoneal dialysis (PD) patients. We sought to determine whether hs-cTnT concentrations were predictive of myocardial infarction (MI) and death and to examine hs-cTnT variability over a 1-year period. METHODS A total of 393 nonacute HD and PD patients (70% HD and 30% PD) were followed in a prospective observational study for new MI and death. RESULTS Median hs-cTnT was 57 ng/L (interquartile range, 36–101 ng/L) with no observed difference between HD and PD patients (P = 0.11). Incremental increases in mortality (P = 0.024) and MI (P = 0.001) were observed with increasing hs-cTnT quartiles. MI incidence increased significantly across quartiles in both HD and PD patients (P = 0.012 and P = 0.025, respectively), whereas mortality increased only in HD patients (P = 0.015). For every increase of 25 ng/L in hs-cTnT, the unadjusted hazard ratio (HR) was 1.10 for mortality in the whole group (95% CI, 1.04–1.16, P = 0.001) and 1.16 for MI (95% CI, 1.08–1.23, P < 0.001). Adjusted HR for mortality was 1.07 (95% CI, 1.01–1.15, P = 0.04) and 1.14 for MI (95% CI, 1.06–1.22, P < 0.001). Changes in hs-cTnT from baseline concentrations after 1 year were minimal (55 ng/L vs 53 ng/L, P = 0.22) even in patients who had an MI (P = 0.53). CONCLUSIONS hs-cTnT appears to have a useful role in predicting MI and death in the dialysis population. Over a 1-year period concentrations remained stable even in patients who sustained a new cardiac event.

High sensitivity cardiac troponin T is a useful biomarker for predicting prognosis of the patients with sarcoidosis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Baba ◽  
T Kubo ◽  
J Kawaguchi ◽  
Y Ochi ◽  
T Hirota ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Cardiac Troponin ◽  
Cardiac Involvement ◽  
Troponin T ◽  
Interleukin 2 ◽  
High Sensitivity ◽  
High Serum ◽  
Diagnostic Tools ◽  
Cardiac Troponin T ◽  
Cardiac Events

Abstract Background Cardiac involvement is one of the most significant prognostic factors for the patients with sarcoidosis. In spite of the advancement of diagnostic tools, such as cardiac magnetic resonance imaging or 18F-fluoro-2-deoxyglucose positron emission tomography, there is still significant room for improvement in cardiac screening and prognostic prediction. Purpose To evaluate the prognostic factors for the patients with sarcoidosis. Methods and results We prospectively studied 133 patients with sarcoidosis and evaluated clinical data including biomarkers. The mean age at diagnosis was 62.1±12.8 years. During a mean follow up period of 5.6±4.1 years, nine patients died and 27 patients suffered from cardiac events (cardiac death, heart failure admission, arrhythmic event). We divided patients into two groups according to cardiac events, event group had high serum high-sensitivity cardiac troponin T (hs-cTnT) (0.028±0.017 vs. 0.015±0.011 ng/ml, p<0.001), high BNP (409.2±634.0 vs. 122.4±195.8 pg/ml, p<0.001), low EF (43.1±16.4 vs. 59.2±15.5%, p<0.001). This was observed even if those patients were not diagnosed with cardiac involvement at the enrollment. On the other hand, there were no significant differences in the values of angiotensin-converting enzyme, lysozyme, soluble interleukin-2 receptor, or calcium in both groups. Multivariate analysis revealed that hs-cTnT was an independent biomarker to predict cardiac events (hs-cTnT >0.014 ng/ml: HR 3.2, 95% CI 1.02 to 10.19, p=0.046). Conclusion Hs-cTnT was a useful biomarker for predicting cardiac events for the patients with sarcoidosis even if cardiac involvement was not detected at initial evaluation. Figure 1 Funding Acknowledgement Type of funding source: None

Cardiac troponin-T immunoassay for diagnosis of acute myocardial infarction

1994 ◽  
Vol 40 (6) ◽  
pp. 900-907 ◽  
Author(s):  
A H Wu ◽  
R Valdes ◽  
F S Apple ◽  
T Gornet ◽  
M A Stone ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Troponin ◽  
Clinical Utility ◽  
Myocardial Injury ◽  
Clinical Performance ◽  
Troponin T ◽  
Cardiac Troponin T ◽  
Negative Bias ◽  
Relative Index

Abstract We evaluated the analytical and clinical performance of an immunoassay for cardiac troponin T (cTnT). Within-run and total imprecision ranged from 1.6 to 11.3%. The sensitivity and linear range was 0.015 and 13 micrograms/L, respectively. Frozen samples were stable for at least 8 weeks. No interferences were seen with lipids or bilirubin (total and conjugated). Hemoglobin caused a negative bias at concentrations > 4 g/L. Heparinized plasma showed a 6% negative bias compared with serum. The clinical utility of cTnT was compared with that of creatine kinase (CK)-MB (mass assay). The sensitivity of cTnT measurements from 63 patients with acute myocardial infarction (AMI) (cTnT cutoff 0.1 microgram/L) was 60% at 0-3 h, 59% at 3-6 h, 94% at 6-9 h, 90% at 9-12 h, 99% at 12-24 h, 92% at 24-48 h, 83% at 48-72 h, and 100% at 72-96 h. Corresponding results for CK-MB (cutoff 5.0 micrograms/L and 2.5% relative index) were 45%, 64%, 82%, 97%, 87%, 81%, 54%, and 59%. The specificity of the markers from 49 non-AMI patients was 46% and 79% for cTnT and CK-MB, respectively. We show that CK-MB is more specific for diagnosis of AMI, and propose that cTnT is more sensitive to myocardial injury.

scholarly journals Biomarkers-in-Cardiology 8 RE-VISITED—Consistent Safety of Early Discharge with a Dual Marker Strategy Combining a Normal hs-cTnT with a Normal Copeptin in Low-to-Intermediate Risk Patients with Suspected Acute Coronary Syndrome—A Secondary Analysis of the Randomized Biomarkers-in-Cardiology 8 Trial

Cells ◽  
2022 ◽  
Vol 11 (2) ◽  
pp. 211
Author(s):  
Evangelos Giannitsis ◽  
Tania Garfias-Veitl ◽  
Anna Slagman ◽  
Julia Searle ◽  
Christian Müller ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Early Discharge ◽  
Cardiac Troponin T ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
Adverse Cardiac Events ◽  
Risk Patients

Regarding the management of suspected Non-ST-segment-elevation acute coronary syndrome (ACS), the main Biomarker-in-Cardiology (BIC)-8 randomized controlled trial study had reported non-inferiority for the incidence of major adverse cardiac events at 30 days in the Copeptin group (dual marker strategy of copeptin and hs-cTnT at presentation) compared to the standard process (serial hs-cTnT testing). However, in 349 (38.7%) of the 902 patients, high-sensitivity cardiac troponin was not available for the treating physicians. High sensitivity cardiac troponin T was re-measured from thawed blood samples collected at baseline. This cohort qualified for a re-analysis of the 30-day incidence rate of MACE (death, survived cardiac death, acute myocardial infarction, re-hospitalization for acute coronary syndrome, acute unplanned percutaneous coronary intervention, coronary bypass grafting, or documented life-threatening arrhythmias), or components of the primary endpoint including death or death/MI. After re-measurement of troponin and exclusion of 9 patients with insufficient blood sample volume, 893 patients qualified for re-analysis. A total of 57 cases were detected with high sensitivity cardiac troponin T ≥ 14 ng/L who had been classified as “troponin negative” based on a conventional cardiac troponin T or I < 99th percentile upper limit of normal. Major adverse cardiac events rates after exclusion were non-inferior in the Copeptin group compared to the standard group (4.34% (95% confidence intervals 2.60–6.78%) vs. 4.27% (2.55–6.66%)). Rates were 53% lower in the per-protocol analysis (HR 0.47, 95% CI: 0.18–1.15, p = 0.09). No deaths occurred within 30 days in the discharged low risk patients of the Copeptin group. Copeptin combined with high sensitivity cardiac troponin is useful for risk stratification and allows early discharge of low-to-intermediate risk patients with suspected acute coronary syndrome is as safe as a re-testing strategy at 3 h or later.

Coronary angiography-related myocardial injury as detected by high-sensitivity cardiac troponin T assay

2016 ◽  
Vol 12 (3) ◽  
pp. 337-344 ◽  
Author(s):  
Haitham Abu Sharar ◽  
Daniel Wohlleben ◽  
Mehrshad Vafaie ◽  
Arnt V. Kristen ◽  
H. Christian Volz ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Cardiac Troponin ◽  
Myocardial Injury ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T

The shocking lack of significant increases in high sensitivity troponin values after cardioversion

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Lobo ◽  
R.D White ◽  
L.J Donato ◽  
Y.M Cha ◽  
R.M Melduni ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Myocardial Injury ◽  
Troponin T ◽  
High Sensitivity ◽  
High Energy ◽  
Funding Source ◽  
Cardiac Troponin T ◽  
Private Industry ◽  
Cumulative Energy ◽  
Dc Cardioversion

Abstract Background and introduction Cardioversion is commonly used to terminate cardiac arrhythmias. Some previous reports have suggested that cardioversion results in myocardial injury as evidenced by increased levels of cardiac troponin. However, many of these studies were done years ago with less sensitive troponin assays and monophasic waveform defibrillators. Purpose To determine if external direct current (DC) cardioversion with biphasic rectilinear waveform shocks results in myocardial injury as assessed by high sensitivity cardiac troponin T (hs-cTnT) and I (hs-cTnI). Methods Patients scheduled for elective DC cardioversion for atrial fibrillation or atrial flutter were recruited. Plasma samples for measurement of hs-cTnT and hs-cTnI were obtained pre-cardioversion and as late as feasible but at least 6 hours post-cardioversion [median of 9 (7–11) hours]. Results A total of 96 patients were recruited. One patient was excluded because the pre-cardioversion sample was hemolysed. Median (25th–75th interquartile range) cumulative energy delivered was 121.6J (62.4–277.4J) and median highest energy individual shock was 121.0J (62.1–146.2J). A total of 39 (41.1%) patients received more than 1 shock, 23 (24.2%) patients received a cumulative energy of 300J or higher and 5 (5.3%) patients received a cumulative energy of 1,000J or more. The median pre-cardioversion hs-cTnT value was 11.48 (7.19–18.38) ng/L and the median hs-cTnI value was 5.1 (2.0–9.4) ng/L. Median post-cardioversion hs-cTnT value were 12.46 (7.98–20.28) ng/L and hs-cTnI value were 6.3 (3.5–10.0) ng/L. Wilcoxon-Signed ranks test showed a statistically significant change between the pre-and-post cardioversion hs-cTnT values (Z=−4.237, p&lt;0.001) and hs-cTnI values (Z=−4.822, p&lt;0.001). In only 5 (hs-cTnT) and 4 patients (hs-cTnI) was there an increase of &gt;5 ng/L. There were 5 cases where the post-cardioversion values of both hs-cTnT and hs-cTnI were above the 50% reference change value. There was no relation between the change in hs-cTn values and sex, number of shocks, total energy delivered (even in those who received more than 1,000J), highest energy per shock, total current delivered, highest current delivered per shock or transthoracic impedance. Conclusion(s) There is a statistically significant but very small change in median hs-cTnT and hs-cTnI values (1 ng/L and 1.2 ng/L respectively) after DC cardioversion. The results were similar even in patients where high energy shocks were delivered and did not vary based on the pre cardioversion baseline value. Patients who have marked troponin elevations after cardioversion should be assessed for other causes of myocardial injury. It should not be assumed that they have myocardial injury from the cardioversion alone. Figure 1 Funding Acknowledgement Type of funding source: Other. Main funding source(s): Dr. Allan Jaffe has substantial research funds from both grants and private industry. Funds were used to pay for blood sample collection and analysis of high sensitivity cardiac troponin T at Mayo Clinic. Abbott Laboratories donated reagents for the high sensitivity cardiac troponin I analysis.

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
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