scholarly journals The Correlation between the Levels of Troponin I with the Amount of Leukocytes in Patients Suspected Acute Myocardial Infarction

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Tri Prasetyorini ◽  
Rizka Noviyanti ◽  
Putu Puja Permata Kasih ◽  
Diah Lestari
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Troponin I ◽  
Leukocyte Count ◽  
Age Group ◽  
Leukocyte Counts ◽  
The Difference ◽  
Coronary Blood Vessels ◽  
Age Range ◽  
Normal Leukocyte

Acute Myocardial Infarction (AMI) is a manifestation of acute myocardial ischemia and is generally caused by the rupture of atherosclerosis and thrombus in the coronary blood vessels. Rupture causes an inflammatory process that leukocytes which acts as a marker of inflammation increases. Heart muscle damage that occurs also resulted in levels of troponin I as one of the markers of increased cardiac examination. Based on that research aims to determine the correlation between the levels of troponin I and the number of leukocytes in patients with suspected AMI.This research method is analytical observation with a data sample of 100 patients with suspected AMI diagnosis by doctors as well as examine the levels of troponin I and the number of leukocytes in dr. Abdulmadjid Chasbullah Bekasi. The correlation between the levels of troponin I and leukocyte counts were analyzed using Spearman's test. Data studied consisted of 52 people (52%) men and 48 (48%) of women. By age group, age range 46-65 years become the largest age group into patients with suspected AMI is 55 people (55%). Obtained 34 (34%) of patients with suspected AMI who had higher levels of troponin I and normal leukocyte count, and 39 (39%) of patients with suspected AMI who had troponin I levels and elevated leukocyte count. On Spearman’s test seen the correlation between levels of troponin I with the total of leukocytes in patients with suspected AMI (p = 0.000 and r = 0.50). This shows an increase in troponin I, which runs parallel with the increase in the total of leukocytes. Suggested for further research to see the difference increased levels of troponin I and the total of leukocytes between 3-5 hours and 14-18 hours after myocardial injury

Abstract 14077: Use of Cardiac Troponin I to Identify Acute Myocardial Infarction in Patients With Impaired Renal Function

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Beatrice von Jeinsen ◽  
Stergios Tzikas ◽  
Lars Palapies ◽  
Tanja Zeller ◽  
Christoph Bickel ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Renal Function ◽  
Impaired Renal Function ◽  
Estimated Glomerular Filtration Rate ◽  
Troponin I ◽  
Reference Population ◽  
Final Diagnosis ◽  
The Difference ◽  
Cardiac Troponins

Introduction: Cardiac troponins are the gold standard to diagnose acute myocardial infarction (AMI). Troponin I (TnI) levels are known to be increased in patients with chronic kidney disease (CKD) irrespective of an AMI. The established diagnostic TnI cut-off to detect AMI is calculated based on a healthy reference population and might not be representative for CKD patients. Hypothesis: The aim of this study was to investigate TnI levels in patients with and without CKD with suspected AMI and to calculate CKD- optimized diagnostic TnI thresholds. Methods: Of 1572 patients enrolled with suspected AMI, 266 patients showed an impaired renal function with estimated glomerular filtration rate (eGFR) of less then 60ml/min and were classified as patients with CKD. N=77 (34%) of patients with CKD and n=278 (24%) without CKD had the final diagnosis AMI. TnI was measured on admission and after 3h. Based on receiver operator characterics curve analyses (AUROC) of the baseline levels CKD optimized TnI threshold were derived. Sensitivity and specifity were calculated for the 99th percentile cut-off (30.0 pg/mL), the optimized cut-off (58.0 pg/mL) and the change in TnI concentration within 3h after admission. Results: Patients with CKD had higher TnI levels then patients without CKD (6.0pg/mL vs. 20.9pg/ml; p<0.001). This difference was more pronounced in patients without AMI (median 9.1 vs. 4.4; p<0.001), whereas the difference diminished in AMI patients (median 337.4 vs. 238.6; p=0.83). In CKD patients TnI remained a strong marker to detect AMI with AUROC of 0.933 compared to 0.969 in patients without CKD. Applying the 99th percentile threshold it was associated with a relevant loss of specificity in CKD patients with 80% compared to 96% in patients without CKD. This poor specificity could be regained by use of a higher CKD-optimized threshold or use of the change in TnI concentration within 3h leading to specificities of 90% and 96%, respectively. Conclusions: Patients presenting with suspected AMI and CKD have higher TnI levels on admission compared to patients without CKD leading to a low specificity detecting AMI in CKD patients. Using an CKD-optimized TnI cut-off level on admission or using the change in TnI concentration within 3h is able to regain this lost specificity.

scholarly journals Role of serum cardiac Troponin-I for risk stratification in first attack in acute myocardial infarction

1970 ◽  
Vol 8 (3) ◽  
pp. 57-63
Author(s):  
Md Sahabuddin Joarder ◽  
Md Jafarullah ◽  
Ahmed Moinuddin
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Risk Stratification ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Outcome Evaluation ◽  
Cardiac Troponin I ◽  
The Mean ◽  
The Difference ◽  
Q Wave

Introduction: Cardiac troponin-I (cTnI) is known to have the highest specificity and analytic sensitivity for detection of myocardial injury; it is used both as diagnostic and prognostic marker. This study was aimed to confirm this idea. Subjects & methods: This prospective observational study included 60 patients of 40 to 65 years age range diagnosed as acute myocardial infarction. The mean ages were 50±8 years and 53±8 years in Q -wave AMI and non Q-wave AMI respectively. Male and female patients included were 86.7% and 13.3%; BMI was 25.3±1.5. Results: Study showed troponin-I 7.53±0.086 ng/ml in Q wave and in non Q-wave AMI was 6.38±0.64 ng/ml after 24 hours of attack of AMI without any significant difference between two groups (P>0.05). The mean troponin-I within 9 hours of attack, were 1.60±0.80 ng/ml and 2.7±1.4 ng/ml in stable and unstable group respectively and the difference found statistically significant (P<0.05). The mean troponin-I between 9-24 hours of attack were 2.90±1.20 ng/ml and 4.90±3.20 ng/ml in stable and unstable group respectively and the difference found statistically significant (P<0.01). The mean troponin-I in unstable group after 24 hours was 9.20±4.30 ng/ml which was more than between 9-24 hours and the difference was significant (P>0.001). In clinicopathological outcome evaluation 37 patients had troponin-I level >1.5 ng/ml in which 29 patients developed unstability and 8 patients were stable. Conclusion: Serum cTnI is better and more characteristic biomarker for risk prediction and prognosis evaluation in AMI patients. Key words: Cardiac Troponin-I, acute myocardial infarction, risk stratification.   DOI: 10.3329/bjms.v8i3.3984 Bangladesh Journal of Medical Sciences Vol.8(3) 2009 p57-63

scholarly journals Cardiac Troponin-I And CK-MB for Risk Stratification in Acute Myocardial Infarction (First Attack): A Comparative Study

2013 ◽  
Vol 4 (1) ◽  
pp. 10-15 ◽  
Author(s):  
S Joarder ◽  
M Hoque ◽  
M Towhiduzzaman ◽  
AF Salehuddin ◽  
N Islam ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
High Risk ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Risk Group ◽  
Risk Groups ◽  
Low Risk ◽  
The Mean ◽  
The Difference

Myocardial infarction is associated with release of two important enzymes. The enzymatic diagnosis is mainly based on the measurement of CK-MB and troponin-I. Cardiac troponin- I(cTnI) is known to have higher specificity and analytic sensitivity than CK-MB for detection of myocardial injury & risk stratification. These are used both as diagnostic and prognostic marker. This prospective observational study included 60 patients of 40-65 years age range, diagnosed as acute myocardial infarction. The mean ages were 50± 8 years and 53±8 years respectively. Male and female patients included were 86.7% and 13.3%; BMI was 25.3±1.5. The two important cardiac markers troponin-I and CK-MB were studied in 60 patients, admitted in the hospital with acute MI. Blood samples to estimate these markers were collected from the patients after admission at 6-9 hours, 9-24 hours and after 24 hours and their mean values with ±SD were calculated, evaluated and compared between the two groups of patients with low and high risk MI. The patients with low risk MI were those who recovered early and the high risk patients improved later in comparison to low risk group. Out of 60 patients, 37 had troponin-I level>1.5 ng /ml. Among them 29 developed high risk MI and 8 recovered earlier than high risk group. 23 patients had troponin-I <1.5 ng /ml, out of whom 10 were high and 13 were low risk. The difference of troponin-I levels between high and low risk groups of patients was statistically significant (p<0.01). On the other hand CK-MB level was >7 ng /ml in 33 patients. Out of them 22 patients developed high and 11 patients were low risk but 18 patients out of 27 who had CK-MB <7 ng /ml became high and 9 patients were low risk. The difference of outcome in respect to higher and lower values of CK-MB between the two groups was not statistically significant (p>0.05). Both troponin-I and CK-MB were estimated in all 60 patients on three occasions. The mean troponin-I levels were statistically significant between the high and the low risk groups on all occasions. On the contrary, the values of CK-MB were not statistically significant on two occasions but was significant (p < 0.01) on one occasion when it was estimated at 9 - 24 hour. Serum cTnI is better and more characteristic biomarker than CK-MB for risk prediction and prognosis evaluation in AMI patients. DOI: http://dx.doi.org/10.3329/bjmb.v4i1.13776 Bangladesh J Med Biochem 2011; 4(1): 10-15

scholarly journals Gambaran jumlah leukosit pada pasien infark miokard akut di RSUP Prof. Dr. R. D.Kandou Manado periode Januari-Desember 2015

e-CliniC ◽  
2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Ade M. Sitepu ◽  
Dewi U. Djafar ◽  
Agnes L. Panda
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Medical Records ◽  
Leukocyte Count ◽  
Descriptive Study ◽  
Blood Stream ◽  
Age Group ◽  
Inclusion Criteria ◽  
Using Data ◽  
Observational Descriptive Study

Abstract: Coronary heart disease (CHD) is the leading cause of death in the world and marked by the existence of atherosclerotic plaque at the coronary artery that progressively blocks the blood stream to myocardium resulting in myocardial infarction. Elevated of leukocyte count typically indicates an infection or inflammation, and has a role in vascular injury and atherogenesis that is a development of an atherosclerotic ruptured plaque and trombosis. This study was aimed to obtain the profile of leukocyte count in patient with acute myocardial infarction (AMI) at Prof. Dr. R. D. Kandou Hospital Manado from January to December 2015. This was an observational descriptive study with a retrospective approach using data of medical records of AMI patients who came to Prof. Dr. R. D. Kandou Hospital Manado from January to Desember 2015. The results showed that of totally 63 medical records of patients with AMI, there were 45 samples that fulfilled the inclusion criteria. The majority patients were in the age group 46-60 years, males, the risk factor was a combination of several major risks, and NSTEMI as the type of type of infarction. There were 57,77% of leukocyte count results ranged 10,000-14,900/mm3 and 8,88% were ≥15,000/mm3. Conclusion: There was an increase in the leukocytes count in more than half of the samples. Keywords: acute myocardial infarction, leukocyte, inflammation Abstrak: Penyakit jantung koroner (PJK) merupakan penyebab kematian tersering di dunia dan ditandai adanya plak aterosklerosis pada arteri koroner yang secara progresif menghalangi aliran darah ke miokardium yang berakibat terjadinya infark miokard. Peningkatan jumlah leukosit secara tipikal mengindikasikan adanya suatu infeksi dan peradangan, serta juga berperan pada cedera vaskular dan aterogenesis yang merupakan perkembangan dari suatu ruptur plak aterosklerosis dan trombosis. Penelitian ini bertujuan untuk mengetahui gambaran jumlah leukosit pada pasien IMA di RSUP Prof. Dr. R. D. Kandou periode Januari sampai Desember 2015. Jenis penelitian ialah deskriptif observasional dengan pendekatan retrospektif menggunakan data rekam medik pasien IMA yang berobat di RSUP Prof. Dr. R. D. Kandou Manado periode Januari-Desember 2015 dengan eksklusi riwayat infeksi minimal 2 minggu sebelum masuk rumah sakit. Hasil penelitian mendapatlan 45 sampel dengan mayoritas kelompok usia 46-60 tahun, jenis kelamin laki-laki, faktor risiko kombinasi beberapa faktor risiko mayor, dan jenis infark NSTEMI. Sebanyak 57,77% hasil pemeriksaan leukosit berkisar 10.000-14.900/mm3 dan 8,88% pada ≥15.000/mm3. Simpulan: Lebih dari setengah jumlah sampel mengalami peningkatan jumlah leukosit.Kata kunci: infark miokard akut, leukosit, peradangan

Alterations in serum selenium levels and their relation to troponin I in acute myocardial infarction

2010 ◽  
Vol 345 (1-2) ◽  
pp. 23-27 ◽  
Author(s):  
Barbara Kutil ◽  
Petr Ostadal ◽  
Jiri Vejvoda ◽  
Jiri Kukacka ◽  
Jana Cepova ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Troponin I ◽  
Serum Selenium ◽  
Serum Selenium Levels

Abstract 058: Early Effect of Medicare Accountable Care Organizations on Acute Myocardial Infarction Episode Payments

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Shashank S Sinha ◽  
Nicholas M Moloci ◽  
Andrew M Ryan ◽  
Brahmajee K Nallamothu ◽  
John M Hollingsworth
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Accountable Care Organizations ◽  
Accountable Care ◽  
Medicare Beneficiaries ◽  
Physician Services ◽  
Post Discharge ◽  
Early Effect ◽  
Medicare Data ◽  
The Difference

Objective: Spending for acute myocardial infarction (AMI) episodes varies widely across hospitals, driven primarily by payments made more than 30 days after discharge. Through collective incentives and an emphasis on care coordination, Medicare accountable care organizations (ACOs) may help reduce this variation. To test this hypothesis, we analyzed national Medicare data. Methods: Using a 20% random sample, we identified Medicare beneficiaries admitted for AMI from January 2010 to December 2013. We distinguished admissions to hospitals affiliated with a Medicare ACO from those that were not. We then calculated 90-day, price-standardized, risk-adjusted episode payments made on behalf of beneficiaries, differentiating between early (index admission to 30 days post-discharge) and late payments (31 to 90 days). We also calculated component payments, including those for the index hospitalization, readmissions, physician services, and post-acute care. Finally, we used difference-in-differences estimation to measure the effect of admission to an ACO-affiliated hospital on early and late episode payments. Results: Over the study period, 15,219 beneficiaries were admitted to 299 eventual ACO-affiliated hospitals and 73,910 were admitted to 1,685 never ACO-affiliated hospitals ( p <0.001). While beneficiaries admitted to eventual ACO-affiliated hospitals tended to be younger than those admitted to never ACO-affiliated hospitals (mean age: 79.2 ± 8.6 versus 80.0 ± 8.5, respectively; p =.003), they had similar levels of comorbidity (mean Elixhauser score: 2.7 ± 1.4 versus 2.7 ± 1.4, respectively; p =0.526). Mean 90-day episode payments were greater for ACO-affiliated hospitals [$24,887 versus $23,966; p <0.001]. In the period after ACO implementation (2012 and 2013), total payments for AMI episodes fell by $1259 (Figure; p <0.001). Most of this savings was attributable to decreases in early ($1118) versus late ($141) episode payments. However, none of these savings differed based on admission to an ACO-affiliated hospital ( p =0.363 for the difference). Conclusions: Early Medicare ACOs have not affected 90-day episode payments for AMI admissions. Future studies should explore the possibility of heterogeneity in effect based on ACO structure.

Diagnoses and mortality in a population without acute myocardial infarction, but with elevated highsensitive troponin I – a retrospective register-based single center study

2021 ◽  
Vol 20 (1) ◽  
pp. 18-24
Author(s):  
Rasmus Søgaard Hansen ◽  
◽  
Jesper Revsholm ◽  
Daniel Pilsgaard Henriksen ◽  
Lars Christian Lund Lund ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Troponin I ◽  
Inclusion Criteria ◽  
Danish Population ◽  
Medical Observation ◽  
Single Center Study ◽  
One Year ◽  
High Sensitive Troponin ◽  
Center Study

Aim: To explore, which differential diagnoses to consider in individuals with elevated troponins without acute myocardial infarction (AMI), and the mortality for those individuals. Methods: Retrospective, register-based study on a representative sample of the Danish population with the following inclusion criteria: High-sensitive troponin I (hs-TnI) ≥25 ng/L, age ≥18 years, and exclusion of AMI. Results: 3067 individuals without AMI but increased hs-TnI were included. Most frequent discharge diagnoses: Pneumonia (12.8%), Aortic valve disorder (11.3%), Medical observation (10.9%) and Heart failure (8.9%). The 30-days and one-year mortality was 15.8% and 32.0%, respectively. Conclusions: A selected number of alternative diagnoses must be considered in individuals with increased hs-TnI. Due to high mortality it is crucial to carefully evaluate these individuals despite the absence of AMI.

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