scholarly journals Efficacy of Troponin-I in the diagnosis of acute coronary syndrome: A Case Report

2021 ◽  
Vol 9 (02) ◽  
Author(s):  
Mayuri Gujrathi
Keyword(s):  
Heart Muscle ◽  
Cardiac Troponin ◽  
Myocardial Injury ◽  
Troponin I ◽  
Past History ◽  
Cardiac Troponin I ◽  
Coronary Syndrome ◽  
Hs Crp ◽  
Asymptomatic Individuals ◽  
Sensitive Marker

A 35 years old male presented to the outpatient department with symptoms of chest pain (retrosternal), sweating/ uneasiness from 24 hours. The patient with these complaints first went to another practitioner and was diagnosed as ACS with following ECG.  PAST HISTORY: The patient has nil medical history. ADDICTION:  Smoker for 8 years and Alcohol intake daily for 10 years and also having h/o Tobacco consummation. CK-MB, TROPONIN-I is the cardiac-specific biomarker for myocardial injury. Cardiac Troponin-I is a protein found in the cells of the heart muscle. The level of cardiac Troponin-I can be measured by the health of the heart muscle. Can be detected in healthy asymptomatic individuals. Current risk stratification tools like Framingham, Euro score, Lipid Profile, hs CRP are not cardiac-specific and can be heavily influenced by age. Myoglobin is a sensitive marker for muscle injury, but, elevated myoglobin has low specificity for acute myocardial infarction. Troponin has more specificity than CK-MB in myocardial injury.

scholarly journals Misclassification of Myocardial Injury by a High-Sensitivity Cardiac Troponin I Assay

2021 ◽  
Author(s):  
Peter A. Kavsak ◽  
Shawn Mondoux ◽  
Andrew Worster ◽  
Janet Martin ◽  
Vikas Tandon ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Myocardial Injury ◽  
Troponin I ◽  
High Sensitivity ◽  
Cardiac Troponin I

Elevations of Troponin I after interventional cardiac catheterization

2001 ◽  
Vol 11 (4) ◽  
pp. 375-378 ◽  
Author(s):  
Prince J. Kannankeril ◽  
David F. Wax ◽  
Elfriede Pahl
Keyword(s):  
Cardiac Catheterization ◽  
Cardiac Troponin ◽  
Baseline Level ◽  
Myocardial Injury ◽  
Troponin I ◽  
Cardiac Troponin I ◽  
Specific Marker ◽  
Before And After ◽  
Baseline Sample

Background: Elevation of cardiac troponin I in the serum is a specific marker for myocardial injury. We measured levels of troponin I in the serum in children before and after cardiac catheterization to determine if this procedure was associated with an increase in levels of troponin. Methods: We enrolled patients under 21 years of age undergoing cardiac catheterization at our institution. A baseline sample of serum was drawn at the start of the procedure. Repeat samples were obtained immediately after, and six hours subsequent to the procedure. All samples were analyzed for cardiac troponin I using the Abbott AxSYM microparticle immunoassay system. Levels were considered normal (0–0.4 ng/ml) or elevated (>0.4ng/ml). Patients were excluded if the baseline level was elevated. Results: Levels of cardiac troponin I were elevated in the serum from 11 of 14 (79%) cases immediately after the procedure (p < 0.0001), and in 12 of 14 (86%) six hours later (p < 0.0001). Only 2 patients had recognized complications potentially causing myocardial injury. Conclusion: Levels of cardiac troponin I increase in the serum in a high proportion of children after cardiac catheterization. These elevations can be observed immediately, and are maintained for at least six hours. Our study suggests that cardiac catheterization, predominantly intervention, is associated with myocardial injury, even in the absence of complications.

Evaluation of Myocardial Injury Following Repeated Internal Atrial Shocks by Monitoring Serum Cardiac Troponin I Levels

CHEST Journal ◽  
2000 ◽  
Vol 118 (2) ◽  
pp. 342-347 ◽  
Author(s):  
Giuseppe Boriani ◽  
Mauro Biffi ◽  
Vittorio Cervi ◽  
Gabriele Bronzetti ◽  
Giorgia Magagnoli ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Myocardial Injury ◽  
Troponin I ◽  
Cardiac Troponin I ◽  
Serum Cardiac Troponin

High Incidence of Myocardial Ischemia during Postpartum Hemorrhage

2004 ◽  
Vol 100 (1) ◽  
pp. 30-36 ◽  
Author(s):  
Peter C. J. Karpati ◽  
Mathias Rossignol ◽  
Marcus Pirot ◽  
Bernard Cholley ◽  
Eric Vicaut ◽  
...  
Keyword(s):  
Intensive Care ◽  
Myocardial Ischemia ◽  
Hemorrhagic Shock ◽  
Postpartum Hemorrhage ◽  
Cardiac Troponin ◽  
Myocardial Injury ◽  
Troponin I ◽  
Elevated Serum ◽  
Cardiac Troponin I ◽  
Arterial Blood

Background Postpartum hemorrhage remains a major cause of global maternal morbidity and mortality, even in developed countries, despite the use of intensive care units. This study sought to (1) assess whether myocardial ischemia could be associated with and even aggravate hemorrhagic shock in young parturients admitted for postpartum hemorrhage, and (2) identify the independent risk factors for myocardial ischemia. Methods On their referral to the intensive care unit, a multidisciplinary team managed parturients with severe postpartum hemorrhage. Ventilation, transfusion, catecholamines, surgery, or angiography with uterine embolization were provided as clinically indicated. Plasma cardiac troponin I levels were used as a surrogate marker of acute myocardial injury and electrocardiograms of myocardial ischemia. Results A total of 55 parturients were referred with severe postpartum hemorrhage, all in hemorrhagic shock. Twenty-eight parturients (51%) had elevated serum levels of cardiac troponin I (9.4 microg/l [3.7-26.6 microg/l]), which were associated with electrocardiographic signs of ischemia and deteriorated myocardial contractility and correlated with the severity of hemorrhagic shock. Indeed, multivariate analysis identified low systolic and diastolic arterial blood pressure (&lt; 88 and &lt; 50 mmHg, respectively) and increased heart rate (&gt; 115 beats/min) as independent predictors of myocardial injury. In addition, all patients who were given catecholamines also had elevated cardiac troponin I levels. Conclusions These results suggest that treatment of postpartum hemorrhage-induced hemorrhagic shock should be coupled with concomitant prevention of myocardial ischemia, even in young parturients.

scholarly journals Value of Cardiac Troponin I Cutoff Concentrations below the 99th Percentile for Clinical Decision-Making

2009 ◽  
Vol 55 (1) ◽  
pp. 85-92 ◽  
Author(s):  
Kai M Eggers ◽  
Allan S Jaffe ◽  
Lars Lind ◽  
Per Venge ◽  
Bertil Lindahl
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Risk Stratification ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Reference Population ◽  
Cardiac Troponin I ◽  
Coronary Syndrome ◽  
Artery Disease

Abstract Background: The aim of this study was to evaluate factors influencing the 99th percentile for cardiac troponin I (cTnI) when this cutoff value is established on a highly sensitive assay, and to compare the value of this cutoff to that of lower cutoffs in the prognostic assessment of patients with coronary artery disease. Methods: We used the recently refined Access AccuTnI assay (Beckman-Coulter) to assess the distribution of cTnI results in a community population of elderly individuals [PIVUS (Prospective Study of the Vasculature in Uppsala Seniors) study; n = 1005]. The utility of predefined cTnI cutoffs for risk stratification was then evaluated in 952 patients from the FRISC II (FRagmin and Fast Revascularization during InStability in Coronary artery disease) study at 6 months after these patients had suffered acute coronary syndrome. Results: Selection of assay results from a subcohort of PIVUS participants without cardiovascular disease resulted in a decrease of the 99th percentile from 0.044 μg/L to 0.028 μg/L. Men had higher rates of cTnI elevation with respect to the tested thresholds. Whereas the 99th percentile cutoff was not found to be a useful prognostic indicator for 5-year mortality, both the 90th percentile (hazard ratio 3.1; 95% CI 1.9–5.1) and the 75th percentile (hazard ratio 2.8; 95% CI 1.7–4.7) provided useful prognostic information. Sex-specific cutoffs did not improve risk prediction. Conclusions: The 99th percentile of cTnI depends highly on the characteristics of the reference population from which it is determined. This dependence on the reference population may affect the appropriateness of clinical conclusions based on this threshold. However, cTnI cutoffs below the 99th percentile seem to provide better prognostic discrimination in stabilized acute coronary syndrome patients and therefore may be preferable for risk stratification.

Prognostic Value of Troponin I with Echocardiography Assessment in Septic Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Sherif Farouk Ibrahim ◽  
Ashraf Elsayed Elagmy ◽  
Abdelrhman Gamal Abdelsabour
Keyword(s):  
Septic Shock ◽  
Acute Coronary Syndrome ◽  
Intensive Care ◽  
Cardiac Troponin ◽  
Prognostic Value ◽  
Troponin I ◽  
Cardiac Troponin I ◽  
Coronary Syndrome ◽  
Sepsis And Septic Shock

Abstract Background Sepsis is heterogenous with regard to factors such as causal microorganism, patient predisposition, co-morbidity and response to therapy, a key element and unifying feature is the manifestation of cardiovascular dysfunction. Elevated concentrations of cardiac troponin I (cTnI) are frequently observed in patients with severe sepsis and septic shock even in the absence of an acute coronary syndrome (ACS). Objective To evaluate the prognostic value of (cTnI) with echocardiography assessment in septic patients. Patients and Methods This study was conducted at the intensive care units of Ain Shams university hospitals. 20 patients of both sexes with age ranging from 18 to 70 years diagnosed with sepsis admitted to Intensive care unit were included in prospective observational study. Results Baseline cTnI had a significant positive correlation with follow up troponine (p = 0.0016). Baseline EF had a significant negative correlation with follow up troponine (p = 0.036). Using ROC-curve analysis, troponin level at a cutoff point (&gt;1.9) predicted patients with mortality, with good (87%) accuracy, sensitivity= 90% and specificity= 90% (p &lt; 0.01). Conclusion Elevated concentrations of cardiac troponin I (cTnI) are frequently observed in patients with sepsis and septic shock even in the absence of an acute coronary syndrome.

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