History of diabetes mellitus is associated with elevated cardiac troponin I levels in patients with chest pain but no coronary heart disease

Background Coronary heart disease is a deadly disease for both men and women. Risk factors for coronary heart disease include age, sex, hypertension, diabetes mellitus, dyslipidemia. The incidence of coronary heart disease is not uniform thus here we reported the profile of coronary heart disease patients in Soetomo General Hospital Objective To analyze the profile of coronary heart disease patients in RSUD dr. Soetomo from February 2018 until September 2018. Materials and Methods A descriptive research based on the medical records patients was done Result There are 65 male patients (76%) and 20 female patients (24%). There are 58% patients aged 50-60 years (49 people), 24% patients aged more than 60 years old (21 people) and 18% patients less than 50 years old (15 people). Types of patients' occupations include 42% public servants (36 people), 36% private employees (31 people), 9% housewives (8 people), 5% retirees (3 people), 3% entrepreneurs (2 people), 1% teachers (1 person), 1% drivers (1 person) , 1% fishermen (1 person), 1% pastor (1 person) 1% merchant (1 person). The main complaints of patients included chest pain (40% or 34 cases), shortness of breath (23.5% or 20 cases),PCI pro staging therapy (4.6% or 4 cases), thump chest (1.2% or 1 case), lower right abdominal pain (1.2% or 1 case), right leg pain (1.2% or 1 case), nausea (1.2% or 1 case), vomiting (1.2% or 1 case), cough (1.2% or 1 case), dysentery (1.2% or 1 case) and no complaints (23.5% or 20 cases). Inpatients with coronary heart disease in Dr. Soetomo General Hospital have a history of hypertension (30.6% or 38 people), heart disease (22.6% or 28 people), diabetes mellitus (21.9% or 26 people), smoking (5.6% or 7 people), dyslipidemia (3.2% or 4 people), stroke (2.4% or 3 people) ), pulmonary TB (0.8% or 1 person), COPD (0.8% or 1 person) and no history of disease (12.9% or 16 people). Fifty-two patients had blood sugar levels of ≥100 mg / dl with a data percentage of 61%. While 16 other patients had blood sugar levels <100 mg / dl with a data percentage of 19%. And the remaining 17 patients did not get data with a percentage of 20% Conclusion We found 85 patients, predominantly males of 50-60 age group. The commonest occupation of these patients is public servant, and they came with major complaints of chest pain with past history of hypertension and high blood levels.

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Assessment of serum cardiac troponin-I over serum CPK-MB in early diagnosis of acute myocardial infarction (AMI)

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20182130 ◽

2018 ◽

Vol 5 (3) ◽

pp. 722

Author(s):

Santosh Kumar ◽

Sachin Patil

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Chest Pain ◽

Early Diagnosis ◽

Cardiac Troponin ◽

Troponin I ◽

Anterior Wall ◽

Cardiac Troponin I ◽

History Of ◽

Serum Cardiac Troponin

Background: The early mortality rate from AMI is 30% with about half of them occurring within 1hour of disability. Although the mortality rate after admission for AMI has declined by 30% over the past decades, approximately 1 of every 25 patients who survive the initial hospitalization die in the first year after AMI. The gold standard for diagnosis of MI has been an elevated serum level of creatinine kinase – myocardial band (CK- MB), the cardiac-specific isoenzyme of CK. However, elevated CK-MB may not detect all myocardial necrosis. In patients who die suddenly after severe or silent episodes of ischemia, autopsies frequently reveal micronecrosis that was not reflected in routine CK-MB measurements. The present study was undertaken to know that serum Cardiac Troponin-I is more sensitive marker than serum CPK-MB in early diagnosis of acute myocardial infarction (AMI).Methods: The study was carried out in tertiary care hospital in Gulbarga. The study was undertaken with an aim to study that serum cardiac troponin-I (cTnl) is more sensitive than serum CK-MB in early diagnosis of acute myocardial infarction (AMI). The study was conducted on patients admitted with history of chest pain suggestive of AMI as diagnosed by WHO criteria to medicine ward of Basaveshwar Teaching and General Hospital, Gulbarga. The period of study was from June 2012 to June 2014. The sample size included 100 patients with history of chest pain suggestive of AMI, selected by simple random method.Results: Our results revealed that cardiac troponin I was more sensitive (62%) than CK-MB in overall cases admitted in between 6-24 hrs from the onset of chest pain. Maximum number (41%) of AMI patients were affected on the anterior wall followed by Inferior wall of AMI. 11 percent were affected with Antero lateral wall wereas 5 to 6 percent were affected with anteroseptal and global acute and right ventricular AMI was seen among 2 percent of patients. Anterior wall AMI was the significantly affected site with AMI (ʎ2:12.5, P:0.0004). The maximum number of acute myocardial infarctions were ST elevation myocardial infarctions. 28% of cases where CKMB is normal, the cTnI detects the AMI cases indicating its sensitivity.Conclusions: Cardiac troponin-I (cTnI) was more sensitive serum marker than CKMB in the early diagnosis of acute myocardial infarction (AMI). Anterior wall was the most significantly affected site of AMI. In the future, further improvements in analytical performance may open additional diagnostic windows.

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High-sensitivity cardiac troponin I and incident coronary heart disease among asymptomatic older adults

Heart ◽

10.1136/heartjnl-2015-309136 ◽

2016 ◽

Vol 102 (15) ◽

pp. 1177-1182 ◽

Cited By ~ 14

Author(s):

Carlos Iribarren ◽

Malini Chandra ◽

Jamal S Rana ◽

Mark A Hlatky ◽

Stephen P Fortmann ◽

...

Keyword(s):

Older Adults ◽

Coronary Heart Disease ◽

Heart Disease ◽

Cardiac Troponin ◽

Troponin I ◽

High Sensitivity ◽

Cardiac Troponin I ◽

Incident Coronary Heart Disease

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Faktor Risiko Terjadinya Penyakit Jantung Koroner pada Pasien di Unit Rawat Jalan Rumah Sakit Panti Rapih Yogyakarta

I Care Jurnal Keperawatan STIKes Panti Rapih ◽

10.46668/jurkes.v1i1.34 ◽

2020 ◽

Vol 1 (1) ◽

pp. 21-30

Author(s):

Deviana Widayanti ◽

Chatarina Setya Widyastuti

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Coronary Heart Disease ◽

Heart Disease ◽

Family History ◽

Disease Risk ◽

Sampling Technique ◽

Excess Body Weight ◽

History Of ◽

Lack Of Exercise

Background: Coronary Heart Disease (CHD) Is a condition when the arteries that supply blood to the heart wall experience hardening and narrowing. It is estimated that 30% of coronary heart disease causes death worldwide. Objective: This study aims to determine the risk factors for CHD in Panti Rapih Hospital. Methods: This descriptive study aims to determine the risk factors for CHD in outpatients at Panti Rapih Hospital. The population is patients who have been diagnosed with coronary heart disease and the sample was taken by 50 respondents with non-random accidental sampling technique. This research take the data use questionnaire and make univariat analysis. Results: Risk factors for CHD are a number of factors that cannot be changed: family history of 42%, age = 40 years 95% in men and 95% age = 65 years in women. Factors that can be changed are: Smoking 78%, history of hypertension 68%, history of diabetes mellitus 28%, dyslipidemic 90%, excess body weight42% and lack of exercise 38%. Conclusion: Risk factors for CHD that cannot be changed: family history of 42%, age = 40 years 95% in men and 95% age = 65 years in women. Factors that can be changed are: Smoking 78%, history of hypertension 68%, history of diabetes mellitus 28%, dyslipidemic 90%, excess body weight 42% and lack of exercise 38%. Keywords: coronary heart disease, risk factors

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Abstract 13887: Cardiac Troponin I and Bnp for Predicting Zero Agatston Score in Patients With Diabetes Mellitus

Circulation ◽

10.1161/circ.142.suppl_3.13887 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Theo Pezel ◽

Jean Guillaume DILLINGER ◽

Guillaume Bonnet ◽

Tiphaine Vidal Trecan ◽

Anouk Asselin ◽

...

Keyword(s):

Diabetes Mellitus ◽

Coronary Artery ◽

Cardiac Troponin ◽

Troponin I ◽

Multivariate Model ◽

Cardiac Troponin I ◽

Agatston Score ◽

Diabetic Patients ◽

Nested Models ◽

Patients With Diabetes

Introduction: Coronary artery calcifications (CAC) Agatston score has shown an excellent prognostic value and particularly in diabetic patients, with a very low rate of cardiovascular (CV) events in patients with zero CAC score. Recent studies have suggested that high-sensitive cardiac troponin I (hs-cTnI) and brain natriuretic peptide (BNP) may be useful to detect subclinical atherosclerosis. Hypothesis: To assess the predictive value of hs-cTnI and BNP to predict zero CAC score in diabetic patients. Methods: Between 2015 and 2019, CAC score was performed in consecutive patients with diabetes mellitus. Patients with symptoms, coronary artery disease or atrial fibrillation were excluded. Within 24h from CT examination, blood samples were taken to measure hs-cTnI and BNP. The relationship between hs-cTnI/BNP concentrations and zero CAC score was evaluated using univariate and multivariate binomial models, and nested models associated with Chi-squared test of independence. Results: Among 844 diabetic patients (61±7 years, 57% men, duration of diabetes 18 years), 35% had zero CAC score, 30% a score from 1-100, 19% from 101-400, and 16% >400. Hs-cTnI/BNP were associated with zero CAC score (OR 2.63, 95%CI[1.51-5.01]; p<0.001; OR 1.09, 95%CI[1.01-1.22]; p=0.03 respectively). In multivariate analysis, hs-cTnI/BNP were associated with zero CAC score (OR 2.38, 95%CI[1.51-4.76]; p=0.009; OR 1.18, 95%CI[1.07-1.32]; p=0.001 respectively). Among 77 variables, the multivariate model including age, gender, smoking, dyslipidaemia, duration of the diabetes, hypertension, diabetic neuropathy, hs-cTnI and BNP significantly discriminated the zero CAC score (AUC=0.81; p<0.001). In nested models, both hs-cTnI and BNP brought information to this multivariate model to predict zero CAC score (p<0.001). Conclusions: Biomarkers hs-cTnI and BNP are associated with zero CAC score in diabetic patients.

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Study of Cardiac Troponin I level in Acute Coronary Syndrome and its correlation with Left Ventricular Systolic Function

Cardiovascular Journal ◽

10.3329/cardio.v12i1.43415 ◽

2019 ◽

Vol 12 (1) ◽

pp. 24-29

Author(s):

Mohammad Jakir Hossain ◽

Khondoker Asaduzzaman ◽

Solaiman Hossain ◽

Muhammad Badrul Alam ◽

Nur Hossain

Keyword(s):

Acute Coronary Syndrome ◽

Chest Pain ◽

Cardiac Troponin ◽

Troponin I ◽

Systolic Function ◽

Left Ventricular ◽

Cardiac Troponin I ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Coronary Syndrome

Background: In the diagnosis of acute coronary syndrome, cardiac troponin I is highly reliable and widely available biomarker. Serum level of cardiac troponin I is related to amount of myocardial damage and also closely relates to infarct size. Our aim of the study is to find out the relationship between cardiac troponin I and left ventricular systolic function after acute coronary syndrome. Methods: Total of 132 acute coronary syndrome patients were included in this study after admission in coronary care unit of Sir Salimullah Medical College, Mitford Hospital. Troponin I level was measured at admission and left ventricular ejection fraction (LVEF) was measured by echocardiography between 12-48 hours of onset of chest pain. Results: There was negative correlation between Troponin I at 12 to 48 hours of chest pain with LVEF in these study patients. With a cutoff value of troponin I e”6.8 ng/ml in STEMI patients there is a significant negative relation between 12 to 48 hrs troponin I and LVEF (p<0.001). Sensitivity of troponin I e” 6.8 ng/ml between 12 to 48 hours of chest pain in predicting LVEF <50% in STEMI was 93.75% and specificity was 77.78%. In NSTEMI sensitivity of troponin I e” 4.5 ng/ml between 12 to 48 hours of chest pain in predicting LVEF <50% was 65% and specificity was 54.05%. Conclusion: Serum troponin I level had a strong negative correlation with left ventricular ejection fraction after acute coronary syndrome and hence can be used to predict the LVEF in this setting. Cardiovasc. j. 2019; 12(1): 24-29

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Emergency department triage of patients with acute chest pain: definition of cardiac troponin I decisional value to manage patients without electrocardiographic evidence of ischemia

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm.2004.094 ◽

2004 ◽

Vol 42 (5) ◽

Cited By ~ 1

Author(s):

Pascale Beyne ◽

Erik Bouvier ◽

Patrick Werner ◽

Pierre Bourgoin ◽

Damien Logeart ◽

...

Keyword(s):

Chest Pain ◽

Cardiac Troponin ◽

Troponin I ◽

Acute Chest Pain ◽

Final Diagnosis ◽

Cardiac Troponin I ◽

Reference Limit ◽

Coronary Syndrome ◽

Definition Of ◽

Upper Reference Limit

AbstractThe aim of this study was to define the use of a new cardiac troponin I (cTnI) assay for emergency patients with chest pain and no specific electrocardiographic changes consistent with the presence of ischemia. Patients (n=106) admitted in Emergency/Cardiology Departments for chest pain and suspicion of acute coronary syndrome (ACS) were randomized into two diagnosis groups (ACS or non-ACS) by two independent cardiologists. cTnI measurements were performed at admission, and 6 hours and 12 hours later with a new generation assay (Access AccuTnI, Beckman Coulter). Using an upper reference limit of 0.04 μg/l, 27 patients had a cTnI elevation not related to the final diagnosis of ischemia; the positive predictive value (PPV) was 67% with specificity 48%. The decisional value was re-defined and set at 0.16 μg/l, a concentration corresponding to the 99th percentile of the non-ACS patient group. Precision (coefficient of variation) was 8% at this level, PPV 97% and specificity 98%. This new decisional value is now used in our institution and could be included in standard care guidelines to improve the management of patients presenting chest pain in emergency departments.

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Challenges of Management of Stunned Myocardium Associated with Acute Subarachnoid Hemorrhage: A Case Report

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v4i2.38932 ◽

2018 ◽

Vol 4 (2) ◽

pp. 150-153

Author(s):

Sirajee Shafiqul Islam ◽

Kazi Mohibur Rahman ◽

Sharif Uddin Khan ◽

Dewan Md Elyas ◽

Md Aminul Hasanat ◽

...

Keyword(s):

Cardiac Troponin ◽

Troponin I ◽

Past History ◽

Cardiac Troponin I ◽

Stunned Myocardium ◽

Anterior Communicating Artery ◽

Acute Subarachnoid Hemorrhage ◽

History Of ◽

Digital Subtraction Angiogram ◽

Small Aneurysm

A 40 year old lady presented with headache and vomiting having no past history of hyper-tension, diabetes, smoking, alcohol or drug abuse. Computed Tomography (CT) scan of brain revealed sub-arachnoid haemorrhage in parasaggital frontal and lt. Sylvian fissure. Digital Subtraction Angiogram (DSA) was performed and revealed a small aneurysm (4x 2.5 x 2) mm in anterior communicating artery. After 12 hours of DSA patient complaints of sudden severe headache followed by unconsciousness. Repeat CT performed and revealed new onset rt. fronto-basal intra-cranial hematoma consistent with rebleed. On admission the patient was with normal Glasgow Coma Scale (GCS-15), Blood pressure (BP125/80mm/Hg), ECG & Echocardiogram. After rebleed patient developed low BP (50/35mmHg), GCS down gread (05), ECG showed sinus tachycardia with poor progression of R(V1-V3) wave, elevated cardiac Troponin –I(-4919.6 Pg). Then patient was given a regimen of ionotropic agent noradrenalin at dose 5mcg/kg/h. From day 3th of rebleed the patient was clinically improving, BP(120/84mmHg), GCS( 8), ECG normal, Cardiac Troponin-I- (790.8 Pg/dl). Then emergency endovascular ACOM coil embolization was done.Journal of National Institute of Neurosciences Bangladesh, 2018;4(2): 150-153

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