scholarly journals Analysis of Cardiac Injury Biomarkers in COVID-19 Patients

2020 ◽  
Vol 15 (4) ◽  
Author(s):  
Salma Abdeladim ◽  
Sara Oualim ◽  
Amal Elouarradi ◽  
Ilham Bensahi ◽  
Rita Aniq Filali ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Injury ◽  
Clinical Syndrome ◽  
Cardiac Troponin I ◽  
The Novel ◽  
Cardiac Damage ◽  
The Mean ◽  
Underlying Mechanisms ◽  
Novel Coronavirus

Background: Infection with the novel coronavirus, named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), producing a clinical syndrome known as COVID-19, is a budding infectious disease that first manifested in December 2019 in China and subsequently spread worldwide. Objectives: We performed an analysis of cardiac injury markers to determine their usefulness as predictors of severity and mortality Methods: In a retrospective study, we enrolled 73 patients with confirmed diagnoses of COVID-19, from March 21, 2020, to April 24, 2020. Serial tests of cardiac injury markers, including cardiac troponin I (cTnI), N‐terminal pro‐brain natriuretic peptide (NT‐proBNP), and Lactate dehydrogenase (LDH), were considered for the analysis of potential cardiac damage. Results: Among 149 patients with confirmed COVID-19, data from 73 patients were studied. Of them, 58 (79.46%) patients were discharged, and 15 (20.54 %) patients died. The mean age was 58.50 (14.66) years. Patients were classified into mild (39 cases), severe (17 cases), and critical (17 cases) groups. The peak cardiac troponin I level (0.11 ng/mL [IQR: 0.33–0.20]), peak NT-pro BNP level (5840.35 pg/mL [IQR: 1609.39 – 10071.32]), and peak LDH level (578.65 UI/l[IQR: 313.40 – 843.90]) were significantly higher in the critical group, and the three cardiac injury parameters were significantly higher in the death group, suggesting that they are significantly associated with a higher risk of in-hospital mortality. Conclusions: The understanding of cardiovascular system injury caused by SARS-CoV-2 and its underlying mechanisms is of great importance for the early clinical management of these patients and mortality reduction.

scholarly journals Evaluation of Cardiac Troponin Level Following Generalized Tonic-Clonic Seizure in Children; Cross-Sectional Study

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Yazdan Ghandi ◽  
Fakhreddin Sharitmadari ◽  
Danial Habibi ◽  
Saeid Sadrnia
Keyword(s):  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Injury ◽  
Cross Sectional Study ◽  
Clonic Seizure ◽  
Cardiac Monitoring ◽  
Cardiac Damage ◽  
Cross Sectional ◽  
History Of ◽  
The Mean

Objectives: Cardiac troponin I (CTnI) is recognized as a proper marker for early detection of cardiac damage. Generalized tonic-clonic (GTC) seizures may lead to cardiac ischemia or myocardial injury associated with elevated CTnI. The present study aimed at evaluating the level of CTnI in children with status GTC seizures. Methods: 50 patients with GTC seizures and a normal cardiac function referred to Amirkabir Hospital, Arak, Iran were evaluated. The medical history of all patients was taken, and clinical examinations were performed. For all patients were performed Serum CTnI measurements, electroencephalography (EEG), electrocardiography (ECG), and echocardiography. Results: The patients’ mean age was 7.80 ± 4.01 years and 26 (52%) children were female (female: male ratio, 1.08). the mean duration of seizure was 31.54 ± 1.56 minutes. Abnormal EEG patterns were documented in 83 (86%) patients, while abnormal CT scan was not found in any of the patients. The mean level of CTnI was at the high end of the range in patients (57.02 ± 10.80 ng/mL). There was a positive correlation between serum CTnI and age (P = 0.001, R = 0.492). Also, the serum level of CTnI was significantly correlated with the onset of GTC seizure (R = 0.004, P = 0.001). Conclusion: The serum CTnI level exceeded the normal level in children with seizures. Therefore, cardiac monitoring of patients with status GTC seizures may be helpful in the ictal and postictal phases for evaluating cardiac injury, especially in children with risk factors for coronary diseases, such as Kawasaki disease, cardiomyopathy, or coronary anomalies.

scholarly journals Clinical characteristics of 41 patients with pneumonia due to 2019 novel coronavirus disease (COVID-19) in Jilin, China

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Qing Zhang ◽  
Qian Xu ◽  
Yi-yang Chen ◽  
Li-xin Lou ◽  
Li-he Che ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Clinical Characteristics ◽  
Troponin I ◽  
Clinical Laboratory ◽  
Ground Glass Opacity ◽  
Hospitalized Patients ◽  
Cardiac Troponin I ◽  
Interquartile Range ◽  
Strong Positive Correlation ◽  
Novel Coronavirus

Abstract Background The clinical characteristics of patients with confirmed 2019 novel coronavirus disease (COVID-19) in Jilin Province, China were investigated. Methods Clinical, laboratory, radiology, and treatment data of 41 hospitalized patients with confirmed COVID-19 were retrospectively collected. The population was stratified by disease severity as mild, moderate, or severe, based on guidelines of the National Health and Medical Commission of China. Results The 41 hospitalized patients with COVID-19 were studied, and the median age was 45 years (interquartile range [IQR], 31–53; range, 10–87 years) and 18 patients (43.9%) were female. All of the patients had recently visited Wuhan or other places (ie, Beijing, Thailand) or had Wuhan-related exposure. Common symptoms included fever (32[78%]) and cough (29[70.7%]). All patients were without hepatitis B/C virus hepatitis. CRP (C-reactive protein, 11.3 mg/L [interquartile range {IQR}, 2.45–35.2]) was elevated in 22 patients (53.7%), and cardiac troponin I (1.5 ng/mL [IQR, 0.8–5.0]) was elevated in 41 patients (100%). Chest computed tomographic scans showed bilateral ground glass opacity (GGO) or GGO with consolidation in the lungs of 27(65.9%) patients. 31(75.6%) patients had an abnormal electrocardiograph (ECG). Comparing the three groups, the levels of CRP and cardiac troponin I, GGO distribution in bilateral lungs, and electrocardiogram changes were statistically significant (p < 0.05). Cardiac troponin I had a strong positive correlation with CRP (r = 0.704, p = 0.042) and LDH (r = 0.738, p = 0.037). Conclusion Significant differences among the groups suggest that several clinical parameters may serve as biomarkers of COVID-19 severity at hospital admission. Elevated cTnI could be considered as a predictor of severe COVID-19, reflecting the prognosis of patients with severe COVID-19. The results warrant further inspection and confirmation.

Comparable detection of acute myocardial infarction by creatine kinase MB isoenzyme and cardiac troponin I

1994 ◽  
Vol 40 (7) ◽  
pp. 1291-1295 ◽  
Author(s):  
J E Adams ◽  
K B Schechtman ◽  
Y Landt ◽  
J H Ladenson ◽  
A S Jaffe
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Characteristic Curve ◽  
Cardiac Injury ◽  
Cardiac Troponin I ◽  
Creatine Kinase Mb ◽  
Coronary Care

Abstract Although measurement of cardiac troponin I (cTnI) is, in some situations, more specific for detection of cardiac injury than is measurement of the MB isoenzyme of creatine kinase (MBCK), its sensitivity and specificity relative to MBCK for detection of myocardial infarction has not been established. Accordingly, we studied prospectively 199 consecutive patients admitted to the coronary care unit. Values of MBCK and cTnI mass were determined in all samples. Of the 188 patients admitted with a suspicion of acute myocardial ischemia, 89 were diagnosed as having an acute myocardial infarction on the basis of the patterns of MBCK values. Eighty-six of these patients also had increased cTnI (concordance, 96.6%); three did not. Of the patients diagnosed as without infarction, five with unstable angina and symptoms in the day(s) prior to admission had increased cTnI, for a cTnI specificity of 94.9%. Receiver operating characteristic curve analysis indicated that cTnI and MBCK had statistically indistinguishable diagnostic accuracies for the detection of acute myocardial infarction.

scholarly journals Cardiac Troponin I Concentrations, but Not Electrocardiographic Results, Predict an Extended Hospital Stay after Coronary Artery Bypass Graft Surgery

2005 ◽  
Vol 51 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Robert F Salamonsen ◽  
Hans-Gerhard Schneider ◽  
Michael Bailey ◽  
Andrew J Taylor
Keyword(s):  
Coronary Artery ◽  
Hospital Stay ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Cardiac Troponin I ◽  
Cardiac Damage ◽  
Simple Method ◽  
Cabg Surgery

Abstract Background: Cardiac damage in coronary artery graft (CABG) surgery is an important contributor to postoperative cardiac dysfunction and delayed hospital discharge. Currently, no simple method exists for its quantification. Methods: In a prospective study of 300 patients having routine CABG surgery, we compared cardiac troponin I (cTnI) concentrations at 6 and 24 h after surgery with electrocardiographic (ECG) results as predictors of an extended postoperative stay in the intensive care unit (ICU) and in the hospital. We stratified outcome variables by tertiles of cTnI concentration and studied the significance of differences between outcome variables across tertiles. Results: Multivariate analysis showed that 24-h cTnI is a significant predictor of increased postoperative ICU stay (P = 0.012) and postoperative hospital stay (P = 0.024). For 6-h cTnI, corresponding significance values were P = 0.29 and 0.9. ECG was of no value (P = 0.39 and 0.47). Differences in 24-h cTnI were highly significant, particularly for lowest vs highest tertiles, and allowed stratification of risk into “low” (&lt;10 μg/L), “equivocal” (10–20 μg/L), and “high” (&gt;20 μg/L). Conclusions: Use of a single 24-h cTnI value to quantify perioperative myocardial damage identifies patients who are at greater risk of extended ICU and hospital stays. This strategy could assist in allocation of patients to different management streams after CABG surgery.

scholarly journals Negative Interference in Cardiac Troponin I Immunoassays from a Frequently Occurring Serum and Plasma Component

2003 ◽  
Vol 49 (7) ◽  
pp. 1095-1104 ◽  
Author(s):  
Susann Eriksson ◽  
Miia Junikka ◽  
Päivi Laitinen ◽  
Kirsi Majamaa-Voltti ◽  
Henrik Alfthan ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Solid Phase ◽  
Cardiac Injury ◽  
Cardiac Troponin I ◽  
Terminal Region ◽  
Variable Component ◽  
Time Resolved ◽  
Heparin Plasma

Abstract Background: Cardiac troponin I (cTnI) is a sensitive marker of cardiac injury, but cTnI assays, like other immunoassays, are susceptible to interferences. We evaluated the presence of interfering substances by measuring the recovery of cTnI added to samples from volunteers and from patients with acute coronary syndromes (ACS). Methods: We added a ternary complex of human cardiac troponin (30–500 μg/L) or cTnI from serum to samples from healthy volunteers and ACS patients. We measured cTnI with a two-site sandwich time-resolved immunofluorometric assay using two antibodies against epitopes in the central stable part of cTnI. We also analyzed 108 heparin-plasma samples from 16 ACS patients with this assay, with an assay based on four antibodies, and with two commercial cTnI assays, AxSYM and ACS:180. Results: In samples from both healthy persons and ACS patients, recoveries for our assay were 1–167% (range). Recoveries were increased by addition of an antibody with an epitope in the N-terminal region of cTnI to the solid phase and an antibody with an epitope in the C-terminal region as a second detection antibody. In 2 of 16 patients with ACS, normal cTnI concentrations found when measured with the original assay demonstrated clinically abnormal (up to 10-fold higher) results with the additional N- and C-terminal antibodies in the early phase of infarction. Both commercial cTnI assays also demonstrated clinically misleading, falsely low cTnI concentrations. Conclusions: Some yet unidentified, variable component, present in the blood from healthy volunteers and ACS patients, interferes with the binding of antibodies against epitopes in the central part of cTnI used in two commercial assays. Our approach to supplement the mid-fragment cTnI antibodies with antibodies in the N- and C-terminal parts of the molecule in an experimental assay represents a step in resolving this interferent.

Cardiac Troponin I in Isoproterenol-Induced Cardiac Injury in the Hanover Wistar Rat: Studies on Low Dose Levels and Routes of Administration

2010 ◽  
Vol 38 (2) ◽  
pp. 287-291 ◽  
Author(s):  
Sally Brady ◽  
Malcolm York ◽  
Cheryl Scudamore ◽  
Thomas Williams ◽  
William Griffiths ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Low Dose ◽  
Troponin I ◽  
Cardiac Injury ◽  
Wistar Rat ◽  
Cardiac Troponin I ◽  
Routes Of Administration ◽  
Dose Levels

scholarly journals Cardiac troponin I. A marker with high specificity for cardiac injury.

Circulation ◽  
1993 ◽  
Vol 88 (1) ◽  
pp. 101-106 ◽  
Author(s):  
J E Adams ◽  
G S Bodor ◽  
V G Dávila-Román ◽  
J A Delmez ◽  
F S Apple ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Injury ◽  
High Specificity ◽  
Cardiac Troponin I

Analytical evaluation of the new Beckman Coulter Access high sensitivity cardiac troponin I immunoassay

2017 ◽  
Vol 56 (1) ◽  
Author(s):  
Giuseppe Lippi ◽  
Anna Ferrari ◽  
Giorgio Gandini ◽  
Matteo Gelati ◽  
Claudia Lo Cascio ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Troponin I ◽  
Limit Of Detection ◽  
High Sensitivity ◽  
Cardiac Troponin I ◽  
Analytical Performance ◽  
The Novel ◽  
Reference Limit ◽  
Automated Immunoassay ◽  
Upper Reference Limit

AbstractBackground:This study was aimed to evaluate the analytical performance of the novel chemiluminescent and fully-automated Beckman Coulter Access hsTnI high-sensitivity immunoassay for measurement of cardiac troponin I (cTnI).Methods:The study, using lithium heparin samples, included assessment of limit of blank (LOB), limit of detection (LOD), functional sensitivity, linearity, imprecision (within run, between-run and total), calculation of 99th percentile upper reference limit (URL) in 175 healthy blood donors (mean age, 36±12 years; 47% women) and comparison with two other commercial cTnI immunoassays.Results:The LOB, LOD and functional sensitivity of Access hsTnI were 0.14, 0.34 and 1.35 ng/L, respectively. The within-run, between-run and total imprecision was 2.2%–2.9%, 4.6%–5.4%, and 5.4%–6.1%, respectively. The linearity was excellent in the range of cTnI values between 0.95 and 4195 ng/L (r=1.00). The 99th percentile URL was 15.8 ng/L. Measurable cTnI values were found in 173/175 healthy subjects (98.9%). Good agreement of cTnI values was found with AccuTnI+3 (r=0.97; mean bias, −9.3%), whereas less satisfactory agreement was found with Siemens Dimension Vista cTnI (r=0.95; mean bias, −55%).Conclusions:The results of our evaluation of the Beckman Coulter Access hsTnI indicate that the analytical performance of this fully-automated immunoassay is excellent.

scholarly journals High-sensitive cardiac troponin-I facilitates timely detection of subclinical anthracycline-mediated cardiac injury

2016 ◽  
Vol 54 (1) ◽  
pp. 149-157 ◽  
Author(s):  
Melissa Jones ◽  
Peter O’Gorman ◽  
Catherine Kelly ◽  
Niall Mahon ◽  
Maria C Fitzgibbon
Keyword(s):  
Anticancer Agents ◽  
Cardiac Troponin ◽  
Dose Group ◽  
Troponin I ◽  
Cardiac Injury ◽  
Cardiac Troponin I ◽  
Chemotherapeutic Regimen ◽  
Continuous Dose ◽  
And Gender

Background Anthracycline drugs are effective anticancer agents, but their optimal use is limited in many patients by the associated cardiotoxicity, even at designated safe doses. As conventionally sensitive cardiac troponin-I assays fail to reliably quantify concentrations of cardiac troponin-I below 30 ng/L, we investigated the potential role of high-sensitive cardiac troponin-I in the detection of subclinical cardiomyocyte injury in patients treated with anthracycline agents. Methods Serial high-sensitive cardiac troponin-I concentrations were assessed in 84 patients, receiving anthracycline-containing ( n = 38) and non-anthracycline-containing ( n = 46) regimens. Results were assessed for change from pretreatment levels and evaluated according to unisex and gender-specific 99th percentiles (25 ng/L and M: 34 ng/L, F: 16 ng/L, respectively). Results A significant increase in high-sensitive cardiac troponin-I was observed in the anthracycline cohort following five cycles of treatment, with the greatest change correlating to an absolute δ increase of 30.7 ng/L in the early-dose group (early-dose group: P < 0.0001, late-dose group: P < 0.01 and continuous-dose group: P < 0.0001). Doxorubicin dose did not correlate directly with high-sensitive cardiac troponin-I concentrations (Spearman r < −0.22). No significant changes in high-sensitive cardiac troponin-I were reported among the non-anthracycline cohort with all measurements below the 99th percentiles. Conclusions Treatment with anthracycline-based chemotherapeutic regimen demonstrated significant elevations of high-sensitive cardiac troponin-I, indicative of subclinical cardiomyocyte damage. This study demonstrates a role for high-sensitive cardiac troponin-I in evaluating those patients where cardiotoxicity is a concern and a potential future role as a biomarker in optimizing cardioprotective treatments in patients receiving anthracycline therapy.

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