scholarly journals Sensitive Troponin I Assay in Patients with Chest Pain - Association with Significant Coronary Lesions with or Without Renal Failure

Author(s):  
Alexandre de Matos Soeiro ◽  
Danielle Menosi Gualandro ◽  
Aline Siqueira Bossa ◽  
Cindel Nogueira Zullino ◽  
Bruno Biselli ◽  
...  
2005 ◽  
Vol 150 (4) ◽  
pp. 674-680 ◽  
Author(s):  
Michael C. Kontos ◽  
Rajat Garg ◽  
F. Philip Anderson ◽  
James L. Tatum ◽  
Joseph P. Ornato ◽  
...  
Keyword(s):  

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 490
Author(s):  
Greta Rodevič ◽  
Povilas Budrys ◽  
Giedrius Davidavičius

Background: Percutaneous coronary intervention (PCI) is known as a very rare possible trigger of pericarditis. Most frequently it develops after a latent period or early in the case of periprocedural complications. In this report, we present an atypical early onset of pericarditis after an uncomplicated PCI. Case Summary: A 58-year-old man was admitted to the hospital for PCI of the chronic total occlusion of the left anterior descending (LAD) artery. An initial electrocardiogram (ECG) was unremarkable. The PCI attempt was unsuccessful. There were no procedure-related complications observed at the end of the PCI attempt and the patient was symptom free. Six hours after the interventional procedure, the patient complained of severe chest pain. The ECG demonstrated ST-segment elevation in anterior and lateral leads. Troponin I was mildly elevated but a coronary angiogram did not reveal the impairment of collateral blood flow to the LAD territory. Due to pericarditic chest pain, typical ECG findings and pericardial effusion with elevated C-reactive protein, the diagnosis of acute pericarditis was established, and a course of nonsteroidal anti-inflammatory drugs (NSAIDs) was initiated. Chest pain was relieved and ST-segment elevation almost completely returned to baseline after three days of treatment. The patient was discharged in stable condition without chest pain on the fourth day after symptom onset. Conclusions: Acute pericarditis is a rare complication of PCI. Despite the lack of specific clinical manifestation, post-traumatic pericarditis should be considered in patients with symptoms and signs of pericarditis and a prior history of iatrogenic injury or thoracic trauma.


Cardiology ◽  
2020 ◽  
pp. 1-8
Author(s):  
Ronny Alcalai ◽  
Boris Varshisky ◽  
Ahmad Marhig ◽  
David Leibowitz ◽  
Larissa Kogan-Boguslavsky ◽  
...  

<b><i>Background:</i></b> Early and accurate diagnosis of acute coronary syndrome (ACS) is essential for initiating lifesaving interventions. In this article, the diagnostic performance of a novel point-of-care rapid assay (SensAheart<sup>©</sup>) is analyzed. This assay qualitatively determines the presence of 2 cardiac biomarkers troponin I and heart-type fatty acid-binding protein that are present soon after onset of myocardial injury. <b><i>Methods:</i></b> We conducted a prospective observational study of consecutive patients who presented to the emergency department with typical chest pain. Simultaneous high-sensitive cardiac troponin T (hs-cTnT) and SensAheart testing was performed upon hospital admission. Diagnostic accuracy was computed using SensAheart or hs-cTnT levels versus the final diagnosis defined as positive/negative. <b><i>Results:</i></b> Of 225 patients analyzed, a final diagnosis of ACS was established in 138 patients, 87 individuals diagnosed with nonischemic chest pain. In the overall population, as compared to hs-cTnT, the sensitivity of the initial SensAheart assay was significantly higher (80.4 vs. 63.8%, <i>p</i> = 0.002) whereas specificity was lower (78.6 vs. 95.4%, <i>p</i> = 0.036). The overall diagnostic accuracy of SensAheart assay was similar to the hs-cTnT (82.7% compared to 76.0%, <i>p</i> = 0.08). <b><i>Conclusions:</i></b> Upon first medical contact, the novel point-of-care rapid SensAheart assay shows a diagnostic performance similar to hs-cTnT. The combination of 2 cardiac biomarkers in the same kit allows for very early detection of myocardial damage. The SensAheart assay is a reliable and practical tool for ruling-in the diagnosis of ACS.


2018 ◽  
Vol 43 (5) ◽  
pp. 568-570
Author(s):  
Hakan Ayyildiz ◽  
Mehmet Kalayci ◽  
Nadire Cinkilinc ◽  
Mahmut Bozkurt ◽  
Makbule Kutlu Karadag

Abstract Objective Myocarditis is an inflammatory disease of the heart caused by various agents and especially enteroviruses, and it is difficult to diagnose and treat. Myocarditis is rarely associated with bacterial infections. Although the most common bacterial infections are Salmonella spp. and Shigella spp., extremely rare cases of Myocarditis due to Campylobacter jejuni are also reported. Patient and methods A 17-year-old male patient with no previous chronic illness was admitted to our emergency department with complaints of abdominal pain, diarrhea, vomiting, and chest pain. He stated that symptoms began after eating a chicken burger a few days ago. Results In the laboratory tests performed, CK-MB and high sensitive Troponin I values were determined as 33.8 IU/L and 1816 ng/L, respectively. Electrocardiogram results revealed left axis left anterior hemiblock in the normal sinus rhythm as well as a ST-T change in the inferior and lateral derivations. Campylobacter jejuni was detected in the stool sample of the patient. Conclusion Myocarditis is one of the rare complications of C. jejuni infection. Bacterial myocarditis should be considered when troponin and cardiac enzymes are elevated in patients admitted to the emergency department with diarrhea and chest pain.


Author(s):  
Mahir Abdulkadhum Khudhair Alzughaibi ◽  
Ammar Waheeb Obeiad ◽  
Nassar Abdalaema Abdalhadi Mera ◽  
Mohammed Sadeq Hamzah Al-Ruwaiee

Background: Cardiac Troponins-I (CTNI) are myoregulatory polypeptides that control the actin-myosin interface, considered specific to cardiomyocytes. Age and sex variances in the extent of CTNI levels have arisen a recent debatable emphasis. Existing revisions do not display a reliable clinical power of sex-specific CTNI 99th centiles, which actually might mirror procedural aspects. Nevertheless, from a biochemical viewpoint, the trends of sex-specific CTNI 99th centiles seem sensible for the ruling-in of acute myocardial infarction AMI. Vulnerable females may be missed when applying the male sex-specific threshold. This study aimed to determine whether gender differences in CTNI exist in patients with AMI presented with chest pain. Methodology: The study was a cross-sectional, single-center, included 236-patients with AMI diagnosis by cardiologists at Merjan teaching hospital during the period from April to July 2020 from patients attending the hospital for cardiac consultation complaining of acute chest pain suggestive of AMI. Blood analysis had initiated at the time of admission included serum creatinine, blood urea, R/FBS, WBCs, PCV, and serum CTNI. A p-value below 0.05 specifies statistical significance. All statistical bioanalyses had performed by IBM-SPSS, version-25 for Windows. Results: The mean age of participants was 67.5 years, the men were dominant 76.2%. The incidence of DM and hypertension were significantly high and 24.5% of the patients were current smokers. Biochemical serum analysis revealed mean creatinine, urea, sugar, and STI values were 79.8±4.2 mmol/l, 15.9±1.7 mmol/l, 10.9±0.9 mmol/l, and 7.9±0.6 ng/ml separately. Both hypertension and smoking were significantly (p-0.001) more among males compared to the females, which is not the case for the prevalence of DM. The males were heavier significantly than females (p-0.001). Almost, there was no impact of gender on most of the other study variables other than serum TNI levels, which were significantly higher among the males (p-0.001). Conclusion: In patients with AMI presented with acute chest pain, the routine of CTNI in the diagnosis of AMI is based on the patient's gender. The application of gender-dependent cutoff levels for CTNI analyses appears to be highly suggested.


2017 ◽  
Vol 145 (3-4) ◽  
pp. 118-123
Author(s):  
Dejan Petrovic ◽  
Marina Deljanin-Ilic ◽  
Sanja Stojanovic

Introduction/Objective. Clinical risk stratification of patients hospitalized due to acute heart failure (AHF) applying B-type natriuretic peptide (BNP), troponin I (TnI), and high-sensitivity C-reactive protein (hsCRP) biochemical markers can contribute to early diagnosis of AHF and lower mortality rates. The aim of this study was to investigate the prognostic significance of biomarkers (BNP, TnI, and hsCRP) and co-morbidities concerning one-year mortality in patients with AHF. Methods. Clinical group comprised 124 consecutive unselected patients, age 60?80 years, treated at the Coronary Care Unit of the Niska Banja Institute, Nis. The patients were monitored for one year after the discharge. During the first 24 hours after admission, BNP, TnI, and hsCRP were measured in fasting serum. Results. Total one-year mortality was 29.8%. The levels of serum BNP were significantly higher in the group of non-survivors compared to the group of survivors (1353.8 ?} 507.8 vs. 718.4 ?} 387.6 pg/mL, p < 0.001). We identified several clinical and biochemical prognostic risk factors by univariate and multivariate analysis. Independent predictors of one-year mortality were the following: BNP, TnI, depression, hypotension, chronic renal failure, ejection fraction, and right-ventricle systolic pressure. Conclusion. The presence of BNP and TnI biomarkers and several co-morbidities such as depression or chronic renal failure have significant influence on one-year mortality in patients with AHF.


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