Diagnostic and prognostic utility of early measurement with high-sensitivity troponin T assay in patients presenting with chest pain

Aldous, Sally; Richards, Mark; Cullen, Louise; Troughton, Richard W.; Than, Martin

doi:10.1503/cmaj.110773

Cited by 69 publications

(79 citation statements)

References 21 publications

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“…This is a marked difference compared to studies of older troponin T assays, in which only 15% to 45% of patients on dialysis were found to have increased concentrations (7, 19 -24 ). The greater sensitivity of the hs-cTnT assay has been shown to improve our ability to diagnose MI, in comparison with the older assays, in the non-renal disease population (11)(12)(13)(14). In line with our current data, hs-cTnT also appears to be a better predictor of outcome than the older assays for patients on dialysis (25 ).…”

Section: Discussionsupporting

confidence: 76%

High-Sensitivity Troponin as a Predictor of Cardiac Events and Mortality in the Stable Dialysis Population

et al. 2014

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BACKGROUND:High-sensitivity cardiac troponin T (hs-cTnT) is a biomarker used in diagnosing myocardial injury. The clinical utility and the variation of this biomarker over time remain unclear in hemodialysis (HD) and peritoneal dialysis (PD) patients. We sought to determine whether hs-cTnT concentrations were predictive of myocardial infarction (MI) and death and to examine hs-cTnT variability over a 1-year period.

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Section: Discussionsupporting

confidence: 76%

High-Sensitivity Troponin as a Predictor of Cardiac Events and Mortality in the Stable Dialysis Population

et al. 2014

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“…However, with the increasing sensitivity of troponin assays, biomarker-negative ACS (ie, UA) is becoming rarer. 39 The pathogenesis of ACS is considered in the "Third Universal Definition of Myocardial Infarction." 21 This statement defines MI caused by a primary coronary artery process such as spontaneous plaque rupture as MI type 1 and one related to reduced myocardial oxygen supply and/or increased myocardial oxygen demand (in the absence of a direct coronary artery process) as a MI type 2 (Appendix 4, Table A and Section 3.4 for an additional discussion on the diagnosis of MI).…”

Section: Definition Of Termsmentioning

confidence: 99%

2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes

Amsterdam¹,

Wenger²,

Brindis³

et al. 2014

Circulation

1,099

908

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“…We also show MR-proADM has modest correlation with cTn, a finding previously demonstrated by Maisel et al 32 Cardiac troponin is incorporated in every algorithm involving the diagnosis of AMI and predicts short-term mortality. 35,36 As high sensitivity assays become more readily available, our understanding of their appropriate use in the evaluation of chest pain will evolve, 37,38 with current studies demonstrating prediction of cardiovascular death 1 year after presentation with chest pain. 39 However, the eligibility study of this trial mandated presentation within 6 hours of symptoms, and the true prognostic value of peak troponin is possibly not captured in our analysis given the time to peak troponin in MI.…”

Section: Mr-proadm and Cardiac Biomarkersmentioning

confidence: 99%

Midregional Proadrenomedullin Predicts Mortality and Major Adverse Cardiac Events in Patients Presenting With Chest Pain: Results From the CHOPIN Trial

Shah

Marston

Müeller

et al. 2015

Academic Emergency Medicine

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Objectives: Chest pain is a common complaint to emergency departments (EDs) and clinical risk factors are used to predict which patients are at risk for worse outcomes and mortality. The goal was to assess the novel biomarker midregional proadrenomedullin (MR-proADM) in prediction of mortality and major adverse cardiac events (MACE).Methods: This was a subanalysis of the CHOPIN study, a 16-center prospective trial that enrolled 2,071 patients presenting with chest pain within 6 hours of onset. The primary endpoint was 6-month all-cause mortality and the secondary endpoint was 30-day and 6-month MACE: ED visits or hospitalization for acute myocardial infarction, unstable angina, reinfarction, revascularization, and heart failure.Results: MR-proADM performed similarly to troponin (cTnI; c-statistic = 0.845 and 0.794, respectively) for mortality prediction in all subjects and had similar results in those with noncardiac diagnoses. MRproADM concentrations were stratified by decile, and the cohort in the top decile had a 9.8% 6-month mortality risk versus 0.9% risk for those in the bottom nine deciles (p < 0.0001). MR-proADM, history of coronary artery disease (CAD), and hypertension were predictors of short-term MACE, while history of CAD, hypertension, cTnI, and MR-proADM were predictors of long-term MACE.

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Diagnostic and prognostic utility of early measurement with high-sensitivity troponin T assay in patients presenting with chest pain

Cited by 69 publications

References 21 publications

High-Sensitivity Troponin as a Predictor of Cardiac Events and Mortality in the Stable Dialysis Population

High-Sensitivity Troponin as a Predictor of Cardiac Events and Mortality in the Stable Dialysis Population

2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes

Midregional Proadrenomedullin Predicts Mortality and Major Adverse Cardiac Events in Patients Presenting With Chest Pain: Results From the CHOPIN Trial

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