Diagnostic and Prognostic Value of High-sensitivity Cardiac Troponin T in Patients with Syncope

Christ, Michael; Geier, Felicitas; Popp, S.; Singler, Katrin; Smolarsky, Alexander; Bertsch, Thomas; Müller, Christian; Greve, Yvonne

doi:10.1016/j.amjmed.2014.09.021

Cited by 17 publications

(14 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Christ et al found that at 180 days, 19 of 148 with a raised troponin died (5.3% vs 1.9% in patients without elevated troponin; P < 0.001). 28 Reed et al found any rise in troponin was associated with increased risk of death at 1 month and 1 year (P < 0.001). 30 Lindner et al found that one of 55 patients with raised troponin died in hospital as compared to zero from 66 with a normal troponin level.…”

Section: Deathmentioning

confidence: 96%

“…30 Lindner et al found that one of 55 patients with raised troponin died in hospital as compared to zero from 66 with a normal troponin level. 28 Hing et al 33 found two of four patients with a raised troponin had died at 30 days as compared to zero of 96 with normal troponin levels.…”

Section: Deathmentioning

confidence: 99%

“…33 In contrast, Christ et al found that high sensitivity troponin T level is not an independent predictor of MACE. 28…”

Section: Major Adverse Cardiac Event (Mace)mentioning

confidence: 99%

“…Christ et al and O'Neill et al both found that serum troponin levels had a limited predictive accuracy for identifying those at increased risk of serious AEs. 27,28…”

Section: Other Serious Aesmentioning

confidence: 99%

“…The outcome measure of AMI was defined byReed et al according to the universal definition 34 and by Christ et al according to the World Health Organization (WHO) troponin cut-off point for AMI at ≥100 ng/ L. 35,36 Reed et al concluded that AMI was infrequent (1.4%) and estimation of troponin I provided little additional benefit to the presenting ED ECG in identifying patients with syncope because of AMI 31. There were zero of 212 patients with normal troponin levels had an AMI within 180 days 28. There were zero of 212 patients with normal troponin levels had an AMI within 180 days 28.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Review article: Utility of troponin after syncope: A systematic review and meta‐analysis

Stark

Smit

Mitra

2018

Emerg Medicine Australasia

View full text Add to dashboard Cite

The role of serum troponin testing in patients presenting to the ED after syncope is unclear. The aim of this systematic review was to examine the practice and utility of troponin testing among patients presenting to the ED after syncope. We conducted a search of MEDLINE, Embase, Cochrane Library, Web of Science and Scopus databases from 1990 to February 2017 using keyword and subject headings for syncope and troponin testing. Design and results of the included studies are extracted. Studies were assessed for heterogeneity and the pooled proportion of measured troponin and positive troponin result described. There were nine studies included for analysis. Significant statistical heterogeneity among studies was observed (P < 0.001). Using the random effects model, the pooled proportion of patients presenting to the ED after syncope who had troponin measured was 0.64 (95% CI 0.46-0.82). Among patients who had been troponin tested, the pooled proportion who had a positive result was 0.19 (95% CI 0.13-0.26). Variability among reported outcomes prevented further meta-analysis. Troponin testing was commonly performed for the assessment of patients with syncope with a substantial proportion returning positive results. The correlation between raised troponin and patient outcomes was not adequately reported. It is possible that an elevated troponin may indicate serious illness, rather than myocardial damage alone.

show abstract

Section: Deathmentioning

confidence: 96%

Section: Deathmentioning

confidence: 99%

“…33 In contrast, Christ et al found that high sensitivity troponin T level is not an independent predictor of MACE. 28…”

Section: Major Adverse Cardiac Event (Mace)mentioning

confidence: 99%

“…Christ et al and O'Neill et al both found that serum troponin levels had a limited predictive accuracy for identifying those at increased risk of serious AEs. 27,28…”

Section: Other Serious Aesmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Review article: Utility of troponin after syncope: A systematic review and meta‐analysis

Stark

Smit

Mitra

2018

Emerg Medicine Australasia

View full text Add to dashboard Cite

show abstract

Did This Patient Have Cardiac Syncope?

Albassam

Redelmeier

Shadowitz

et al. 2019

JAMA

View full text Add to dashboard Cite

IMPORTANCE Syncope can result from a reduction in cardiac output from serious cardiac conditions, such as arrhythmias or structural heart disease (cardiac syncope), or other causes, such as vasovagal syncope or orthostatic hypotension.OBJECTIVE To perform a systematic review of studies of the accuracy of the clinical examination for identifying patients with cardiac syncope.STUDY SELECTION Studies of adults presenting to primary care, emergency departments, or referred to specialty clinics.DATA EXTRACTION AND SYNTHESIS Relevant data were abstracted from articles in databases through April 9, 2019, and methodologic quality was assessed. Included studies had an independent comparison to a reference standard. Sensitivity, specificity, and likelihood ratios (LRs). MAIN OUTCOMES AND MEASURESRESULTS Eleven studies of cardiac syncope (N = 4317) were included. Age at first syncope of at least 35 years was associated with greater likelihood of cardiac syncope (n = 323

show abstract

Cardiac troponins—Translational biomarkers in cardiology: Theory and practice of cardiac troponin high‐sensitivity assays

et al. 2016

View full text Add to dashboard Cite

Tn is a unique translational biomarker in cardiology whose potential has not been diminished in the new era of high sensitive assays. cTns can be valuable markers in cardiac diseases as well as in infectious diseases and respiratory diseases. Furthermore, the role of cTns is growing in the routine evaluation of cardioxicity and in determining the efficacy/safety ratio of novel cardioprotective strategies in clinical settings. cTns can detect myocardial injury not only in a wide spectrum of laboratory animals in experimental studies in vivo, but also in isolated heart models or cardiomyocytes in vitro. The crucial issue regarding the cross‐species usage of cardiac troponin investigation remains the choice of cardiac troponin testing. This review summarizes the recent proteomic data on aminoacid sequences of cTnT and cTnI in various species, as well as selected analytical characteristics of human cardiac troponin high‐sensitivity assays. Due to the highly phylogenetically conserved structure of troponins, the same bioindicator can be investigated using the same method in both clinical and experimental cardiology, thus contributing to a better understanding of the pathogenesis of cardiac diseases as well as to increased effectiveness of troponin use in clinical practice. Measuring cardiac troponins using commercially available human high‐sensitivity cardiac troponin tests with convenient antibodies selected on the basis of adequate proteomic knowledge can solve many issues which would otherwise be difficult to address in clinical settings for various ethical and practical reasons. Our survey could help elaborate the practical guidelines for optimizing the choice of cTns assay in cardiology. © 2016 BioFactors, 42(2):133–148, 2016

show abstract

Diagnostic and Prognostic Value of High-sensitivity Cardiac Troponin T in Patients with Syncope

Cited by 17 publications

References 44 publications

Review article: Utility of troponin after syncope: A systematic review and meta‐analysis

Review article: Utility of troponin after syncope: A systematic review and meta‐analysis

Did This Patient Have Cardiac Syncope?

Cardiac troponins—Translational biomarkers in cardiology: Theory and practice of cardiac troponin high‐sensitivity assays

Contact Info

Product

Resources

About