High sensitivity cardiac troponin T in patients not having an acute coronary syndrome: results from the TRAPID-AMI study

Nowak, Richard M.; Müeller, Christian; Giannitsis, Evangelos; Christ, Michael; Ordóñez-Llanos, Jordi; deFilippi, Christopher R.; McCord, James; Body, Richard; Panteghini, Mauro; Jernberg, Tomas; Plebani, Mario; Verschuren, Franck; French, John K.; Christenson, Robert H.; Jacobsen, Gordon; Dinkel, Carina; Lindahl, Bertil

doi:10.1080/1354750x.2017.1334154

Cited by 14 publications

(8 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 1–3 Less than one in five patients presenting to the emergency department with chest pain have acute myocardial infarction (MI). 4 5 Other potential causes for their symptoms include non-ischaemic cardiac disease (aneurysm, aortic dissection or pulmonary embolism) and non-cardiac disease (respiratory, gastrointestinal or musculoskeletal disorders). However, for a significant number of patients the cause of symptoms is unclear and such patients are defined as having non-specific chest pain (NSCP).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of coronary artery calcification in a non-specific chest pain population in emergency and cardiology departments compared with the background population: a prospective cohort study in Southern Denmark with 12-month follow-up of cardiac endpoints

Ilangkovan

Mogensen²,

Mickley

et al. 2018

BMJ Open

View full text Add to dashboard Cite

ObjectivesTo examine and compare the prevalence of coronary artery calcification (CAC) and the frequency of cardiac events in a background population and a cohort of patients with non-specific chest pain (NSCP) who present to an emergency or cardiology department and are discharged without an obvious reason for their symptom.DesignA double-blinded, prospective, observational cohort study that measures both CT-determined CAC scores and cardiac events after 1 year of follow-up.SettingEmergency and cardiology departments in the Region of Southern Denmark.SubjectsIn total, 229 patients with NSCP were compared with 722 patients from a background comparator population.Main outcomes measuresPrevalence of CAC and incidence of unstable angina (UAP), acute myocardial infarction (MI), ventricular tachycardia (VT), coronary revascularisation and cardiac-related mortality 1 year after index contact.ResultsThere was no significant difference in the prevalence of CAC (OR 0.9 (95% CI 0.6 to 1.3), P=0.546) or the frequency of cardiac endpoints (P=0.64) between the studied groups. When compared with the background population, the OR for patients with NSCP for a CAC >100 Agatston units (AU) was 1.0 (95% CI 0.6 to 1.5), P=0.826. During 1 year of follow-up, two (0.9%) patients with NSCP underwent cardiac revascularisation, while none experienced UAP, MI, VT or death. In the background population, four (0.6%) participants experienced a clinical cardiac endpoint; two had an MI, one had VT and one had a cardiac-related death.ConclusionThe prevalence of CAC (CAC >0 AU) among patients with NSCP is comparable to a background population and there is a low risk of a cardiac event in the first year after discharge. A CAC study does not provide notable clinical utility for risk-stratifying patients with NSCP.Trial registration numberNCT02422316; Pre-results.

show abstract

Section: Introductionmentioning

confidence: 99%

Prevalence of coronary artery calcification in a non-specific chest pain population in emergency and cardiology departments compared with the background population: a prospective cohort study in Southern Denmark with 12-month follow-up of cardiac endpoints

Ilangkovan

Mogensen²,

Mickley

et al. 2018

BMJ Open

View full text Add to dashboard Cite

show abstract

“…arrhythmia or myocarditis) may have higher hsTn levels than those with non-cardiac aetiologies, such as anaemia or hypoxia. [ 104 ]…”

Section: Impact Of High-sensitivity Troponinmentioning

confidence: 99%

“…arrhythmia or myocarditis) may have higher hsTn levels than those with non-cardiac aetiologies, such as anaemia or hypoxia. 104 HsTn might allow greater precision with risk stratification in certain clinical settings of type 2 MI, such as tachyarrhythmia. One study found that patients with tachyarrhythmia who had a positive hsTn (accounting for 47% of all tachyarrhythmia patients) had a significantly higher mortality than those with a negative hsTn, with rates similar to that of non-STelevation MI patients.…”

Section: Impact Of High-sensitivity Troponinmentioning

confidence: 99%

Type 2 MI and Myocardial Injury in the Era of High-sensitivity Troponin

et al. 2022

View full text Add to dashboard Cite

Troponin has been the cornerstone of the definition of MI since its introduction to clinical practice. High-sensitivity troponin has allowed clinicians to detect degrees of myocardial damage at orders of magnitude smaller than previously and is challenging the definitions of MI, with implications for patient management and prognosis. Detection and diagnosis are no doubt enhanced by the greater sensitivity afforded by these markers, but perhaps at the expense of specificity and clarity. This review focuses on the definitions, pathophysiology, prognosis, prevention and management of type 2 MI and myocardial injury. The five types of MI were first defined in 2007 and were recently updated in 2018 in the fourth universal definition of MI. The authors explore how this pathophysiological classification is used in clinical practice, and discuss some of the unanswered questions in this era of availability of high-sensitivity troponin.

show abstract

“…For example, cTnT elevation can also be observed in myocarditis, hypertrophic cardiomyopathy, sometimes unstable angina, etc. Sometimes, unexpected elevation of the markers can also be observed without obvious connection to cardiac injury (2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

Plasma Metabolites Alert Patients With Chest Pain to Occurrence of Myocardial Infarction

et al. 2021

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Myocardial infarction (MI) is one of the leading causes of death worldwide, and knowing the early warning signs of MI is lifesaving. To expand our knowledge of MI, we analyzed plasma metabolites in MI and non-MI chest pain cases to identify markers for alerting about MI occurrence based on metabolomics. A total of 230 volunteers were recruited, consisting of 146 chest pain patients admitted with suspected MI (85 MIs and 61 non-MI chest pain cases) and 84 control individuals. Non-MI cardiac chest pain cases include unstable angina (UA), myocarditis, valvular heart diseases, etc. The blood samples of all suspected MI cases were collected not longer than 6 h since the onset of chest pain. Gas chromatography–mass spectrometry and liquid chromatography–mass spectrometry were applied to identify and quantify the plasma metabolites. Multivariate statistical analysis was utilized to analyze the data, and principal component analysis showed MI could be clearly distinguished from non-MI chest pain cases (including UA and other cases) in the scores plot of metabolomic data, better than that based on the data constructed with medical history and clinical biochemical parameters. Pathway analysis highlighted an upregulated methionine metabolism and downregulated arginine biosynthesis in MI cases. Receiver operating characteristic curve (ROC) and adjusted odds ratio (OR) were calculated to evaluate potential markers for the diagnosis and prediction ability of MI (MI vs. non-MI cases). Finally, gene expression profiles from the Gene Expression Omnibus (GEO) database were briefly discussed to study differential metabolites' connection with plasma transcriptomics. Deoxyuridine (dU), homoserine, and methionine scored highly in ROC analysis (AUC > 0.91), sensitivity (>80%), and specificity (>94%), and they were correlated to LDH and AST (p < 0.05). OR values suggested, after adjusting for gender, age, lipid levels, smoking, type II diabetes, and hypertension history, that high levels of dU of positive logOR = 3.01, methionine of logOR = 3.48, and homoserine of logOR = 1.61 and low levels of isopentenyl diphosphate (IDP) of negative logOR = −5.15, uracil of logOR = −2.38, and arginine of logOR = −0.82 were independent risk factors of MI. Our study highlighted that metabolites belonging to pyrimidine, methionine, and arginine metabolism are deeply influenced in MI plasma samples. dU, homoserine, and methionine are potential markers to recognize MI cases from other cardiac chest pain cases after the onset of chest pains. Individuals with high plasma abundance of dU, homoserine, or methionine have increased risk of MI, too.

show abstract

High sensitivity cardiac troponin T in patients not having an acute coronary syndrome: results from the TRAPID-AMI study

Cited by 14 publications

References 15 publications

Prevalence of coronary artery calcification in a non-specific chest pain population in emergency and cardiology departments compared with the background population: a prospective cohort study in Southern Denmark with 12-month follow-up of cardiac endpoints

Prevalence of coronary artery calcification in a non-specific chest pain population in emergency and cardiology departments compared with the background population: a prospective cohort study in Southern Denmark with 12-month follow-up of cardiac endpoints

Type 2 MI and Myocardial Injury in the Era of High-sensitivity Troponin

Plasma Metabolites Alert Patients With Chest Pain to Occurrence of Myocardial Infarction

Contact Info

Product

Resources

About