High sensitivity troponin in the management of tachyarrhythmias

Mariathas, Mark; Gemmell, C; Olechowski, Bartosz; Nicholas, Zoe; Mahmoudi, Michael; Curzen, Nick

doi:10.1016/j.carrev.2017.11.011

Cited by 12 publications

(12 citation statements)

References 31 publications

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“…Third, that the general awareness that type 2 MI and myocardial injury are common, distinct clinical entities from type 1 MI, both pathophysiologically and in terms of appropriate management algorithms, and with potentially even worse prognosis, is low at the front line. This is neatly illustrated, for example, by the low rate of diagnosis of type 2 MI in one series from our group 3…”

supporting

confidence: 50%

Use of troponins in clinical practice: Evidence against the use of troponins in clinical practice

Mariathas

Curzen

2019

Heart

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supporting

confidence: 50%

Use of troponins in clinical practice: Evidence against the use of troponins in clinical practice

Mariathas

Curzen

2019

Heart

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“…This result was mainly driven by cardiovascular readmissions, unlike the observations in this study. Mariathas et al observed elevated cTnI levels (Beckman Coulter Access) in 46.8% of patients in a retrospective study of patients with different types of primary tachyarrhythmia. Consistent with our results, patients with elevated cTnI levels showed a higher mortality rate compared to patients without cTnI elevation, with mortality rates similar to patients with MI and without ST‐segment elevation.…”

Section: Discussionmentioning

confidence: 99%

Prognostic implications of troponin I elevation in emergency department patients with tachyarrhythmia

González‐Del‐Hoyo

Cediel

Carrasquer

et al. 2019

Clinical Cardiology

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Background Tachyarrhythmias are very common in emergency medicine, and little is known about the long‐term prognostic implications of troponin I levels in these patients. Hypothesis This study aimed to investigate the correlation of cardiac troponin I (cTnI) levels and long‐term prognosis in patients admitted to the emergency department (ED) with a primary diagnosis of tachyarrhythmia. Methods A retrospective cohort study was conducted between January 2012 and December 2013, enrolling patients admitted to the ED with a primary diagnosis of tachyarrhythmia and having documented cTnI measurements. Clinical characteristics and 5‐year all‐cause mortality were analyzed. Results Of a total of 222 subjects with a primary diagnosis of tachyarrhythmia, 73 patients had elevated levels of cTnI (32.9%). Patients with elevated cTnI levels were older and presented significantly more cardiovascular risk factors. At the 5‐year follow‐up, mortality was higher among patients with elevated cTnI levels (log‐rank test P < 0.001). In the multivariable Cox regression analysis, elevated cTnI was an independent predictor of all‐cause death (hazard ratio, 1.95, 95% confidence interval: 1.08‐3.50, P = 0.026), in addition to age and prior heart failure. Conclusion Patients admitted to the ED with a primary diagnosis of tachyarrhythmia and high cTnI levels have higher long‐term mortality rates than patients with low cTnI levels. cTnI is thus a biomarker with predictive capacity for mortality in late follow‐up, conferring utility in the risk stratification of this population.

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“…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-ST-elevation MI patients. [ 80 ]…”

Section: Impact Of High-sensitivity Troponinmentioning

confidence: 99%

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

et al. 2022

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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.

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High sensitivity troponin in the management of tachyarrhythmias

Cited by 12 publications

References 31 publications

Use of troponins in clinical practice: Evidence against the use of troponins in clinical practice

Use of troponins in clinical practice: Evidence against the use of troponins in clinical practice

Prognostic implications of troponin I elevation in emergency department patients with tachyarrhythmia

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

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