Insight on the Etiologies of Chronically Elevated Troponin

Hong, Jimmy; Chatila, Khaled; John, Jaison; Thakker, Ravi; Kassem, Hania

doi:10.1016/j.cpcardiol.2022.101204

Cited by 2 publications

(2 citation statements)

References 41 publications

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“…cardiac injury (rise and fall in troponin) [45] and chronic troponin elevations [46]. Moreover, this patient cohort originated from the pre-vaccination era and further studies are needed to elucidate the diagnostic value of troponins in vaccinated populations.…”

Section: Plos Onementioning

confidence: 99%

Normal high-sensitivity cardiac troponin for ruling-out inpatient mortality in acute COVID-19

et al. 2023

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Introduction Assessment of inpatient mortality risk in COVID-19 patients is important for guiding clinical decision-making. High sensitivity cardiac troponin T (hs-cTnT) is a biomarker of cardiac injury associated with a worse prognosis in COVID-19. We explored how hs-cTnT could potentially be used in clinical practice for ruling in and ruling out mortality in COVID-19. Method We tested the diagnostic value of hs-cTnT in laboratory-confirmed COVID-19 patients (≥18 years old) admitted to the Royal Berkshire Hospital (UK) between 1st March and 10th May 2020. A normal hs-cTnT was defined as a value within the 99th percentile of healthy individuals (≤14 ng/L), and an elevated hs-cTnT was defined as >14 ng/L. Adverse clinical outcome was defined as inpatient mortality related to COVID-19. Results A total of 191 COVID-19 patients (62% male; age 66±16 years) had hs-cTnT measured on admission. Of these patients, 124 (65%) had elevated hs-cTnT and 67 (35%) had normal hs-cTnT. On a group level, patients with elevated hs-cTnT had worse inpatient survival (p = 0.0014; Kaplan-Meier analysis) and higher risk of inpatient mortality (HR 5.84 [95% CI 1.29–26.4]; p = 0.02; Cox multivariate regression) compared to patients with normal hs-cTnT. On a per-patient level, a normal hs-cTnT had a negative predictive value of 94% (95% CI: 85–98%) for ruling out mortality, whilst an elevated hs-cTnT had a low positive predictive value of 38% (95% CI: 39–47%) for ruling in mortality. Conclusions In this study cohort of COVID-19 patients, the potential clinical utility of hs-cTnT appears to rest in ruling out inpatient mortality. This finding, if prospectively validated in a larger study, may allow hs-cTnT to become an important biomarker to facilitate admission-avoidance and early safe discharge.

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Section: Plos Onementioning

confidence: 99%

Normal high-sensitivity cardiac troponin for ruling-out inpatient mortality in acute COVID-19

et al. 2023

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“…Heresi et al (2012);Vélez-Martínez et al (2013);Chaulin, 2021b) The increase in C-reactive protein triggers the inflammatory mechanism involved in the increase of cTnI levels.Acute and chronic kidney failure• Increased molecules in the blood circulation due to decreased glomerular filtration rate Ziebig et al (2003)Khan et al (2005); Defilippi and Herzog, (2017); Chaulin, (2021a);Hong et al (Forthcoming 2022) …”

mentioning

confidence: 99%

A review of cardiac troponin I detection by surface enhanced Raman spectroscopy: Under the spotlight of point-of-care testing

Saviñon-Flores

Trejo

et al. 2022

Front. Chem.

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Cardiac troponin I (cTnI) is a biomarker widely related to acute myocardial infarction (AMI), one of the leading causes of death around the world. Point-of-care testing (POCT) of cTnI not only demands a short turnaround time for its detection but the highest accuracy levels to set expeditious and adequate clinical decisions. The analytical technique Surface-enhanced Raman spectroscopy (SERS) possesses several properties that tailor to the POCT format, such as its flexibility to couple with rapid assay platforms like microfluidics and paper-based immunoassays. Here, we analyze the strategies used for the detection of cTnI by SERS considering POCT requirements. From the detection ranges reported in the reviewed literature, we suggest the diseases other than AMI that could be diagnosed with this technique. For this, a section with information about cardiac and non-cardiac diseases with cTnI release, including their release kinetics or cut-off values are presented. Likewise, POCT features, the use of SERS as a POCT technique, and the biochemistry of cTnI are discussed. The information provided in this review allowed the identification of strengths and lacks of the available SERS-based point-of-care tests for cTnI and the disclosing of requirements for future assays design.

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Insight on the Etiologies of Chronically Elevated Troponin

Cited by 2 publications

References 41 publications

Normal high-sensitivity cardiac troponin for ruling-out inpatient mortality in acute COVID-19

Normal high-sensitivity cardiac troponin for ruling-out inpatient mortality in acute COVID-19

A review of cardiac troponin I detection by surface enhanced Raman spectroscopy: Under the spotlight of point-of-care testing

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