Positive predictive value of an elevated cardiac troponin for type I myocardial infarction in ED patients based on the chief complaint

Maag, Ronald; Sun, Susie X.; Hannon, Michael J.; Davies, Rhian; Alagona, Peter; Foy, Andrew

doi:10.1016/j.ajem.2015.01.003

Cited by 5 publications

(6 citation statements)

References 14 publications

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“…However, when "chest pain" was the chief complaint, nearly all patients with an elevated cTn had a type I MI (OR, 7.3). 38 Because this is an article on the evaluation of chest pain, we will not belabor this point. It suffices to say that, when chest pain is not the chief complaint, caution should be exercised in ordering cTn and interpreting the result.…”

Section: Cardiac Troponinmentioning

confidence: 97%

“…It must be kept in mind that despite the high specificity of cTn for myocardial necrosis, it is not specific for the cause of injury. Maag and colleagues 38 found that in a large, undifferentiated cohort of patients who underwent cTn testing in the ED that when "chest pain" was not the chief complaint, an elevated cTn that met the definition for AMI was unlikely to be owing to type I MI (20%). However, when "chest pain" was the chief complaint, nearly all patients with an elevated cTn had a type I MI (OR, 7.3).…”

Section: Cardiac Troponinmentioning

confidence: 98%

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Chest Pain Evaluation in the Emergency Department

Foy

Filippone

2015

Medical Clinics of North America

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Section: Cardiac Troponinmentioning

confidence: 97%

Section: Cardiac Troponinmentioning

confidence: 98%

Chest Pain Evaluation in the Emergency Department

Foy

Filippone

2015

Medical Clinics of North America

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“…Cardiac causes are one of the etiologic agents that should be considered in patients with dizziness or risk factors for dizziness. It was determined that 2.6% of the cases admitted to the ER and evaluated as type 1 myocardial infarction approached emergency services with dizziness complaints 26 . Navi and colleagues found that in 16.4% of patients who approach emergency services with a dizziness complaint, ECG changes such as ST and T wave changes, atrial fibrillation / flatter and 2nd-3rd degree block was observed 11 .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of patients with dizziness who applied to emergency service

Koçer

Avcı²,

Gülen³

et al. 2019

Cukurova Medical Journal

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Öz Purpose: In this study, it was aimed to evaluate the demographic characteristics of the patients presenting to the emergency room with dizziness, the etiologic causes leading to the complaints and the laboratory findings as well as the prognosis. Material and Methods: The file data of a total of 5,056 patients admitted to the Adana Numune Training and Research Hospital Emergency Medicine Clinic between January 2013 and January 2015 were reviewed retrospectively. Mean, standard deviation, median, lowest, highest, frequency and ratio values were used in the descriptive statistics of the data. SPSS 22.0 program was used in the analyses. Results: Two thousand nine hundered four of the patients were female (57.4%), 2,152 were male (42.6%) and the average age was 53.6 (± 18.2) years. It was determined that the complaints were common in the population between the ages of 51-70, and peripheric peripheral vertigo (n: 4.130, 81.6%), systemic causes (n: 664, 13.1%), and central vertigo (n: 249, 4.9%) were the most prevalent etiologies, respectively. 83% of the patients were discharged following necessary procedures in the emergency room. Conclusion: Dizziness is one of the most important symptoms that brings patients to the emergency services. While many etiologies play a part in it, it is determined that neurological and cardiological evaluations must be done, annd patients can mainly be managed in emergency services by simple maneuvering or medical treatment options.

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“…TnC binds calcium and regulates activation during contraction. TnT binds the complex to tropomyosin while TnI inhibits binding in the absence of activation [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…TnT and TnI on the other hand, exist as different isoforms in each type of muscle cell. This has led to the development of specific assays for the cardiac isoforms of Troponin T, I, and Troponin T high sensitivity (CTnT, CTnI, and TnT-HS) to indicate myocardial injury [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

The Prognostic Significance of Elevated Cardiac Troponin in Non-Cardiac Medical Disorders. Pilot Study

AlQassas¹,

Walid²,

Nadia³

et al. 2019

Int J Clin Cardiol

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Background: Several studies have linked elevated cardiac troponin to increased overall risk in patients with acute coronary syndrome but the prognostic significance of elevated troponin in non-cardiac conditions remains scanty. Objectives:The primary aim of this study was to investigate the prognostic significance of elevated high sensitivity troponin T (TnT-HS) in non-cardiac disorders outside the remit of an acute coronary syndrome (ACS). Secondarily we aimed to investigate the impact of cardiovascular comorbidities and other clinical presentations in the release of cardiac biomarkers in non-cardiac disorders.Methodology: This was a retrospective electronic patient record pilot review where all patients with elevated TnT-HS without acute coronary syndrome, recent angioplasty or heart failure within a three month period were enrolled into the study and subsequently followed prospectively for a six month period. From January 1, 2016 to June 30, 2016, a total of 2535 patients were screened of which 306 patients had elevated TnT-HS and 162 patients met the study inclusion criteria.Data were encrypted and collected in Google database format, exported into excel spreadsheet, analyzed and computed using SPSS (version 24) to identify clinical associations with increased values of TnT-HS.Results: Most troponin TnT-HS samples (77.1%) were obtained from emergency room (ER) attendance and 63.4% of patients were male. The mean age was 72 years and no Conclusions: TnT-HS positivity should be cautiously interpreted in patients exhibiting non acute cardiac conditions associated CKD, infections, and CVAs. This troponin elevation in non-cardiac conditions still carries a significant adverse prognosis.After adjusting for age and renal insufficiency, we can suggest a new cut off level of TnT-HS > 30 ng/l to have increased risk of MACCE within 180 days in non-cardiac conditions.

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Positive predictive value of an elevated cardiac troponin for type I myocardial infarction in ED patients based on the chief complaint

Cited by 5 publications

References 14 publications

Chest Pain Evaluation in the Emergency Department

Chest Pain Evaluation in the Emergency Department

Evaluation of patients with dizziness who applied to emergency service

The Prognostic Significance of Elevated Cardiac Troponin in Non-Cardiac Medical Disorders. Pilot Study

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