The Dilemma Behind Negative Troponin: A Case Report

Sharma, Nava R; Sharma, Bharati; Pokhrel, Madalasa; Gautam, Sudarshan; Lamichhane, Saral

doi:10.7759/cureus.34377

Cited by 3 publications

(3 citation statements)

References 12 publications

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“…While troponin T is found in significant volumes within the cardiac myocytes, it may also be found in small volumes within skeletal muscles and a few other body cells. 31 However, cTnI is specific to the myocardial tissue. Injury to the cardiac myocytes causes the release of unbound cytoplasmic troponin and increases its levels 4-6 h postinjury, with the peak manifesting 12-24 h post-myocardial damage.…”

Section: Discussionmentioning

confidence: 99%

Postoperative cardiac troponin I as an indicator of surgical outcomes: A systematic review

Ahmed

Pervez

Rehan

et al. 2022

Journal of Cardiac Surgery

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Introduction Cardiac surgeries are generally associated with high morbidity and mortality. To prevent any adverse outcomes, it is crucial to identify patients at risk of developing postoperative complications and initiate relevant therapeutic interventions. Several biomarkers are used to determine postoperative myocardial injury but they either lack sensitivity and specificity or are elevated for a short time. In this systematic review, we evaluate postoperative troponin I as a predictor of postoperative myocardial infarction, mortality, and hospital and Intensive Care Unit stay. Methods This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta‐Analysis guidelines. A thorough literature search was conducted over PubMed, clinicaltrials. gov, and the Cochrane library from inception till May 24, 2022 using relevant keywords, and only articles that met the pre‐defined criteria were recruited. Results Following a comprehensive literature search, a total of 359 articles were obtained. Following a rigid screening and full‐length review, only 13 studies met our inclusion criteria and were included. The recruited studies evaluated data from a total of 12,483 individuals and assessed troponin I as a predictor of at least one outcome. Conclusion Troponin I has the potential to be used as a stand‐alone predictor of surgical outcomes following coronary artery bypass grafting and valvular surgeries. However, supplementing it with other markers and scores offers the best chance at timely diagnosing any complications.

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Section: Discussionmentioning

confidence: 99%

Postoperative cardiac troponin I as an indicator of surgical outcomes: A systematic review

Ahmed

Pervez

Rehan

et al. 2022

Journal of Cardiac Surgery

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“…In patients with myocardial infarction (MI), serum troponin levels rise within 2 to 3 hours of cardiac ischemia. 32,33 The use of high-sensitivity troponin (hs-cTn) assays, approved by the FDA in early 2017, has become increasingly common in recent years because of their earlier detection ability and increased accuracy compared with conventional troponin assays. 11,34 However, interpretation of hs-cTn is limited by baseline troponin level variability from patient to patient.…”

Section: Diagnosismentioning

confidence: 99%

Managing patients with sex-, race-, or ethnicity-based cardiovascular health inequities

Luntz,

Creary,

Bruessow

2023

Jaapa

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“…The reduction of blood flow through the coronary artery causes cellular death and cytolysis with subsequent release of intracellular contents. Troponin levels increase within 2-3 h from chest pain, with a peak in 12-24 h. 5 An increase in CPK and myoglobin can also be seen in myocardial infarction, with kinetics similar to those caused by rhabdomyolysis. Both in rhabdomyolysis and myocardial infarction myoglobin increases early, however it's not considered a specific marker of MI.…”

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confidence: 99%

Rhabdomyolysis as cause, consequence, or mimicker of myocardial infarction: A case report

Nasello,

Ippolito,

Federico

et al. 2023

Clinical Case Reports

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Key Clinical MessageA timely diagnosis is essential to start appropriate therapy and to reduce risks of life‐threatening complications of rhabdomyolysis. Some cases can undergo differential diagnosis with other clinical conditions, e.g., myocardial infarction.AbstractWe present the case of a 65‐years‐old male who was admitted to the emergency department with a clinical presentation related to myocardial infarction. The patient underwent coronary angioplasty and was then admitted to ICU due to hemodynamical instability, elevated potassium levels, and anuria. Further investigations revealed rhabdomyolysis. The patient received vasopressors, oxygenation support and renal replacement therapy. Outcomes at ICU discharge were favorable. The temporal association between rhabdomyolysis and myocardial infarction, together with an unclear pathophysiological relationship, made differential diagnosis difficult. We discuss this uncertainty in light of published literature.

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The Dilemma Behind Negative Troponin: A Case Report

Cited by 3 publications

References 12 publications

Postoperative cardiac troponin I as an indicator of surgical outcomes: A systematic review

Postoperative cardiac troponin I as an indicator of surgical outcomes: A systematic review

Managing patients with sex-, race-, or ethnicity-based cardiovascular health inequities

Rhabdomyolysis as cause, consequence, or mimicker of myocardial infarction: A case report

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