Use of cardiac troponin in the early diagnosis of acute myocardial infarction

Muzyk, Piotr; Twerenbold, Raphael; Morawiec, Beata; Lopez-Ayala, Pedro; Boeddinghaus, Jasper; Nestelberger, Thomas; Mueller, Christian; Kawecki, Damian

doi:10.33963/kp.15585

Cited by 9 publications

(5 citation statements)

References 57 publications

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“…Early and reliable identification and risk evaluation of AMI, which could prevent progression and improve outcomes, is still a major challenge. Although serial cardiac troponin tests have been considered as essential diagnostic steps to differentiate AMI, several limitations exist [ 2 ]. Some comorbidities like acute heart failure or chronic renal dysfunction are usually accompanied by elevated cardiac troponin in clinical practice [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Association of serum sclerostin and osteoprotegerin levels with the presence, severity and prognosis in patients with acute myocardial infarction

Shui

Dong

et al. 2022

BMC Cardiovasc Disord

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Background Bone-related proteins (such as sclerostin and osteoprotegerin [OPG]) are involved in the development of atherosclerosis. However, the relationship between bone-related proteins and acute myocardial infarction (AMI) has not been extensively evaluated. The purpose of this study was to assess the association of serum sclerostin and OPG with the presence, severity and prognosis in patients with AMI. Methods This study prospectively enrolled 152 patients attacked by acute chest pain. Serum sclerostin and OPG were detected within the first 24 h after AMI diagnosis by ELISA kits. The AMI predictive efficacy of sclerostin and OPG were analyzed by receiver operating characteristics (ROC) curve. Univariable and multivariable linear regression analyses were performed to determine the association between bone-related proteins and scores indicating the severity of coronary artery occlusion. Moreover, prognostic values were assessed by Kaplan–Meier curves and Cox regression analysis. Results There were 92 patients in AMI group, 60 in non-AMI group. Serum levels of sclerostin and OPG were significantly higher in AMI group than in non-AMI group (all p < 0.001), which showed predictive value for the presence of AMI (all p < 0.001). The area under the ROC curve values of sclerostin and OPG were 0.744 and 0.897, respectively. A multivariable linear regression analysis demonstrated that Ln-transformed sclerostin (β = 0.288, p = 0.009) and Ln-transformed OPG (Ln-OPG: β = 0.295, p = 0.019) levels were associated with GENISINI score, independently of conventional clinical parameters. In addition, Ln-OPG levels were still positively associated with GRACE score after adjustments (β = 0.320, p = 0.001). During a 1-year follow-up, patients above the median of sclerostin levels had higher incidence of major adverse cardiac events (MACE) than those below the median (p = 0.028). It was also observed that the MACE rates were higher in patients above the median of OPG levels, though no statistic importance (p = 0.060). After adjusting conventional risk factors by multivariate Cox regression, Ln-OPG was associated with incident MACE (hazard ratio = 2.188 [95% confidence intervals 1.102–4.344], p = 0.025). Conclusions Bone-related proteins could exert a potential role in early risk stratification and prognosis assessment in patients with AMI.

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Section: Introductionmentioning

confidence: 99%

Association of serum sclerostin and osteoprotegerin levels with the presence, severity and prognosis in patients with acute myocardial infarction

Shui

Dong

et al. 2022

BMC Cardiovasc Disord

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“…Acute myocardial infarction (AMI) is the most serious fatal disease in the cardiovascular system of the elderly. It is caused by a variety of internal and external environmental factors such as previous diseases, lifestyle, mood, and weather changes and causes the blockage of the blood supply channel of the heart, resulting in the imbalance of coronary artery oxygen supply and demand, which lead to myocardial necrosis, heart failure, and even death [1]. e main symptoms of AMI are severe and persistent compressive pain in the anterior heart area or pain in the retrosternum, accompanied by feelings of su ocation or near death.…”

Section: Introductionmentioning

confidence: 99%

The Diagnostic Value of Serum GDF15 and hs-CTnT in Elderly Patients with Acute Myocardial Infarction

Wang

Fang

2022

Computational Intelligence and Neuroscience

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Objective. To analyze the diagnostic value of serum growth differentiation factor 15 (GDFl5) and high-sensitivity troponin T (hs-cTnT) in elderly acute myocardial infarction (AMI). Methods. A retrospective analysis of 165 patients with acute chest pain admitted to the Department of Cardiology in our hospital from January to December 2020, Among them, 76 AMI patients (AMI group), 89 non-AMI patients (non-AMI group), and 80 healthy people were selected as the control group during the same period. Compare the three groups of serum GDF15, hs-CTnT levels, and left ventricular ejection fraction (LVEF) parallel correlation analysis, and draw the receiver operating curve (ROC) of serum GDF15 and hs-CTnT levels to diagnose AMI. Results. The serum GDF15 and hs-CTnT levels of the AMI group were significantly higher than those of the non-AMI group and the control group, and the difference was statistically significant (p < 0.01). The LVEF was significantly lower than the non-AMI group and the control group, whose difference was statistically significant (p < 0.01). Among them, the indicators of the non-AMI group were both higher and lower than the control group, and the difference was statistically significant (p < 0.01). Serum GDF15 and hs-CTnT levels of AMI patients increased with the increase of NYHA grade, among which grade IV group was significantly higher than grade I∼II group and grade III group (P < 0.01), and grade III group was significantly higher than grade I∼II Group (p < 0.01). Pearson correlation analysis showed that GDF15 and hs-CTnT levels of AMI patients were significantly negatively correlated with LVEF (r = −0.584, −0.612, − < 0.01). The ROC curve showed that GDF15 had a high specificity (93.75%) and hs-CTnT has a high sensitivity (90.67%). The area under the curve for diagnosing AMI is > 0.7 (0.895, 0.948). The sensitivity of the combined detection and the specificity are higher than that of individual detection. Conclusion. Serum GDF15 and hs-CTnT are highly expressed in elderly patients with AMI. The combined detection of the two can improve the efficiency of AMI diagnosis. GDF15 can be used as a new biomarker for AMI diagnosis and disease monitoring.

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“…Despite advancements in prompt reperfusion and pharmaceutical treatments, patients continue to face considerable risks of morbidity and mortality post-discharge. While serial cardiac troponin tests are crucial for AMI differentiation, they come with various limitations [1][2][3] . Moreover, cardiac troponin levels may not accurately reflect the severity of coronary artery disease (CAD).…”

Section: Introductionmentioning

confidence: 99%

El papel del eje osteoprotegerina/RANKL/RANK y la osteopontina en el síndrome coronario agudo

Vega-Rosales,

Saucedo-Orozco,

Márquez-Velasco

et al. 2024

ACM

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Objectives:The primary objective of this study is to ascertain the levels of osteoprotegerin (OPG) and osteopontin (OPN), alongside osteoprotegerin/RANKL ratio (ORR), and assess their association with the SYNTAX score and ascertain the potential of these molecules as predictive markers for risk, aiding in risk stratification. Eventually, they could potentially be employed even before angiography to gauge the severity of coronary lesions. Methods: Prospective study with 147 participants, 101 (69%) were men, with an average age of 60. We included three groups -(1) patients with acute coronary syndrome undergoing percutaneous coronary intervention (ACS-PCI), (2) patients without ACS who underwent coronary angiography for an indication other than ischemia and did not undergo PCI (non-ACS without), and (3) one asymptomatic subject. OPG and OPN were measured. ORR and SYNTAX scores were calculated. The association between OPG and OPN levels and important clinical variables was investigated. Results: OPG levels in Group 1 were lower compared to Groups 2 and 3 (controls), Group 1 (490 pg/mL) versus Group 2 (829 pg/mL) versus Group 3 (845 pg/mL) (p = 0.001). OPG had lower levels in patients with coronary artery stenosis versus without stenosis. A decrease in ORR was shown in all groups and no association with the SYNTAX score. Conclusion: OPG and OPN (and ORR) levels are decreased in patients with ACS and show no correlation with the SYNTAX score. As an exploratory study, our work suggest that increased OPG and OPN levels in non-ACS patients may have, in fact, a protective effect. This study is one of the few with an appropriate control in ACS and reproducibility is necessary mainly with multicenter studies.

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Use of cardiac troponin in the early diagnosis of acute myocardial infarction

Cited by 9 publications

References 57 publications

Association of serum sclerostin and osteoprotegerin levels with the presence, severity and prognosis in patients with acute myocardial infarction

Association of serum sclerostin and osteoprotegerin levels with the presence, severity and prognosis in patients with acute myocardial infarction

The Diagnostic Value of Serum GDF15 and hs-CTnT in Elderly Patients with Acute Myocardial Infarction

El papel del eje osteoprotegerina/RANKL/RANK y la osteopontina en el síndrome coronario agudo

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