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Mecinaj A, Gulati G, Ree AH, Gravdehaug B, Røsjø H, Steine K, Wisløff T, Geisler J, Omland T, Heck SL. Impact of the ESC Cardio-Oncology Guidelines Biomarker Criteria on Incidence of Cancer Therapy-Related Cardiac Dysfunction. JACC CardioOncol 2024; 6:83-95. [PMID: 38510299 PMCID: PMC10950440 DOI: 10.1016/j.jaccao.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 10/12/2023] [Accepted: 10/31/2023] [Indexed: 03/22/2024] Open
Abstract
Background The impact of recent consensus definitions of cancer therapy-related cardiac dysfunction (CTRCD) from the European Society of Cardiology cardio-oncology guidelines on the reported incidence of CTRCD has not yet been assessed. Objectives The aim of this study was to assess the: 1) cumulative incidence; 2) point prevalence during and after adjuvant therapy; and 3) prognostic value of CTRCD as defined by different asymptomatic CTRCD guideline criteria. Methods The cumulative incidence and point prevalence of CTRCD were retrospectively assessed in 118 patients participating in the PRADA (Prevention of Cardiac Dysfunction During Adjuvant Breast Cancer Therapy) trial. Asymptomatic CTRCD was assessed using alternative cardiac troponin (cTn) 99th percentile upper reference limits (URLs) to define cTnT and cTnI elevation. Results The cumulative incidence of moderate or severe CTRCD was low (1.7%), whereas the cumulative incidence of mild asymptomatic CTRCD was higher and differed markedly according to the biomarker criteria applied, ranging from 49.2% of patients when cTnT greater than the sex-specific 99th percentile URL was used to define cTn elevation to 9.3% when sex-neutral cTnI was used. The point prevalence of CTRCD was highest at the end of anthracycline therapy (47.8%) and was driven primarily by asymptomatic cTn elevation. CTRCD during adjuvant therapy was not prognostic for CTRCD at extended follow-up of 24 months (Q1-Q3: 21-29 months) after randomization. Conclusions Mild asymptomatic CTRCD during adjuvant breast cancer therapy was frequent and driven mainly by cTn elevation and was not prognostic of subsequent CTRCD. The incidence of mild, asymptomatic CTRCD differed markedly depending on the cTn assay and whether sex-neutral or sex-dependent URLs were applied. (Prevention of Cardiac Dysfunction During Adjuvant Breast Cancer Therapy [PRADA]; NCT01434134).
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Affiliation(s)
- Albulena Mecinaj
- K.G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Geeta Gulati
- K.G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Cardiology, Division of Medicine, Oslo University Hospital, Ullevål, Oslo, Norway
- Division of Research and Innovation, Akershus University Hospital, Lørenskog, Norway
| | - Anne Hansen Ree
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Oncology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Berit Gravdehaug
- Department of Breast and Endocrine Surgery, Division of Surgery, Akershus University Hospital, Lørenskog, Norway
| | - Helge Røsjø
- K.G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Research and Innovation, Akershus University Hospital, Lørenskog, Norway
| | - Kjetil Steine
- Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Torbjørn Wisløff
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Health Service Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Jürgen Geisler
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Oncology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Torbjørn Omland
- K.G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Siri Lagethon Heck
- K.G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Diagnostic Imaging, Akershus University Hospital, Lørenskog, Norway
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2
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Elseidy SA, Awad AK, Mandal D, Vorla M, Elkheshen A, Mohamad T. Copeptin plus troponin in the rapid rule out of acute myocardial infarction and prognostic value on post-myocardial infarction outcomes: a systematic review and diagnostic accuracy study. Heart Vessels 2023; 38:1-7. [PMID: 35794488 DOI: 10.1007/s00380-022-02123-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/15/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND A critical and unmet therapeutic need is the prompt and reliable exclusion of acute myocardial infarction (AMI), which would allow for prompt discharge from the emergency department. High-sensitivity troponin (HS-TnT) combined with copeptin has been proposed to expedite the diagnostic exclusion of AMI in addition to its predictive usefulness in the intermediate and long-term outcomes of AMI. The European Society of Cardiology recommends the Global Registry of Acute Coronary Events (GRACE) as a prognostic score to manage acute coronary syndrome (ACS) without ST segment elevation. The purpose of this study was to compare the diagnostic accuracy of HS-TnT combined with copeptin in ruling out AMI compared to HS-TnT alone. By combining a low GRACE score (108) with negative HS-TnT (14 ng/L) and copeptin (14 pmol/L), non-ST and ACS were reliably ruled out, including non-ST segment elevation MI and unstable angina. RESULTS The present research included nine studies with a total of 13,232 participants. The negative predictive value (NPV) for copeptin and HS-TnT was found to be slightly higher in combination (62-99%) than for HS-TnT alone (60-99%). The sensitivity of copeptin ranged from 0% to 100%, with a pooled sensitivity of 0.79 (CI 95% 0.76, 0.82). The specificity of copeptin ranged from 13% to 100%, with a pooled specificity of 0.89 (CI 95% 0.85, 0.91), a pooled positive likelihood ratio (PLR) of 9.86 (CI 95% 4.42, 22.02), and a pooled negative likelihood ratio (NLR) of 0.08. (95% CI 0.01, 0.44). CONCLUSIONS The use of combined negative copeptin and highly sensitive troponin testing in low-to-intermediate risk patients with suspected acute coronary syndrome resulted in a quick discharge with a safe and rapid rule out of non-ST + ACS.
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Affiliation(s)
- Sheref A Elseidy
- Internal Medicine Department, Rochester General Hospital, Rochester, NY, USA.
| | - Ahmed K Awad
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Mounika Vorla
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Ahmed Elkheshen
- Texas Tech University Health Sciences Center School of Medicine-Lubbock Campus, Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX, USA
| | - Tamam Mohamad
- Cardiovascular Disease Department, Wayne State University, Detroit, MI, USA
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3
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ÖZBIÇER S, KALKAN G, URGUN ÖD, NEŞELİOĞLU S, EREL Ö. Ischemia modified albumin levels in distinguishing NSTEMI patients from non-ischemic controls and correlation with disease severity. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.976875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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4
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Taranova NA, Byzova NA, Pridvorova SM, Zherdev AV, Dzantiev BB. Comparative Assessment of Different Gold Nanoflowers as Labels for Lateral Flow Immunosensors. SENSORS (BASEL, SWITZERLAND) 2021; 21:7098. [PMID: 34770405 PMCID: PMC8587648 DOI: 10.3390/s21217098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 10/21/2021] [Accepted: 10/23/2021] [Indexed: 11/16/2022]
Abstract
Many studies have found that gold nanoparticles with branched surfaces (nanoflowers) are markers for immunosensors that provide higher sensitivity gains than the commonly used spherical gold nanoparticles. Although the analytical characteristics of nanoparticle-using systems vary significantly depending on their size and shape, the question of choosing the best gold nanoflowers remains open. This work presents a comparative study of a panel of 33 preparations of gold nanoflowers formed by varying several parameters: the size of spherical nanoparticles-nuclei, the concentrations of nuclei, and tetrachloroauric acid during growth. The sizes of the resulting particles, their sorption capacity under antibody immobilization, mobility along membranes for lateral flow assays, and the effects of these parameters on the limits of detection of lateral flow immunoassay are characterized. The optimality of preparations obtained by growing a 0.2% v/v solution of nuclei with a diameter of 10 or 20 nm with tetrachloroauric acid at a concentration of 0.12 mM was shown. With their use, lateral flow immune tests were developed to determine markers of acute myocardial infarction-fatty acids binding protein and troponins I and T. The use of gold nanoflowers obtained under the proposed protocols led to significant gains in the limits of detection-3 to 10 times under visual detection and over 100 times under instrumental detection-compared to spherical gold nanoparticles. The significant increase under instrumental detection is due to the label's low nonspecific binding.
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Affiliation(s)
| | | | | | | | - Boris B. Dzantiev
- Research Center of Biotechnology, A.N. Bach Institute of Biochemistry, Russian Academy of Sciences, Leninsky Prospect 33, 119071 Moscow, Russia; (N.A.T.); (N.A.B.); (S.M.P.); (A.V.Z.)
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5
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Krintus M, Panteghini M. Laboratory-related issues in the measurement of cardiac troponins with highly sensitive assays. Clin Chem Lab Med 2021; 58:1773-1783. [PMID: 32134723 DOI: 10.1515/cclm-2020-0017] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 01/24/2020] [Indexed: 12/13/2022]
Abstract
A number of assay-related issues can affect the performance of cardiac troponin (cTn) measurement in everyday practice. In this respect, it is vital that all information on cTn assays is known and that the performance characteristics of assays are objectively assessed and adequately described. The advent of the latest generation of more sensitive cTn assays has heralded a new wave of information about low concentrations of cTn in blood. These recent generation assays have improved analytical sensitivity and corresponding performance at low cTn concentrations when compared to their predecessors, providing a convincing goal for laboratory medicine in helping clinicians in the diagnosis of acute myocardial infarction. Crucial to the clinical utility of highly sensitive cTn assays is the laboratorians' role in closely scrutinizing proposed assays and defining their value in relation to available evidence. Analytical, as well as pre-analytical and post-analytical, aspects must be documented. In this review, we describe what laboratory professionals should know about their cTn assay performance characteristics and the pre-analytical prerequisites for robustness to ensure optimal post-analytical reporting.
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Affiliation(s)
- Magdalena Krintus
- Department of Laboratory Medicine, Nicolaus Copernicus University, Collegium Medicum, 9 Sklodowskiej-Curie Street, 85-094 Bydgoszcz, Poland, Phone: +48 52 585 44 90, Fax: +48 52 585 36 03
| | - Mauro Panteghini
- Department of Biomedical and Clinical Sciences 'Luigi Sacco', University of Milan, Milan, Italy
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6
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Bellini C, Cinci F, Bova G, Mascarucci M, Leoncini R, Scapellato C, Guerranti R. Methodology to Evaluate Clinical Impact of 0/3 Hour High-Sensitivity Cardiac Troponin T Protocol on Managing Acute Coronary Syndrome in Daily Emergency Department Practice. Lab Med 2021; 52:452-459. [PMID: 33511991 DOI: 10.1093/labmed/lmaa118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Sex-/age-differentiated cutoffs and the magnitude of serial changes in high-sensitivity cardiac troponins (hs-cTn) for acute coronary syndrome (ACS) diagnosis algorithms are still under discussion. This study presents a methodology to evaluate decision-making limits and to assess whether sex-specific cutoffs could improve diagnostic accuracy. METHODS A high-sensitivity cardiac troponin T (hs-cTnT) 0-/3-hour protocol was adopted, applying the 2015 European Society of Cardiology Guidelines. Decision-making limits (99th percentile: 14 ng/L; delta change ≥ 30%) were agreed upon with the emergency department (ED) at the University Hospital of Siena in Siena, Italy. One-year requests (5177) for hs-cTnT serial determination were compared with the final International Classification of Diseases, 9th revision, clinical modifications diagnosis (contingency tables; receiver operating characteristic curves). RESULTS The algorithm's capability to exclude or confirm ACS was verified by remarkable negative predictive value (97%) and high areas under the curve for the first troponin sampling (0.712), troponin sampling at 3 hours (0.789), and delta (0.744). The clinical utility for the general population-even those with comorbidities-accessing the ED was verified. Our data did not support a sex-differentiated cutoff utility because it would not have affected patient management. CONCLUSION This methodology allowed us to confirm the effectiveness of our decision-making limits.
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Affiliation(s)
- Claudia Bellini
- Department of Medical Biotechnologies, University of Siena, Siena, Italy.,Clinical Pathology Unit, Innovation, Experimentation and Clinical and Translational Research Department, University Hospital of Siena, Siena, Italy
| | - Francesca Cinci
- Department of Medical Biotechnologies, University of Siena, Siena, Italy.,Clinical Pathology Unit, Innovation, Experimentation and Clinical and Translational Research Department, University Hospital of Siena, Siena, Italy
| | - Giovanni Bova
- Emergency-Urgency and Transplants Department, University Hospital of Siena, Siena, Italy
| | - Monica Mascarucci
- Emergency-Urgency and Transplants Department, University Hospital of Siena, Siena, Italy
| | - Roberto Leoncini
- Department of Medical Biotechnologies, University of Siena, Siena, Italy.,Clinical Pathology Unit, Innovation, Experimentation and Clinical and Translational Research Department, University Hospital of Siena, Siena, Italy
| | - Carlo Scapellato
- Clinical Pathology Unit, Innovation, Experimentation and Clinical and Translational Research Department, University Hospital of Siena, Siena, Italy
| | - Roberto Guerranti
- Department of Medical Biotechnologies, University of Siena, Siena, Italy.,Clinical Pathology Unit, Innovation, Experimentation and Clinical and Translational Research Department, University Hospital of Siena, Siena, Italy
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7
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Neurological update: use of cardiac troponin in patients with stroke. J Neurol 2020; 268:2284-2292. [PMID: 33372247 PMCID: PMC8179917 DOI: 10.1007/s00415-020-10349-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/04/2020] [Indexed: 02/07/2023]
Abstract
Cardiac troponin is a specific and sensitive biomarker to identify and quantify myocardial injury. Myocardial injury is frequently detected after acute ischemic stroke and strongly associated with unfavorable outcomes. Concomitant acute coronary syndrome is only one of several possible differential diagnoses that may cause elevation of cardiac troponin after stroke. As a result, there are uncertainties regarding the correct interpretation and optimal management of stroke patients with myocardial injury in clinical practice. Elevation of cardiac troponin may occur as part of a 'Stroke-Heart Syndrome'. The term 'Stroke-Heart Syndrome' subsumes a clinical spectrum of cardiac complications after stroke including cardiac injury, dysfunction, and arrhythmia which may relate to disturbances of autonomic function and the brain-heart axis. In this review, we provide an up-to-date overview about prognostic implications, mechanisms, and management of elevated cardiac troponin levels in patients with acute ischemic stroke.
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8
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Odsæter IH, Grenne B, Hov GG, Laugsand LE, Wiseth R, Mikkelsen G. Establishing the 99th percentile of a novel assay for high-sensitivity troponin I in a healthy blood donor population. Clin Chem Lab Med 2020; 58:1557-1563. [PMID: 32286238 DOI: 10.1515/cclm-2019-1023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 03/10/2020] [Indexed: 01/22/2023]
Abstract
Background The recommended cut-off of cardiac troponin (cTn) for the diagnosis of acute myocardial infarction (AMI) is the 99th percentile in a healthy reference population. We aimed to determine the 99th percentile of the novel ADVIA Centaur® High Sensitivity Troponin I assay (Siemens Healthcare Diagnostics) in fresh lithium heparin plasma samples from healthy blood donors. Methods A total of 1000 apparently healthy blood donors were included. High-sensitivity (hs) cTnI, hs-cTnT, creatinine and N-terminal pro b-type natriuretic peptide (NT-proBNP) were measured in fresh lithium heparin plasma samples, and glycated hemoglobin (HbA1c) was measured in ethylenediaminetetraacetic acid (EDTA)-blood. The 99th percentile was estimated for the whole population, as well as for males and females separately. Results For the total population the 99th percentile of ADVIA Centaur® High Sensitivity Troponin I was 96 (65-149) ng/L. The estimated value differed significantly from results published by others and was highly dependent on which values were considered statistical outliers. Conclusions The estimated 99th percentile for hs-cTnI in the population studied differed significantly from previously published results. There is a need for further specifications regarding how subjects used for estimating the 99th percentile of cTns in healthy populations should be recruited and how outlier values should be identified, as this can highly influence the diagnostic cut-off applied for AMI.
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Affiliation(s)
- Ingrid Hov Odsæter
- Department of Clinical Chemistry, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bjørnar Grenne
- Clinic of Cardiology, St. Olav's hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gunhild Garmo Hov
- Department of Clinical Chemistry, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lars Erik Laugsand
- Department of Emergency Medicine, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Rune Wiseth
- Clinic of Cardiology, St. Olav's hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gustav Mikkelsen
- Department of Clinical Chemistry, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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9
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Approaching 2020 acuity for high-sensitivity cardiac troponin assays in Clinical Biochemistry. Clin Biochem 2020; 78:1-3. [PMID: 31991127 DOI: 10.1016/j.clinbiochem.2020.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 01/18/2020] [Accepted: 01/23/2020] [Indexed: 11/23/2022]
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10
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Development of an algorithm for ruling-out non-ST elevation myocardial infarction in the emergency department using high sensitivity troponin T assay. Clin Chim Acta 2019; 495:1-7. [DOI: 10.1016/j.cca.2019.03.1625] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 02/26/2019] [Accepted: 03/21/2019] [Indexed: 12/26/2022]
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11
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Ljung L, Reichard C, Hagerman P, Eggers KM, Frick M, Lindahl B, Linder R, Martinsson A, Melki D, Svensson P, Jernberg T. Sensitivity of undetectable level of high-sensitivity troponin T at presentation in a large non-ST-segment elevation myocardial infarction cohort of early presenters. Int J Cardiol 2019; 284:6-11. [DOI: 10.1016/j.ijcard.2018.10.088] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/26/2018] [Accepted: 10/25/2018] [Indexed: 11/26/2022]
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12
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High-sensitivity cardiac troponin T and severity of cerebral white matter lesions in patients with acute ischemic stroke. J Neurol 2018; 266:37-45. [PMID: 30311052 DOI: 10.1007/s00415-018-9085-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/02/2018] [Accepted: 10/03/2018] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Cardiac troponin (hs-cTnT) is a sensitive marker of myocardial injury and has been linked to incident dementia. The underlying mechanism of that observation is still unknown. Given that severity of cerebral small vessel disease is a predictor of cognitive decline, we aimed to explore whether there is an association between hs-cTnT and severity of white matter lesions (WML) as a marker of cerebral small vessel disease in patients with ischemic stroke. METHODS We analyzed consecutive acute ischemic stroke patients admitted to Charité-University Hospital, Berlin from 2011 to 2013. Severity of WML was graded on 3T-MRI using the age-related white matter severity score (ARWMS). Patients with hs-cTnT elevation suggestive of acute coronary syndrome (ACS) were excluded (hs-cTnT > 52 ng/l or dynamic change of hs-cTnT > 50%, ESC guideline). We performed unadjusted and adjusted quantile regression models to assess the association between increased hs-cTnT (dichotomized at the 99th percentile, 14 ng/l) and severity of WML. RESULTS A total of 860 patients was analyzed (median age 73 years, 44.8% female, median ARWMS 6). Patients with elevated hs-cTnT had more extensive WML than those without (median ARWMS 8 vs. 5, adjusted beta for 50th percentile 1.12, 95% CI 0.41-1.84). The association between WML and hs-cTnT elevation was strongest in patients with severe WML (adjusted beta 1.77, 95% CI 0.26-3.27 for 80th WML percentile). CONCLUSION Elevated hs-cTnT levels were associated with extent of WML in acute stroke patients. Further studies are needed to assess whether hs-cTnT can be used to identify stroke patients at risk for cognitive decline.
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Twerenbold R, Boeddinghaus J, Mueller C. Update on high-sensitivity cardiac troponin in patients with suspected myocardial infarction. Eur Heart J Suppl 2018. [DOI: 10.1093/eurheartj/suy020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Raphael Twerenbold
- Cardiovascular Research Institute Basel (CRIB), Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland
| | - Jasper Boeddinghaus
- Cardiovascular Research Institute Basel (CRIB), Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland
| | - Christian Mueller
- Cardiovascular Research Institute Basel (CRIB), Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland
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14
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O'Day E, Hosta-Rigau L, Oyarzún DA, Okano H, de Lorenzo V, von Kameke C, Alsafar H, Cao C, Chen GQ, Ji W, Roberts RJ, Ronaghi M, Yeung K, Zhang F, Lee SY. Are We There Yet? How and When Specific Biotechnologies Will Improve Human Health. Biotechnol J 2018; 14:e1800195. [PMID: 29799175 DOI: 10.1002/biot.201800195] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 05/11/2018] [Indexed: 12/11/2022]
Abstract
Patient X: A 67-year-old Caucasian man slips on a patch of ice. He has abrasions to his hands and has sustained significant damage to his hip. At the emergency room, he informs clinicians he takes atorvastatin, metformin, and glimepiride to treat hypertension and Type 2 Diabetes Mellitus (T2DM). X-rays reveal a fractured hip, which will require total hip replacement surgery.
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Affiliation(s)
- Elizabeth O'Day
- Global Future Council on the Future of Biotechnologies, World Economic Forum, Cologny, CH-1223, Geneva, Switzerland.,Olaris Therapeutics, Inc., 45 Moulton St., Cambridge, MA, 02138, USA
| | - Leticia Hosta-Rigau
- Global Future Council on the Future of Biotechnologies, World Economic Forum, Cologny, CH-1223, Geneva, Switzerland.,Department of Micro- and Nanotechnology, Center for Nanomedicine and Theranostics, Technical University of Denmark, 2800, Kongens Lyngby, Denmark
| | - Diego A Oyarzún
- Global Future Council on the Future of Biotechnologies, World Economic Forum, Cologny, CH-1223, Geneva, Switzerland.,Department of Mathematics, Imperial College London, London, SW7 2AZ, UK.,EPSRC Centre for Mathematics of Precision Healthcare, Imperial College London, London, SW7 2AZ, UK
| | - Hideyuki Okano
- Global Future Council on the Future of Biotechnologies, World Economic Forum, Cologny, CH-1223, Geneva, Switzerland.,Department of Physiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Víctor de Lorenzo
- Global Future Council on the Future of Biotechnologies, World Economic Forum, Cologny, CH-1223, Geneva, Switzerland.,National Center of Biotechnology CSIC, Systems Biology Program, Campus de Cantoblanco, E-28049, Madrid, Spain
| | - Conrad von Kameke
- Global Future Council on the Future of Biotechnologies, World Economic Forum, Cologny, CH-1223, Geneva, Switzerland.,BioInnovators Europe, Berlin, Germany
| | - Habiba Alsafar
- Global Future Council on the Future of Biotechnologies, World Economic Forum, Cologny, CH-1223, Geneva, Switzerland.,Khalifa University Center for Biotechnology, Khalifa University, PO Box 127788, Abu Dhabi, United Arab Emirates
| | - Cong Cao
- Global Future Council on the Future of Biotechnologies, World Economic Forum, Cologny, CH-1223, Geneva, Switzerland.,University of Nottingham, 199 East Taikang Road, Ningbo, 315100, China
| | - Guo-Qiang Chen
- Global Future Council on the Future of Biotechnologies, World Economic Forum, Cologny, CH-1223, Geneva, Switzerland.,Center for Synthetic and Systems Biology, MOE Lab for Industrial Biocatalysis, Tsinghua-Peking University Center of Life Sciences, School of Life Sciences, Tsinghua University, Beijing, 100084, China
| | - Weizhi Ji
- Global Future Council on the Future of Biotechnologies, World Economic Forum, Cologny, CH-1223, Geneva, Switzerland.,Kunming University of Science and Technology, 727 Jingming South Rd. Chenh Gong, Kunming, 650500, Yunnan, China
| | - Richard J Roberts
- Global Future Council on the Future of Biotechnologies, World Economic Forum, Cologny, CH-1223, Geneva, Switzerland.,New England Biolabs, 240 County Road, Ipswich, MA, 01938, USA
| | - Mostafa Ronaghi
- Global Future Council on the Future of Biotechnologies, World Economic Forum, Cologny, CH-1223, Geneva, Switzerland.,Illumina Inc., 5200 Illumina Way, San Diego, CA, 92121, USA
| | - Karen Yeung
- Global Future Council on the Future of Biotechnologies, World Economic Forum, Cologny, CH-1223, Geneva, Switzerland.,Law School and School of Computer Science University of Birmingham, Birmingham, UK, B15 2TT
| | - Feng Zhang
- Global Future Council on the Future of Biotechnologies, World Economic Forum, Cologny, CH-1223, Geneva, Switzerland.,Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA.,McGovern Institute for Brain Research at MIT, Cambridge, MA, 02139, USA.,Department of Brain and Cognitive Sciences and Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Sang Yup Lee
- Global Future Council on the Future of Biotechnologies, World Economic Forum, Cologny, CH-1223, Geneva, Switzerland.,Department of Chemical and Biomolecular Engineering (BK21 Plus program), Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-Ro, Daejeon, 34141, Republic of Korea.,The Novo Nordisk Foundation Center for Biosustainability, Technical University of Denmark, Kemitorvet Bygning 220, 2800, Kongens Lyngby, Denmark
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Newby LK, Lowenstern A. Implications of High-Sensitivity Troponin Testing. J Am Coll Cardiol 2018; 71:2625-2627. [DOI: 10.1016/j.jacc.2018.03.516] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 03/18/2018] [Indexed: 12/31/2022]
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