Cardiac Magnetic Resonance Imaging Study for Quantification of Infarct Size Comparing Directly Serial Versus Single Time-Point Measurements of Cardiac Troponin T

Giannitsis, Evangelos; Steen, Henning; Kurz, Kathinka D.; Ivandic, Boris; Simon, Anke; Futterer, Simon; Schild, Christian; Isfort, Peter; Jaffe, Allan S.; Katus, Hugo A.

doi:10.1016/j.jacc.2007.09.041

Cited by 164 publications

(97 citation statements)

References 33 publications

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“…Furthermore, Troponin within the first days after STEMI without OHCA is associated with infarct size, left ventricular function as well as mortality in several studies [20][21][22]. However, in the present study hs-TnT did not predict death due to cardiovascular causes or multi-organ failure in the group without STEMI.…”

Section: Discussioncontrasting

confidence: 80%

High-sensitivity troponin-T as a prognostic marker after out-of-hospital cardiac arrest – A targeted temperature management (TTM) trial substudy

et al. 2016

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High-sensitivity troponin-T as a prognostic marker after out-of-hospital cardiac arrest -A targeted temperature management (TTM) trial substudyGilje, Patrik; Koul, Sasha; Thomsen, Jakob Hartvig; Devaux, Yvan; Friberg, Hans; Kuiper, Michael; Horn, Janneke; Nielsen, Niklas; Pellis, Tomasso; Stammet, Pascal; Wise, Matthew P.; Kjaergaard, Jesper; Hassager, Christian; Erlinge, David Link to publication Citation for published version (APA): Gilje, P., Koul, S., Thomsen, J. H., Devaux, Y., Friberg, H., Kuiper, M., ... Erlinge, D. (2016). High-sensitivity troponin-T as a prognostic marker after out-of-hospital cardiac arrest -A targeted temperature management (TTM) trial substudy. Resuscitation, 107, 156-161. DOI: 10.1016/j.resuscitation.2016 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Predicting outcome of unconscious patients after successful resuscitation is challenging and better prognostic markers are highly needed. Ischemic heart disease is a common cause of out-of-hospital cardiac arrest (OHCA).Whether or not high-sensitivity troponin T (hs-TnT) is a prognostic marker among survivors of OHCA with both ischemic and non-ischemic aetiologies remains to be determined. We sought to evaluate the ability of hs-TnT to prognosticate all-cause mortality, death due to cardiovascular causes or multi-organ failure and death due to cerebral causes after OHCA. The influence of the level of target temperature management on hs-TnT as a marker of infarct size was also assessed. Methods:A total of 699 patients from the Targeted Temperature Management (TTM) trial were included and hs-TnT was analysed in blood samples from 24, 48 and 72 h after return of spontaneous circulation (ROSC). The endpoints were 180 day all-cause mortality, death due to cardiovascular causes or multi-organ failure and death due to cerebral causes. Subgroups based on the initial ECG after ROSC (STEMI vs all other ECG presentations) were analysed. Results:Hs-TnT was independently associated with all-cause mortality which was driven by death due to cardiovascular causes or multi-organ failure and not cerebral causes (at 48h: OR 1.10, CI 1.01-1.20, p<0.05). Hs-TnT was also an independent predictor of death due to cardiovascular causes or multi-organ failure (at 48h: OR 1.13, CI 1.01-1.26, p<0.05). In patients with STEMI, hs-TnT was independently associated with death due to cardiovascular causes or multi-organ failure (at 48h: OR 1.47, CI 1.10-1.95, p<0.01). Targeted temperature management at 33 °C was not ...

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Section: Discussioncontrasting

confidence: 80%

High-sensitivity troponin-T as a prognostic marker after out-of-hospital cardiac arrest – A targeted temperature management (TTM) trial substudy

et al. 2016

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“…The maximal cTnT value (obtained typically on day 1) was closely correlated with the value from day 3, reported to correlate best with magnetic resonance imaging-determined infarct size. 33,34 Thus, our data are consistent with the association between the size of MI and outcomes, particularly among incident cases, and underscore that maximal cTnT value measured clinically can be used as a suitable indicator of MI severity.…”

Section: Discussionsupporting

confidence: 83%

“…37 In addition, there are data linking cTnT level measured at 72 hours after MI to infarct size, regardless of reperfusion status. 33,34 Finally, previous studies have shown that troponin elevation was associated with subsequent cardiac events in patients with acute coronary syndromes, probably as a reflection of severe anatomical disease. [3][4][5][6][7][8] However, several important limitations of previous studies hinder their clinical applicability.…”

Section: Prognostic Value Of Ctnt Post-mimentioning

confidence: 98%

Prognostic Value of Cardiac Troponin T After Myocardial Infarction: A Contemporary Community Experience

Gerber

Jaffe

Weston

et al. 2012

Mayo Clinic Proceedings

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Objective: To evaluate the role of cardiac troponin T (cTnT) in predicting death, recurrent ischemic events, and heart failure among community-dwelling persons with first myocardial infarction (MI). Patients and Methods: Consecutive Olmsted County, Minnesota, residents with an incident MI between November 6, 2002, and December 31, 2007, were studied (Nϭ1177; mean age, 68 years). Maximal cTnT value was measured at a median of 1 day after MI (median, 0.52 ng/mL; interquartile range, 0.16-1.75 ng/mL) and evaluated as a prognostic factor using measures of absolute risk. Results: During a mean follow-up of 16 months, 276 deaths (23%) occurred, 341 patients (29%) experienced a recurrent ischemic event, and 326 patients (28%) experienced heart failure. A dose-response relationship was demonstrated early after MI between cTnT and the adjusted cumulative incidence of all outcomes. The multivariateadjusted absolute risk differences (events per 100 patients) between the upper and lower cTnT tertiles at 30 days were 5.8 (95% confidence interval [CI], 1.4-10.2) for death, 5.2 (95% CI, 0.2-10.3) for recurrent ischemic event, and 6.9 (95% CI, 1.4-12.4) for heart failure. These differences were either maintained or increased at 2 years. Conclusion: In the community, cTnT level predicts death and nonfatal cardiac events independently of other prognostic factors. The increased risk associated with elevated cTnT level appears shortly after MI and persists for at least 2 years.

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“…cTnT have characteristic higher molecular weight, higher fraction of unbound cTnT, less degradation, whereas cTnI is more frequently found as binary or tertiary complex in blood. Previous studies proves that early appearing troponin pool may give information on the quality of microvascular reperfusion, while the concentration of cTn on Day 3 or 4 reflects myocardial infarct size [2].…”

Section: Introductionmentioning

confidence: 95%

High Sensitive Troponin as Biomarker for Coronary Artery Disease

Kumar¹,

Ahmad²

2017

J Clin Exp Cardiolog

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There are various cardiac biomarkers available for diagnosis and stratification of patients with acute coronary syndrome but only few are cardiospecific and sensitive. Troponins are protein molecules that are part of cardiac and skeletal muscle. Smooth muscle cells do not contain troponins. There are three subunits of troponin T, I and C subunits. Cardiac troponins are known to increase on myocardial cell damage leading to myocardial necrosis. The kinetic pattern of release of troponin is known. The technological advancements in Immunoassay has led to improvement in the limit of detection, (LoD) Limit of quantitation (LoQ) and cut off detection limits. There are decreases in false positive cases due to antihuman antibodies use of sandwich fifth generation Troponin T immunoassay. Recently the troponin T fifth generation by (Roche diagnostics) is approved by US-FDA. The cutoffs detections and positive 99 th percentile of reference population cutoffs has to be established by verification of manufacturers reference cutoff s limits. The delta change value after serial measurements of suspected patients with symptoms of AMI leads to diagnosis.

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Cardiac Magnetic Resonance Imaging Study for Quantification of Infarct Size Comparing Directly Serial Versus Single Time-Point Measurements of Cardiac Troponin T

Abstract: All single-point cTnTs, except on admission, give a good estimation of infarct size and perform as well as peak cTnT or AUC cTnT. Infarct estimation by single-point measurements, particularly cTnTD4, may gain clinical acceptance because the measurement is easy and inexpensive.

Cited by 164 publications

References 33 publications

High-sensitivity troponin-T as a prognostic marker after out-of-hospital cardiac arrest – A targeted temperature management (TTM) trial substudy

High-sensitivity troponin-T as a prognostic marker after out-of-hospital cardiac arrest – A targeted temperature management (TTM) trial substudy

Prognostic Value of Cardiac Troponin T After Myocardial Infarction: A Contemporary Community Experience

High Sensitive Troponin as Biomarker for Coronary Artery Disease

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