Cardiac Troponin - diagnostic problems and impact on cardiovascular disease

Alaour, Bashir; Liew, Felicity; Kaier, Thomas E

doi:10.1080/07853890.2018.1530450

Cited by 23 publications

(14 citation statements)

References 103 publications

(38 reference statements)

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“…Finally, their data confirm that a diagnosis of MI still relies on clinical opinion and evaluating cTn levels should be seriously assessed and should consider the clinical manifestations ( Eidizadeh et al, 2021 ). Clinicians should be able to interpret cardiac biomarkers in the same manner as they comprehend blood count reference ranges, in order to get the most out of greater sensitivity, quicker decision paths, and improved risk prediction ( Alaour et al, 2018 ).…”

Section: Challenges and Perspectivementioning

confidence: 99%

Significance of Cardiac Troponins as an Identification Tool in COVID-19 Patients Using Biosensors: An Update

Rasmi

Mosa

Alipour

et al. 2022

Front. Mol. Biosci.

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Coronavirus disease 2019 (COVID-19) has rapidly developed as a global health emergency. Respiratory diseases are significant causes of morbidity and mortality in these patients with a spectrum of different diseases, from asymptomatic subclinical infection to the progression of severe pneumonia and subsequent acute respiratory distress syndrome. Individuals with cardiovascular disease are more likely to become infected with SARS-CoV-2 and develop severe symptoms. Hence, patients with underlying cardiovascular disease mortality rate are over three times. Furthermore, note that patients with a history of cardiovascular disease are more likely to have higher cardiac biomarkers, especially cardiac troponins, than infected patients, especially those with severe disease, making these patients more susceptible to cardiac damage caused by SARS-2-CoV. Biomarkers are important in decision-making to facilitate the efficient allocation of resources. Viral replication in the heart muscle can lead to a cascade of inflammatory processes that lead to fibrosis and, ultimately, cardiac necrosis. Elevated troponin may indicate damage to the heart muscle and may predict death. After the first Chinese analysis, increased cardiac troponin value was observed in a significant proportion of patients, suggesting that myocardial damage is a possible pathogenic mechanism leading to severe disease and death. However, the prognostic performance of troponin and whether its value is affected by different comorbidities present in COVID-19 patients are not known. This review aimed to assess the diagnostic value of troponin to offer insight into pathophysiological mechanisms and reported new assessment methods, including new biosensors for troponin in patients with COVID-19.

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Section: Challenges and Perspectivementioning

confidence: 99%

Significance of Cardiac Troponins as an Identification Tool in COVID-19 Patients Using Biosensors: An Update

Rasmi

Mosa

Alipour

et al. 2022

Front. Mol. Biosci.

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“…Depending on the specific healthcare environment studied, this results in wide variation in prevalence of myocardial infarction—from 5% to 20% in published studies across the world. 8 , 9 …”

Section: Summary Of the 4th Udmimentioning

confidence: 99%

“…In fact, the decision thresholds are optimized for high sensitivity at the rule-out threshold, and high specificity at the rule-in threshold. As a consequence, 24–50% of patients assessed with the ESC 0/1 h algorithm remain in the ‘observe’ zone after a second blood draw 9 , 43–63 and require further assessment.…”

Section: Static or Changing Troponin?mentioning

confidence: 99%

Cardiac troponin and defining myocardial infarction

Kaier

Alaour

Marber

2021

Cardiovascular Research

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The 4th Universal Definition of Myocardial Infarction has stimulated considerable debate since its publication in 2018. The intention was to define the types of myocardial injury through the lens of their underpinning pathophysiology. In this review we discuss how the 4th Universal Definition of Myocardial Infarction defines infarction and injury and the necessary pragmatic adjustments that appear in clinical guidelines to maximise triage of real-world patients.

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“…In current practice, simple tools such as ECG, troponin assay, and echocardiography are used to validate the emergency diagnosis of MI. ST segment analysis on ECG (especially in case of ST persistent elevation), the intensity of troponin elevation, or LVEF (left ventricular ejection fraction) assessment from transthoracic echocardiography (TTE) have been shown highly correlated with MI (5)(6)(7)(8). Given these facts, when patients arrive in the emergency department complaining of chest pain, generally a series of indicators will be first listed with the help of the abovementioned simple tools.…”

Section: Introductionmentioning

confidence: 99%

Prediction of Myocardial Infarction From Patient Features With Machine Learning

Chen

Shi

Pommier

et al. 2022

Front. Cardiovasc. Med.

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This study proposes machine learning-based models to automatically evaluate the severity of myocardial infarction (MI) from physiological, clinical, and paraclinical features. Two types of machine learning models are investigated for the MI assessment: the classification models classify the presence of the infarct and the persistent microvascular obstruction (PMO), and the regression models quantify the Percentage of Infarcted Myocardium (PIM) of patients suspected of having an acute MI during their reception in the emergency department. The ground truth labels for these supervised models are derived from the corresponding Delayed Enhancement MRI (DE-MRI) exams and manual annotations of the myocardium and scar tissues. Experiments were conducted on 150 cases and evaluated with cross-validation. Results showed that for the MI (PMO inclusive) and the PMO (infarct exclusive), the best models obtained respectively a mean error of 0.056 and 0.012 for the quantification, and 88.67 and 77.33% for the classification accuracy of the state of the myocardium. The study of the features' importance also revealed that the troponin value had the strongest correlation to the severity of the MI among the 12 selected features. For the proposal's translational perspective, in cardiac emergencies, qualitative and quantitative analysis can be obtained prior to the achievement of MRI by relying only on conventional tests and patient features, thus, providing an objective reference for further treatment by physicians.

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Cardiac Troponin - diagnostic problems and impact on cardiovascular disease

Cited by 23 publications

References 103 publications

Significance of Cardiac Troponins as an Identification Tool in COVID-19 Patients Using Biosensors: An Update

Significance of Cardiac Troponins as an Identification Tool in COVID-19 Patients Using Biosensors: An Update

Cardiac troponin and defining myocardial infarction

Prediction of Myocardial Infarction From Patient Features With Machine Learning

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