Cardiac Troponin I Elevation in Hospitalized Patients Without Acute Coronary Syndromes

Achieving biosensing at attomolar concentrations of cardiac troponin T in human biofluids by developing a label-free nanoplasmonic analytical assay

“…Furthermore, we also show that our chip-based fabrication methodology is highly reproducible in which biosensors fabricated six months apart (batch-to-batch variation) produced nearly identical sensitivity. Owing to the enormous importance of cTnT in human health where >10 ng/L level is considered to be high risk for Myocardial Infarction (MCI), [26][27][28][29][30][31][32][33][34][35] we expect that our simple, cost-effective, and ultrasensitive assay in real human biofluids will be capable of detecting the potentially minute change in cTnT concentrations in symptom-free (chest, back, or jaw pain, and stable coronary artery disease) and poorly differentiated cases and allow interpretation to prevent heart attack by early diagnosis, thereby greatly improving patient survival. 36 Finally, our determination of the most influential nanoscale structural parameters and our methodology to control surface functionalization and immobilization of receptors will provide experimental benchmarks for the fabrication of ultrasensitive biosensors to quantitatively study a variety of important protein-protein interactions.…”

Troponin Rise in Hospitalized Patients With Nonacute Coronary Syndrome: Retrospective Assessment of Outcomes and Predictors

“…[9][10][11][13][14][15][16] In fact, elevated levels of cTnI also correlate with increased severity of stroke. 17 Blich et al 18 previously demonstrated an increase in both short-and long-term mortality in the presence of non-ACS cTnI elevation when compared with primary ACS cTnI elevation. Many patients with type II MI can have flow-limiting CAD disease on coronary angiography or regional wall motion abnormalities with left ventricular dysfunction on echocardiography caused by ischemic imbalance.…”

Reducing Excess Cardiac Biomarker Testing at an Academic Medical Center

“…Furthermore, reduced cardiac biomarker testing results in fewer false positive test results, which may lead to decreased ordering of downstream cardiac tests such as noninvasive stress testing, echocardiography, and invasive procedures such as cardiac catheterization and percutaneous coronary intervention (PCI). 20 We provide an example of a successful intervention that led providers to order "less" in the realm of excess cardiac biomarker testing that does not improve diagnostic yield, and receive "more" in terms of potential savings to payers, providers, and patients, along with mitigation of potential downstream harm and cost associated with spurious tests results. Given this success, we believe this approach warrants trial at other institutions and with other diagnostic tests that may be inappropriately ordered.…”