Circadian rhythm of cardiac troponin I and its clinical impact on the diagnostic accuracy for acute myocardial infarction

Wildi, Karin; Singeisen, Hélène; Twerenbold, Raphael; Badertscher, Patrick; Wussler, Desiree; Klinkenberg, Lieke J.J.; Meex, Steven J.R.; Nestelberger, Thomas; Boeddinghaus, Jasper; Miró, Òscar; Martín‐Sánchez, Francisco Javier; Morawiec, Beata; Muzyk, Piotr; Pařenica, Jiří; Keller, Dagmar I.; Geigy, Nicolas; Potluková, Eliška; Sabti, Zaid; Kozhuharov, Nikola; Puelacher, Christian; Lavallaz, Jeanne du Fay de; Giménez, María Rubini; Shrestha, Samyut; Marzano, G; Rentsch, Katharina; Oßwald, Stefan; Reichlin, Tobias; Investigators, Apace

doi:10.1016/j.ijcard.2018.05.136

Cited by 28 publications

(24 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…78 These findings may have implications for the diagnosis of myocardial infarction and also the determination of biological variability because of differences in blood sampling times. 78,79 Although there may be associations between circadian rhythm and acute myocardial infarction, the significance of diurnal variation in cTn concentration is yet to be established and further larger studies are needed. 77,80 Although biological variability studies are normally conducted in healthy individuals, determining RCVs for cTn in older individuals or in individuals with chronic but stable renal or cardiac disease is also important.…”

Section: Biological Variation Results From Previous Studiesmentioning

confidence: 99%

Revisiting the Biological Variability of Cardiac Troponin: Implications for Clinical Practice

Lan

Bell

2019

CBR

View full text Add to dashboard Cite

The diagnosis of acute myocardial injury requires a rise and/or fall of cardiac troponin (cTn) on serial testing, with at least one concentration above the 99th percentile value of a normal reference population according to the recently published Fourth Universal Definition of Myocardial Infarction.1 However, the magnitude of change in cTn that constitutes a significant rise and/or fall was again not specified in detail. High-sensitivity cardiac troponin (hs-cTn) assays can measure ten-fold lower concentrations of cTn with more precision than older assays, and can accurately quantitate cTn in more than 50% of healthy individuals with a coefficient of variation of less than 10% at the 99th percentile. These hs-cTn assays are also able to detect the normal variations in cTn results that are due to biological variability. Understanding and quantifying the normal variations in cTn is important as this would allow significant changes to be better defined. Numerous studies have sought to investigate the biological variability of cTn over the last ten years. Such studies are usually conducted in healthy individuals, however individuals with chronic cardiac disease or chronic renal failure have also been examined. These studies have yielded varying results in regards to significant change values for cTn. In light of the recent redefinition for myocardial infarction, the purpose of this mini-review is to revisit the biological variability of cTn. In particular, we outline concepts for determining a significant change value, review the results of previous studies on the biological variation of cTn and discuss potential considerations for clinical practice.

show abstract

Section: Biological Variation Results From Previous Studiesmentioning

confidence: 99%

Revisiting the Biological Variability of Cardiac Troponin: Implications for Clinical Practice

Lan

Bell

2019

CBR

View full text Add to dashboard Cite

show abstract

“…e rhythm does not seem to affect the diagnostic accuracy for AMI, except for screening purposes. hs-TnI does not seem to express the same rhythm, it demonstrates high diagnostic accuracy for AMI, and it does not differ with time of presentation [35].…”

Section: Cardiac Troponinmentioning

confidence: 92%

The Biomarkers for Acute Myocardial Infarction and Heart Failure

Wang

Zhang

et al. 2020

BioMed Research International

View full text Add to dashboard Cite

The use of a large number of cardiovascular biomarkers, meant to complement the use of the electrocardiogram, echocardiography cardiac imaging, and clinical symptom assessment, has become a routine in clinical diagnosis, differential diagnosis, risk stratification, and prognosis and guides the management of patients with suspected cardiovascular diseases. There is a broad consensus that cardiac troponin and natriuretic peptides are the preferred biomarkers in clinical practice for the diagnosis of the acute coronary syndrome and heart failure, respectively, while the roles and possible clinical applications of several other potential biomarkers are still under study. This review mainly focuses on the recent studies of the roles and clinical applications of troponin and natriuretic peptides, which seem to be the best-validated markers in distinguishing and predicting the future cardiac events of patients with suspected cardiovascular diseases. Additionally, the review briefly discusses some of the large number of potential markers that may play a more prominent role in the future.

show abstract

“…Во всех упомянутых выше исследованиях ЦР присутствовали у СТ-Т, но не были статистически значимы для СТ-I [25][26][27]. Wildi K, et al также не обнаружили ЦР СТ-I, характерных для СТ-Т [29]. Весьма примечательно, что в исследовании Klinkenberg L почасовые различия концентрации СТ-I составляли не более 1 нг/л [25], тогда как у пациентки с ХБП в исследовании van der Linden N они достигали 2,6 нг/л [26].…”

Section: циркадные ритмы стunclassified

“…Роль биохимических различий СТ в формировании ЦР. Для СТ-I, в отличие от СТ-Т, как показал ряд исследований, практически не характерны ЦР [28,29], однако причина тому окончательно не установлена. Для объяснения этих возможных различий обратимся к биохимическим особенностям молекул СТ-Т и СТ-I, которые могут лежать в основе различий в механизмах высвобождения и элиминации молекул СТ (табл.…”

Section: возможные механизмы формирования цр стunclassified

“…Молекулярная масса и, соответственно, размеры молекулы СТ-I меньше, в связи с чем данный белок гораздо легче проходит через клеточную мембрану кардиомиоцитов. А общее содержание СТ-Т в миокарде и объем цитоплазматической (свободной фракции) СТ-Т практически в два раза выше, чем СТ-I (10-11 мг/г vs 4-6 мг/г и 6-7% vs 3-4%, соответственно) [29]. Принимая во внимание, что содержание СТ-Т в миокарде и объем цитоплазматической ("легковысвобождаемой") фракции выше, можно предположить, что возможность высвобождения СТ-Т гораздо выше, чем у СТ-I, что может в определенной степени объяснять различия в степени циркадных колебаний.…”

Section: возможные механизмы формирования цр стunclassified

See 1 more Smart Citation

Circadian rhythms of cardiac troponins: mechanisms and clinical significance

2020

View full text Add to dashboard Cite

Modern laboratory methods for determining biomarkers of cardiovascular diseases are highly sensitive and can detect almost single molecules in human biological fluids, significantly speeding up and improving the diagnosis of cardiovascular diseases. However, in this case, there is a decrease in specificity and it is necessary to take into account a number of additional factors that may affect the result of the study. Recent studies have shown that circadian rhythms (CR) are among these factors. This review article is devoted to the discussion of recently discovered CR of cardiac troponins (CT). A number of articles reported that, both in healthy people and in patients with a number of chronic diseases, CT concentrations change during the day. Given that modern algorithms for diagnosing myocardial infarction (MI) are based on serial studies (0-1 h and 0-3 h) of blood serum, and the values of CT in the blood serum for the diagnosis of myocardial infarction (MI) for this period of time are only a few ng/l, the CT CR can to some extent affect the accuracy of MI diagnosis. Thus, natural physiological changes in the concentration of CT during the day can be mistakenly interpreted as diagnostically significant deviations and lead to an erroneous interpretation of laboratory test results.

show abstract

Circadian rhythm of cardiac troponin I and its clinical impact on the diagnostic accuracy for acute myocardial infarction

Abstract: NCT00470587, http://clinicaltrials.gov/show/NCT00470587.

Cited by 28 publications

References 36 publications

Revisiting the Biological Variability of Cardiac Troponin: Implications for Clinical Practice

Revisiting the Biological Variability of Cardiac Troponin: Implications for Clinical Practice

The Biomarkers for Acute Myocardial Infarction and Heart Failure

Circadian rhythms of cardiac troponins: mechanisms and clinical significance

Contact Info

Product

Resources

About