Determinants of High-Sensitivity Troponin T Among Patients with a Noncardiac Cause of Chest Pain

Irfan, Affan; Twerenbold, Raphael; Reiter, Miriam; Reichlin, Tobias; Stelzig, Claudia; Freese, Michael; Haaf, Philip; Hochholzer, Willibald; Steuer, Stephan; Bassetti, Stefano; Zellweger, Christa; Freidank, Heike; Peter, Federico; Campodarve, Isabel; Meune, Christophe; Müeller, Christian

doi:10.1016/j.amjmed.2011.10.031

Cited by 68 publications

(28 citation statements)

References 31 publications

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“…4 However, the observed levels were higher, as expected was based on a previous study. 9 Although the negative predictive value for presence of ACS for the initial high-sensitive troponin T level corresponded with the current European Society of Cardiology guidelines, it was much lower for patients with renal insufficiency. 7 The area under the curve in the receiver operating characteristic for patients with moderate to severe renal insufficiency presenting with acute chest pain or dyspnea was 0.535 in the present study, which is close to pure chance.…”

Section: Discussionmentioning

confidence: 81%

Diagnostic Performance of High-Sensitive Troponin T in Patients With Renal Insufficiency

Pfortmueller¹,

Funk²,

Marti³

et al. 2013

The American Journal of Cardiology

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Section: Discussionmentioning

confidence: 81%

Diagnostic Performance of High-Sensitive Troponin T in Patients With Renal Insufficiency

Pfortmueller¹,

Funk²,

Marti³

et al. 2013

The American Journal of Cardiology

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“…W tym przypadku takie patologie w obrębie serca, jak przewlekła CHD lub nadciśnieniowa choroba serca, wydają się odgrywać główną rolę we wzroście stężenia troponin [41]. Inne stany zagrożenia życia, przebiegające z bólem w klatce piersiowej, takie jak rozwarstwienie orty i zatorowość płucna, również mogą powodować wzrost stężenia troponin i należy je uwzględnić w diagnostyce różnicowej (tab.…”

Section: Biomarkeryunclassified

“…W większości przypadków wzrost stężenia troponin sercowych nie powinien być w pierwszej kolejności przypisywany zaburzeniom klirensu kreatyniny i kwalifikowany jako niegodny uwagi, gdyż patologie w obrębie serca, takie jak przewlekła CAD lub nadciśnieniowa choroba serca, wydają się najważniejszymi czynnikami przyczyniającymi się do wzrostu stężenia troponiny w tym przypadku [41]. Jedynie u pacjentów z ciężką dysfunkcją nerek (np.…”

Section: Przewlekła Choroba Nerekunclassified

2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

Roffi¹,

Patrono²,

Collet³

et al. 2015

Kardiol Pol

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192

165

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“…The attendant desire to avoid FP tests is one of the reasons that the currently recommended cut-offs for cTn (99 th percentile and 10% CV) are more stringent than the 97.5th percentile and 20% CV commonly used for other laboratory tests (77). With increasing cTn sensitivity, even more non-ACS and chronic cTn elevations are found (14,61,66,80,81). For example, cTnT was detectable in 10.4% of the analyzed population with the cTnT assay (detection limit ≤10 ng/L) compared with 92.0% with the new high-sensitive cTnT assay (≤1 ng/L) (82,83) and as low as 0.1 ng/L.…”

Section: Discussionmentioning

confidence: 99%

False Positive Troponin – A True Problem

Koraćević¹,

Ćosić²,

Stojanović³

2013

Journal of Medical Biochemistry

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Summary Cardiac troponins have a crucial role in diagnosing acute myocardial infarction, but have been considered by some authors to have a high false positive rate. Such opinions may decrease the confidence in troponin with important clinical consequences. The aim of the paper is to analyze three different meanings of the phrase »false positive troponin«: A) analytic (technical) false positive, with no real myocardial damage; B) false positive considering AMI: cardiac injury is present, but there is no AMI; C) false positive considering CAD: there is myocardial damage, but no CAD. The most frequent and the most important source of misunderstanding is the confusion between aspects A) and B). Namely, there has been a relatively small percentage of false positive troponin elevations due to analytic reasons. On the contrary, there has been a re - latively large percentage of »false positive« results in patients with myocardial necrosis due to causes other than AMI; for them - instead of »FP troponin elevation« - another phrase ought to be used, e.g., »non-AMI troponin elevation « until the etiopathogenesis in an individual patient is recognized. The phrase »false positive troponin« should be restricted to the artificial increase in troponin due to preanalytic and analytic reasons. By doing so, we may decrease the degree of confusion about troponin and increase the confidence in this highly specific marker of myocardial injury. The possibility of an analytic false positive result should always be kept in mind when one interprets elevated troponin.

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Determinants of High-Sensitivity Troponin T Among Patients with a Noncardiac Cause of Chest Pain

Cited by 68 publications

References 31 publications

Diagnostic Performance of High-Sensitive Troponin T in Patients With Renal Insufficiency

Diagnostic Performance of High-Sensitive Troponin T in Patients With Renal Insufficiency

2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

False Positive Troponin – A True Problem

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