Diagnostic Marker Cooperative Study for the Diagnosis of Myocardial Infarction

Zimmerman, Janice L.; Fromm, Robert E.; Meyer, Denise; Boudreaux, Ann; Wun, Chuan-Chuan; Smalling, Richard W.; Davis, Barry R.; Habib, Gabriel B.; Roberts, Robert

doi:10.1161/01.cir.99.13.1671

Cited by 257 publications

(131 citation statements)

References 21 publications

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“…cTnI contributed significantly to the prognostic power of another scoring system for dogs with severe systemic diseases, the physiologic and laboratory evaluation (APPLE) full score in those patients 38. Using immunoassays with high sensitivity for cTnI improved the sensitivity for detection of myocardial injury as compared to older generation cTnI assays 7, 39, 40, 41…”

mentioning

confidence: 99%

Serum Cardiac Troponin I Concentrations in Dogs with Systemic Inflammatory Response Syndrome

Hamacher¹,

Dörfelt²,

Müller³

et al. 2015

Veterinary Internal Medicne

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BackgroundMyocardial injury can be detected by cardiac troponin I (cTnI) concentration, which appears to be a predictor of short‐term death in critically ill patients. It is unknown if the best prognostic indicator of short‐term survival is cTnI measurement at admission or at later time points.Hypothesis/ObjectivesMeasuring cTnI with a high‐sensitivity (HS) test at different time points after admission may be a better short‐term prognostic indicator than a single cTnI measurement at admission in dogs with systemic inflammatory response syndrome (SIRS).AnimalsProspective, observational clinical study of 60 dogs with SIRS.MethodsCardiac troponin I concentration was measured in 133 serum samples, collected at days 1, 2, 3, and 5. Additionally, the acute patient physiologic and laboratory evaluation (APPLE) fast score was evaluated at admission. Prognostic capabilities of cTnI measurement and APPLE fast score for 28‐day mortality were assessed by receiver operating characteristic curve analysis.ResultsForty‐one dogs with SIRS that survived 28 days had significantly lower serum cTnI concentrations at admission (median, 0.09 ng/mL; P = .004) and at the peak time point (median, 0.23 ng/mL; P = .01) compared to 19 nonsurvivors (median at admission, 0.63 ng/mL; median at peak, 1.22 ng/mL). Area under the curve to predict survival, using cTnI was similar at admission (0.732) and at peak (0.708), and was 0.754 for the APPLE fast score.Conclusions and Clinical ImportanceIncreased cTnI concentration in dogs with SIRS is associated with poor outcome. Daily follow‐up measurement of cTnI concentration provides no additional prognostic information for short‐term mortality.

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mentioning

confidence: 99%

Serum Cardiac Troponin I Concentrations in Dogs with Systemic Inflammatory Response Syndrome

Hamacher¹,

Dörfelt²,

Müller³

et al. 2015

Veterinary Internal Medicne

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“…Moreover, patients with typical chest pain suspected of myocardial ischemia were subjected to observation with serial ECGs and serial troponin I test. All the patients underwent resting echocardiography [1,2,12,13]. Patients with abnormal ECG and diagnosis of acute myocardial infarction or unstable angina were admitted to the coronary care unit.…”

Section: Study Populationmentioning

confidence: 99%

“…The value of troponin was considered positive if above the 99°percentile of a control group in at least 1 set eventually during the first 24 hours after onset of symptoms [1,13]. All the patients received resting echocardiography [1,2,12,13].…”

Section: Patients' Managementmentioning

confidence: 99%

“…All the patients received resting echocardiography [1,2,12,13]. Patients showing ischemic ECG changes with or without troponin elevation, with or without cardiac wall motion abnormalities at the echocardiography during observation, were considered at high risk of cardiac events [12,17,19], and they were admitted and considered for coronary angiography.…”

Section: Patients' Managementmentioning

confidence: 99%

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Short- and long-term cardiac events in patients with chest pain with or without known existing coronary disease presenting normal electrocardiogram

Conti

Poggioni

Viviani

et al. 2012

The American Journal of Emergency Medicine

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Aim: The aim of this study is to evaluate incidence of adverse cardiac events in patients with chest pain with or without known existing coronary disease presenting normal electrocardiogram (ECG) and initial troponin. Methods: Prospective, nonrandomized study enrolled low-risk patients with normal ECG and troponin on admission who underwent observation and/or stress testing by unstandardized clinical judgment. Patients who experienced recurrent angina or positive ECGs or positive troponins during observation or patients with positive stress testing were admitted; otherwise, they were discharged. End Point: The end points are cardiac events at short-and long-term follow-up including cardiovascular death, myocardial infarction, unstable angina, and revascularization. Results: Of 5656 patients considered, 1732 with ischemic ECG were initially admitted and, therefore, excluded from the analysis; 2860 with pleuritic chest pain and normal ECG were discharged; 1064 with visceral chest pain and normal ECG were enrolled. Patients with known coronary disease (45%) were older and likely presented known vascular disease. Patients with known vascular disease, older age, female sex, diabetes mellitus, and lower chest pain score were likely managed with observation. In patients with known coronary disease as compared with patients without, overall cardiac events account for 35% vs 14%, respectively (P b .001), as follows: in-hospital, 23% vs 10%, (P b .001); 1 month, 4% vs 2% (P = .133); and 9.9 ± 4.9 months, 8% vs 2%, respectively (P b .001). Conclusions: One-third of patients with chest pain with known coronary disease, negative ECG, and biomarkers were subsequently found to have adverse cardiac events. The value of this research for an emergency medicine audience could be extended to all clinicians and general practitioners beyond cardiologists.

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“…As subformas da CK-MB têm surgido como marcadores precoces (menos de 6h) de lesão miocárdica. Alguns estudos demonstraram que uma relação de CK-MB2/MB1 é mais sensível para o diagnóstico de infarto do miocárdio na admissão e 6h após, quando comparado com CK total, CK-MB atividade, CK-MB massa e mioglobina 68,69 . Uma limitação das subformas de CK-MB é sua menor especificidade e a dificuldade técni-ca para reprodução dos resultados, justificando sua pequena penetração no mercado.…”

Section: Creatinoquinase Suas Isoenzimas E Isoformasunclassified

Diretrizes da Sociedade Brasileira de Cardiologia sobre Angina Instável e Infarto Agudo do Miocárdio sem Supradesnível do Segmento ST: PARTE II Condutas nos Pacientes de Risco Intermediário e Alto

Nicolau¹,

César²,

Timerman³

et al. 2001

Arq. Bras. Cardiol.

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Diagnostic Marker Cooperative Study for the Diagnosis of Myocardial Infarction

Abstract: The CK-MB subform assay alone or in combination with a troponin reliably triages patients with chest pain and should lead to improved therapy and reduced cost.

Cited by 257 publications

References 21 publications

Serum Cardiac Troponin I Concentrations in Dogs with Systemic Inflammatory Response Syndrome

Serum Cardiac Troponin I Concentrations in Dogs with Systemic Inflammatory Response Syndrome

Short- and long-term cardiac events in patients with chest pain with or without known existing coronary disease presenting normal electrocardiogram

Diretrizes da Sociedade Brasileira de Cardiologia sobre Angina Instável e Infarto Agudo do Miocárdio sem Supradesnível do Segmento ST: PARTE II Condutas nos Pacientes de Risco Intermediário e Alto

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