Evaluation of a Rapid Bedside Assay for Detection of Serum Cardiac Troponin T

Antman, Elliott M.; Grudzien, Christine; Sacks, David B.

doi:10.1001/jama.1995.03520400049043

Cited by 125 publications

(29 citation statements)

References 16 publications

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“…Cardiac TnT determination was carried out with the second-generation cThT assay which has been found to be highly cardiospecific. In the control group, the level of serum cTnT was insignificant and undetectable which is comparable to the study by Katus et al (18) and Antman et al (19). Mair et aL (20) found that the serum cTnT was high in both non-'Q' wave and 'Q' wave infarctions, which is similar to our study.…”

Section: Resultssupporting

confidence: 91%

Serum markers for early diagnosis of non-‘Q’ wave and ‘Q’ wave myocardial infarction

Singh

Uthappa

Govindaraju

et al. 2002

Indian J Clin Biochem

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The present study conducted on twenty-five uncomplicated cases of acute myocardial infarction diagnosed by clinical and electrocardiographic findings indicated significantly increased level of cardiac Troponin-T and increased activities of the enzymes total creatine kinase, creatine kinase-MB, aspartate transaminase and lactate dehydrogenase as compared to the twenty-five healthy control subjects. The level of cardiac Troponin-T and the activities of the enzymes total creatine kinase, creatine kinase-MB, aspartate transaminase and lactate dehydrogenase was found to be higher in "Q" wave myocardial infarction patients as compared to the non-"Q" wave and the controls. Since cardiac Troponin-T has been shown to increase in unstable angina and renal failure without cardiac disease and creatine kinase-MB activity has been found to be normal in patients with unstable angina and increase very slightly in patients with renal failure, it was concluded that a combination of cardiac Troponin-T and creatine kinase-MB activity was sufficient for the early diagnosis of acute myocardial infarction.

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Section: Resultssupporting

confidence: 91%

Serum markers for early diagnosis of non-‘Q’ wave and ‘Q’ wave myocardial infarction

Singh

Uthappa

Govindaraju

et al. 2002

Indian J Clin Biochem

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“…In other areas of medicine, likelihood ratios greater than 5 are generally a prerequisite for the adoption of a clinical test or procedure. By way of comparison, the positive likelihood ratio for mammography is 14 (Kerlikowske et al, 1995), for bedside cardiac-specific troponin T 6.3 (Antman et al, 1995) and for ultrasonography for deep venous thrombosis 47.8 (Wells et al, 2000). The separate BRCA1/2 performance measures for Manchester, BRCAPRO and Penn displayed similar trends to the combined values, with the only exception being the use of Penn for assessment of BRCA2 risk, where the positive likelihood ratio was 5.9.…”

Section: Discussionmentioning

confidence: 92%

Evaluation of models to predict BRCA germline mutations

et al. 2006

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The selection of candidates for BRCA germline mutation testing is an important clinical issue yet it remains a significant challenge. A number of risk prediction models have been developed to assist in pretest counselling. We have evaluated the performance and the inter-rater reliability of four of these models (BRCAPRO, Manchester, Penn and the Myriad-Frank). The four risk assessment models were applied to 380 pedigrees of families who had undergone BRCA1/2 mutation analysis. Sensitivity, specificity, positive and negative predictive values, likelihood ratios and area under the receiver operator characteristic (ROC) curve were calculated for each model. Using a greater than 10% probability threshold, the likelihood that a BRCA test result was positive in a mutation carrier compared to the likelihood that the same result would be expected in an individual without a BRCA mutation was 2.10 (95% confidence interval (CI) 1.66 -2.67) for Penn, 1.74 (95% CI 1.48 -2.04) for Myriad, 1.35 (95% CI 1.19 -1.53) for Manchester and 1.68 (95% CI 1.39 -2.03) for BRCAPRO. Application of these models, therefore, did not rule in BRCA mutation carrier status. Similar trends were observed for separate BRCA1/2 performance measures except BRCA2 assessment in the Penn model where the positive likelihood ratio was 5.93. The area under the ROC curve for each model was close to 0.75. In conclusion, the four models had very little impact on the pre-test probability of disease; there were significant clinical barriers to using some models and risk estimates varied between experts. Use of models for predicting BRCA mutation status is not currently justified for populations such as that evaluated in the current study.

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“…Troponin, however, offers far more than just improved diagnostic sensitivity and specificity. Several groups have demonstrated a powerful relationship between the increase in troponin and the risk of mortality in patients presenting with a non-ST-elevation acute coronary syndrome (NSTEACS), i.e., without classical changes on the electrocardiogram consistent with an acute injury pattern (2 ). New high-sensitivity assays have been developed that have lower limits of detection below the 99th percentile in a healthy reference population.…”

confidence: 99%

Integration of Proteomic-Based Tools for Improved Biomarkers of Myocardial Injury

2010

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BACKGROUND:Given the mounting evidence in favor of early pharmacologic and catheter-based interventions for patients across the spectrum of acute coronary syndromes, discovering novel diagnostically sensitive and specific biomarkers that provide biochemical proof of early or reversible myocardial injury could have a substantial positive impact on patient care. CONTENT:To address unmet needs in disease biomarkers, investigators have turned to proteomics approaches. We describe advances in proteomics discovery technologies based on liquid chromatographytandem mass spectrometry that facilitate the unbiased analysis of low-abundance blood proteins. We detail the development of emerging techniques to enhance the biomarker verification process, such as accurate inclusion mass screening, stable isotope dilutionmultiple reaction monitoring-mass spectrometry (SID-MRM-MS), and stable isotope standards with capture by antipeptide antibodies, which combines the advantages of specific immunoaffinity enrichment of a target peptide with the structural specificity and quantitative capabilities of SID-MRM-MS. We highlight new assays incorporating these techniques for troponin I, a representative low-abundance cardiac biomarker, and interleukin-33, an emerging novel marker of myocardial stress for which no existing ELISA exists. We demonstrate that troponin I and interleukin-33 peptides have a linear, dynamic range spanning 4 orders of magnitude and limits of detection of approximately 0.5 g/L back-calculated to the protein concentration.

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Evaluation of a Rapid Bedside Assay for Detection of Serum Cardiac Troponin T

Abstract: The rapid cTnT assay is a simple, efficient test that for the first time provides clinicians with a useful laboratory tool for point-of-care evaluation of patients with chest pain.

Cited by 125 publications

References 16 publications

Serum markers for early diagnosis of non-‘Q’ wave and ‘Q’ wave myocardial infarction

Serum markers for early diagnosis of non-‘Q’ wave and ‘Q’ wave myocardial infarction

Evaluation of models to predict BRCA germline mutations

Integration of Proteomic-Based Tools for Improved Biomarkers of Myocardial Injury

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