High-sensitivity troponin in chronic kidney disease: Considerations in myocardial infarction and beyond

doi:10.31083/j.rcm.2020.02.17

Cited by 26 publications

(15 citation statements)

References 112 publications

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“…Chronic kidney disease is associated with worse outcomes in coronary artery disease, end stage renal disease patients being at high risk for adverse cardiovascular events [ 45 ]. The management of these patients represents one of the most challenging tasks in the setting of a MI, due to atypical presenting symptomatology, higher risk of post-intervention complications and increased bleeding and ischaemic risk [ 46 ]. Moreover, even the diagnosis of coronary disease in these patients represents a challenge, as the majority of patients have elevated hs-cTn values at baseline with a high prevalence which cannot be explained only by the reduced renal clearance [ 47 ].…”

Section: Cardiac Troponins: From Promising To Gold Standardmentioning

confidence: 99%

“…Even though three observational studies that evaluated the diagnostic performance of hs-cTn by comparing the performance of the 0/1-hour ESC algorithms of rapid rule-in and rule-out in patients with and without renal dysfunction using both hs-TnT and hs-TnI showed lower specificity in CKD patients, the sensitivity of the test remained close to 100%, hs-cTnI being able to identify over 90% of MI within 3 hours [ 46 ].…”

Section: Cardiac Troponins: From Promising To Gold Standardmentioning

confidence: 99%

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High-Sensitivity Troponin: A Review on Characteristics, Assessment, and Clinical Implications

Lazar

Homorodean

et al. 2022

Disease Markers

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The use of high-sensitivity cardiac troponin (hs-cTn) assays has become part of the daily practice in most of the laboratories worldwide in the initial evaluation of the typical chest pain. Due to their early surge, the use of hs-cTn may reduce the time needed to recognise myocardial infarctions (MI), which is vital for the patients presenting in the emergency departments for chest pain. The latest European Society of Cardiology Guidelines did not only recognise their central role in the diagnosis algorithm but also recommended their use for rapid rule-in/rule-out of MI. High-sensitivity cardiac troponins are also powerful prognostic markers for long-term events and mortality, not only in a wide spectrum of other cardiovascular diseases (CVD) but also in several non-CVD pathologies. Moreover, these biomarkers became a powerful tool in special populations, such as paediatric patients and, most recently, COVID-19 patients. Although highly investigated, the assessment and interpretation of the hs-cTn changes are still challenging in the patients with basal elevation such as CKD or critically ill patients. Moreover, there are still various analytical characteristics not completely understood, such as circadian or sex variability, with major clinical implications. In this context, the present review focuses on summarizing the most recent research in the current use of hs-cTn, with a main consideration for its role in the diagnosis of MI but also its prognostic value. We have also carefully selected the most important studies regarding the challenges faced by clinicians from different specialties in the correct interpretation of this biomarker. Moreover, future perspectives have been proposed and analysed, as more research and cross-disciplinary collaboration are necessary to improve their performance.

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Section: Cardiac Troponins: From Promising To Gold Standardmentioning

confidence: 99%

Section: Cardiac Troponins: From Promising To Gold Standardmentioning

confidence: 99%

High-Sensitivity Troponin: A Review on Characteristics, Assessment, and Clinical Implications

Lazar

Homorodean

et al. 2022

Disease Markers

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“…Therefore, we did not gather the creatinine and liver enzyme levels. BNP and troponin are usually influenced by renal function, and the remaining indicators are closely related to liver function (42)(43)(44). Unfortunately, the above-mentioned indicators were not selected in the Lasso regression.…”

Section: Risk Factors For Recurrence Factorsmentioning

confidence: 99%

A Simple Logistic Regression Model for Predicting the Likelihood of Recurrence of Atrial Fibrillation Within 1 Year After Initial Radio-Frequency Catheter Ablation Therapy

Jia

Mou

et al. 2022

Front. Cardiovasc. Med.

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BackgroundThe clinical factors associated with the recurrence of atrial fibrillation (Af) in patients undergoing catheter ablation (CA) are still ambiguous to date.Purpose1. To recognize preoperative serologic factors and clinical features associated with Af recurrence after the first ablation treatment. 2. To Develop a Logical Regression Model for Predicting the Likelihood of Recurrence Within 1 Year After the Initial Radio-Frequency Catheter Ablation (RFCA) Therapy.MethodsAtrial fibrillation patients undergoing RFCA at our institution from January 2016 to June 2021 were included in the analysis (n = 246). A combined dataset of relevant parameters was collected from the participants (clinical characteristics, laboratory results, and time to recurrence) (n = 200). We performed the least absolute shrinkage and selection operator (Lasso) regression with 100 cycles, selecting variables present in all 100 cycles to identify factors associated with the first recurrence of atrial fibrillation. A logistic regression model for predicting whether Af would recur within a year was created using 70% of the data as a training set and the remaining data to validate the accuracy. The predictions were assessed using calibration plots, concordance index (C-index), and decision curve analysis.ResultsThe left atrial diameter, albumin, type of Af, whether other arrhythmias were combined, and the duration of Af attack time were associated with Af recurrence in this sample. Some clinically meaningful variables were selected and combined with recognized factors associated with recurrence to construct a logistic regression prediction model for 1-year Af recurrence. The receiver operating characteristic (ROC) curve for this model was 0.8695, and the established prediction model had a C-index of 0.83. The performance was superior to the extreme curve in the decision curve analysis.ConclusionOur study demonstrates that several clinical features and serological markers can predict the recurrence of Af in patients undergoing RFCA. This simple model can play a crucial role in guiding physicians in preoperative evaluation and clinical decision-making.

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“…On the other hand, the elevation of cardiac troponins below this threshold is not considered in the guidelines but may still be clinically significant [ 39 ]. Finally, temporary elevation of cardiac troponins may be a common finding in a wide variety of conditions, including systemic infections [ 42 ], renal failure [ 43 ], cerebrovascular accident or atrial fibrillation [ 44 ], as well as following professional sport activity [ 45 ]. Hence, biomarkers of PMI are still needed.…”

Section: Mirna Utility To Diagnose Type 5 Myocardial Infarctionmentioning

confidence: 99%

Diagnostic and Prognostic Value of miRNAs after Coronary Artery Bypass Grafting: A Review

Błażejowska

Urbanowicz

Olasińska-Wiśniewska

et al. 2021

Biology

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MiRNAs are noncoding, 21–24 nucleotide-long RNA particles that control over 60% of genes. MiRNAs affect gene expression through binding to the 3’-untranslated region of messenger RNA (mRNA), thus inhibiting mRNA translation or inducing mRNA degradation. MiRNAs have been associated with various cardiovascular diseases, including heart failure, hypertension, left ventricular hypertrophy, or ischemic heart disease. In addition, miRNA expression alters during coronary artery bypass grafting (CABG) surgery, which could be used to predict perioperative outcomes. CABG is an operation in which complex coronary arteries stenosis is treated by bypassing atherosclerotic lesions with venous or arterial grafts. Despite a very low perioperative mortality rate and excellent long-term survival, CABG is associated with postoperative complications, including reperfusion injury, graft failure, atrial fibrillation and perioperative myocardial infarction. So far, no reliable diagnostic and prognostic tools to predict prognosis after CABG have been developed. Changes in the perioperative miRNA expression levels could improve the diagnosis of post-CABG myocardial infarction and atrial fibrillation and could be used to stratify risk after CABG. Herein, we describe the expression changes of different subtypes of miRNAs during CABG and review the diagnostic and prognostic utility of miRNAs in patients undergoing CABG.

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High-sensitivity troponin in chronic kidney disease: Considerations in myocardial infarction and beyond

Cited by 26 publications

References 112 publications

High-Sensitivity Troponin: A Review on Characteristics, Assessment, and Clinical Implications

High-Sensitivity Troponin: A Review on Characteristics, Assessment, and Clinical Implications

A Simple Logistic Regression Model for Predicting the Likelihood of Recurrence of Atrial Fibrillation Within 1 Year After Initial Radio-Frequency Catheter Ablation Therapy

Diagnostic and Prognostic Value of miRNAs after Coronary Artery Bypass Grafting: A Review

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