One-hour rule-in and rule-out of acute myocardial infarction using high-sensitivity cardiac troponin I

Jaeger, Cédric; Wildi, Karin; Twerenbold, Raphael; Reichlin, Tobias; Giménez, María Rubini; Neuhaus, Jean-Daniel; Grimm, Karin; Boeddinghaus, Jasper; Hillinger, Petra; Nestelberger, Thomas; Singeisen, Hélène; Gugala, Mathias; Prêtre, Gil; Puelacher, Christian; Wagener, Max; Honegger, Ursina; Schumacher, Carmela; Weidmann, Zoraida Moreno; Kreutzinger, Philipp; Krivoshei, Lian; Freese, Michael; Stelzig, Claudia; Dietsche, Sebastian; Ernst, Susanne; Rentsch, Katharina; Oßwald, Stefan

doi:10.1016/j.ahj.2015.07.022

Cited by 104 publications

(84 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Meanwhile, the discriminating power of the two miRNAs was significantly lower than troponin T (cTnT) [area under the operating receiver curve (AUC): cTNT 0.95; miR-208b 0.82; miR-499-5p 0.79] [22]. Despite the continuous improvement of troponin assays and the introduction of high sensitive troponins, there is still a considerable percentage of false positive results [84]. In this respect, miRNAs might help to improve the diagnostic accuracy of blood-based biomarkers in AMI.…”

Section: Diagnostic Biomarkers Single Mirnas In the Diagnosis Of Acutmentioning

confidence: 99%

microRNAs in cardiovascular disease – clinical application

Schulte

Karakas

Zeller

2017

Clinical Chemistry and Laboratory Medicine (CCLM)

104

View full text Add to dashboard Cite

microRNAs (miRNAs) are well-known, powerful regulators of gene expression, and their potential to serve as circulating biomarkers is widely accepted. In cardiovascular disease (CVD), numerous studies have suggested miRNAs as strong circulating biomarkers with high diagnostic as well as prognostic power. In coronary artery disease (CAD) and heart failure (HF), miRNAs have been suggested as reliable biomarkers matching up to established protein-based such as cardiac troponins (cT) or natriuretic peptides. Also, in other CVD entities, miRNAs were identified as surprisingly specific biomarkers -with great potential for clinical applicability, especially in those entities that lack specific protein-based biomarkers such as atrial fibrillation (AF) and acute pulmonary embolism (APE). In this regard, miRNA signatures, comprising a set of miRNAs, yield high sensitivity and specificity. Attempts to utilize miRNAs as therapeutic agents have led to promising results. In this article, we review the clinical applicability of circulating miRNAs in CVD. We are giving an overview of miRNAs as biomarkers in numerous CVD entities to depict the variety of their potential clinical deployment. We illustrate the function of miRNAs by means of single miRNA examples in CVD.

show abstract

Section: Diagnostic Biomarkers Single Mirnas In the Diagnosis Of Acutmentioning

confidence: 99%

microRNAs in cardiovascular disease – clinical application

Schulte

Karakas

Zeller

2017

Clinical Chemistry and Laboratory Medicine (CCLM)

104

View full text Add to dashboard Cite

show abstract

“…Finally, recommending the use of an hsTn before being commercially available (i.e. Dimension Vista) [30], with the evidence based on just one paper authored by some extensors of the ESC guidelines [37], is not fair and scientifically sound [38,39]. In agreement with the validity of available data, the limitations of fast track protocols, in particular of the 0-1 h algorithm for NSTEMI rule-in, call for caution.…”

Section: Discussionmentioning

confidence: 96%

Fast track protocols using highly sensitive troponin assays for ruling out and ruling in non-ST elevation acute coronary syndrome

Ferraro

Dolci²,

Panteghini³

2017

Clinical Chemistry and Laboratory Medicine (CCLM)

View full text Add to dashboard Cite

Abstract:The introduction of "highly sensitive" cardiac troponin assays (hsTn) has reinforced the evidence that only serial testing incorporated in running algorithms allows a more accurate diagnosis of acute myocardial infarction. In this report, we consider the available evidence supporting the use of fast track protocols for ruling out and ruling in non-ST elevation myocardial infarction (NSTEMI) and compare it with the content of recently released guideline by the European Society of Cardiology, noting some uncomfortable aspects that need urgent clarification and/or revision. Firstly, the guideline drafters have to reconsider the available evidence that does not permit to assign the same class and level of evidence to the very well-validated 0-3 h algorithm and to the 0-1 h algorithm. In agreement with the validity of available data, the limitations of fast track protocols, in particular of the 0-1 h algorithm for NSTEMI rule-in, calls for caution. Secondly, as the current diagnostics guidance by the UK National Institute for Health and Care Excellence recommends, rapid diagnostic protocols should be performed only using well-validated hsTn; recommending the use of an assay before being commercially available is not fair and scientifically sound.

show abstract

“…The problem became one of whether the increase is indicative of AMI, or of acute or chronic CHF, or of renal failure. A type I diagnosis was consistent with acute coronary occlusion and/or plaque rupture (Haider et al, ; Jaeger et al, ; Filippatos, Nieminen, & Gheorghiade, ; Thygesen et al, ).…”

Section: The Unfolded Protein Response Under Oxidative Stressmentioning

confidence: 98%

What role does the stress response have in congestive heart failure?

Badreddin

Youssef

Attia

et al. 2017

Journal Cellular Physiology

View full text Add to dashboard Cite

This review is concerned with cardiac malfunction as a result of an imbalance in protein proteostasis, the homeostatic balance between protein removal and regeneration in a long remodeling process involving the endoplasmic reticulum (ER) and the unfolded protein response (UPR). The importance of this is of special significance with regard to cardiac function as a high energy requiring muscular organ that has a high oxygen requirement and is highly dependent on mitochondria. The importance of mitochondria is not only concerned with high energy dependence on mitochondrial electron transport, but it also has a role in the signaling between the mitochondria and the ER under stress. Proteins made in the ER are folded as a result of sulfhydryl groups (-SH) and attractive and repulsive reactions in the tertiary structure. We discuss how this matters with respect to an imbalance between muscle breakdown and repair in a stressful environment, especially as a result of oxidative and nitrosative byproducts of mitochondrial activity. The normal repair is a remodeling, but under this circumstance, the cell undergoes or even lysosomal "self eating" autophagy, or even necrosis instead of apoptosis. We shall discuss the relationship of the UPR pathway to chronic congestive heart failure (CHF).

show abstract

One-hour rule-in and rule-out of acute myocardial infarction using high-sensitivity cardiac troponin I

Cited by 104 publications

References 45 publications

microRNAs in cardiovascular disease – clinical application

microRNAs in cardiovascular disease – clinical application

Fast track protocols using highly sensitive troponin assays for ruling out and ruling in non-ST elevation acute coronary syndrome

What role does the stress response have in congestive heart failure?

Contact Info

Product

Resources

About