Rates of Echocardiography, Coronary Angiography, and Coronary Intervention Associated With Troponin Testing in Hospitalized Patients

Wilson, Gibbs; Kurian, Kevin; Zamin, Syed A.; Urbanczyk, Jonathan; Haneke, Travis; Simonsen, Cameron; Mehta, S.; Suresh, Mitta; Michel, Jeffrey B.

doi:10.1016/j.amjcard.2018.02.009

Cited by 5 publications

(4 citation statements)

References 13 publications

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“…Coronary atherosclerosis is the primary cause of AMI. Studies have shown that coronary atherosclerosis can result in narrowing of the lumen of one or more coronary arteries and myocardial insufficiency [ 12 ]. On the basis of insufficient collateral circulation, fatigue, emotional excitement, stress response, and other inducements will lead to the rupture of unstable atherosclerotic plaques, the formation of lumen thrombosis, and the rupture of lumen.…”

Section: Discussionmentioning

confidence: 99%

Clinical Study on Characteristics and Risk Factors of Coronary Artery Lesions in Young Patients with Acute Myocardial Infarction

Liu

Zhang

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Epidemiological evidence suggests that the incidence of acute myocardial infarction (AMI) among people under 40 years of age has an increasing trend in recent years. Smoking, hypertension, diabetes mellitus, family history, and gender (male) are considered as classic risk factors for CHD, but the pathogenesis of CHD in young people is not exactly the same. Moreover, the relationship between the pattern of coronary artery disease and risk factors in young patients with acute myocardial infarction is inconclusive. In this study, we retrospectively studied the clinical data of 150 AMI patients treated in our hospital from January 2020 to May 2021. The patients were divided into the young group and elderly group according to the difference in age. The number of coronary artery lesions, the degree of coronary artery stenosis, the distribution dominance typing, the position of the lesions, and the presence of collateral circulation were observed and compared between the two groups. Multivariate logistic regression analysis was used to investigate the risk factors affecting coronary artery lesions in young patients with AMI. The results showed that the number of coronary lesions in young patients with AMI was mainly single-vessel, and the dominant type of distribution was mainly right dominant type. The stenosis degree is lighter than that of elderly patients, and the incidence of collateral circulation is lower than that of elderly patients, but the position of the lesions has no obvious regular. Smoking, staying up late, HDL-C, and LDL-C/ApoB were independent factors affecting the number of coronary artery lesions, and the changes of HDL-C and LDL-C/ApoB had an important influence on the degree of coronary stenosis in young patients. This provides a new idea for clinical treatment.

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Section: Discussionmentioning

confidence: 99%

Clinical Study on Characteristics and Risk Factors of Coronary Artery Lesions in Young Patients with Acute Myocardial Infarction

Liu

Zhang

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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“…Several studies have investigated resource utilization in different settings, e.g., the ED or chest-pain unit, before and after introduction of high-sensitivity troponin testing, giving rather ambiguous results: some of the studies showed increased use [33][34][35][36][37], while others reported unchanged rates of coronary angiography and revascularization [32,[38][39][40]. Our results show no significant change in resource utilization and revascularization in the entirety of patients, but document decreased use of invasive imaging in the subgroup of individuals with highest probability of AMI diagnosis.…”

Section: Resource Utilizationmentioning

confidence: 99%

High-Sensitivity Troponin T Testing: Consequences on Daily Clinical Practice and Effects on Diagnosis of Myocardial Infarction

Zachoval

Dolscheid‐Pommerich

Graeff

et al. 2020

JCM

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It remains unclear how introduction of high-sensitivity troponin T testing, as opposed to conventional troponin testing, has affected the diagnosis of acute myocardial infarction (AMI) and resource utilization in unselected hospitalized patients. In this retrospective analysis, we include all consecutive cases from our center during two corresponding time frames (10/2016–04/2017 and 10/2017–04/2018) for which different troponin tests were performed: conventional troponin I (cTnI) and high-sensitivity troponin T (hs-TnT) assays. Testing was performed in 18,025 cases. The incidence of troponin levels above the 99th percentile was significantly higher in cases tested using hs-TnT. This was not associated with increased utilization of echocardiography, coronary angiography, or percutaneous coronary intervention. Although there were no changes in local standard operating procedures, study site personnel, or national coding guidelines, the number of coded AMI significantly decreased after introduction of hs-TnT. In this single-center retrospective study comprising 18,025 mixed medical and surgical cases with troponin testing, the introduction of hs-TnT was not associated with changes in resource utilization among the general cohort, but instead, led to a decrease in the international classification of diseases (ICD)-10 coded diagnosis of AMI.

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“…Elevated troponin I may complicate cardiac catheterization in patients with sepsis. Many patients with a primary diagnosis of sepsis receive troponin testing [ 4 ] and have a higher rate of catheterization [ 5 ]. There are several ways in which sepsis can complicate AMI diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Troponin I Cutoff for Non-ST-Segment Elevation Myocardial Infarction in Sepsis

Tsai

Lai

Hung

et al. 2022

Mediators of Inflammation

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The diagnostic value and optimal cutoff level of cardiac troponin I in patients with sepsis have not been studied. In this single hospital retrospective study, we assessed the optimal cutoff value of troponin I for diagnosing non-ST-segment elevation myocardial infarction (NSTEMI) with type 1 myocardial infarction (MI) in patients with sepsis who had undergone a percutaneous coronary intervention from 2009 to 2019. In total, 5,341 patients (excluding patients with chronic kidney disease) were included, of whom 277 had sepsis or septic shock. Of the 123 patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and sepsis, 77 (62.6%) were diagnosed with NSTEMI with type 1 MI. The receiver-operating characteristic curve showed an area under the curve (AUC) of 0.705 for diagnosis of NSTEMI with type 1 MI with a troponin I cutoff of >300 ng/L (sensitivity: 68.4%, specificity: 70.2%, Youden index: 0.386). Multiple linear regression showed no significant predictors of NSTEMI with type 1 MI. Troponin level and the Global Registry of Acute Coronary Events (GRACE) scores were correlated ( R 2 = 0.0625 , p = 0.032 ) and showed comparable predictive value for 6-month mortality (AUC: 0.637 and 0.611, respectively, p = 0.7651 ). The optimal troponin I cutoff to effectively diagnose NSTEMI with type 1 MI in patients with sepsis was 300 ng/L.

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Rates of Echocardiography, Coronary Angiography, and Coronary Intervention Associated With Troponin Testing in Hospitalized Patients

Cited by 5 publications

References 13 publications

Clinical Study on Characteristics and Risk Factors of Coronary Artery Lesions in Young Patients with Acute Myocardial Infarction

Clinical Study on Characteristics and Risk Factors of Coronary Artery Lesions in Young Patients with Acute Myocardial Infarction

High-Sensitivity Troponin T Testing: Consequences on Daily Clinical Practice and Effects on Diagnosis of Myocardial Infarction

Troponin I Cutoff for Non-ST-Segment Elevation Myocardial Infarction in Sepsis

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