Troponin elevations in patients with chronic cardiovascular disease: An analysis of current evidence and significance

Martin, Archer Kilbourne; Malhotra, Anita K.; Sullivan, Breandan; Ramakrishna, Harish

doi:10.4103/0971-9784.179638

Cited by 8 publications

(3 citation statements)

References 53 publications

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“…The prevalence of the targeted disease was directly associated with the NPV specifically population under consideration, which represents a probability of negative test outcome. It becomes essential for establishing the NPV for every health facility in order that a negative test can be interpreted by an attending physician [24]. Strengths and Limitations: Despite the small sample size, this retrospective observational study has important strengths including post-operative factors such as incidence of arrhythmias, type of arrhythmias, examination of the interaction of cTnI and CPB levels with arrhythmias.…”

Section: Discussionmentioning

confidence: 99%

Correlation of Cardiopulmonary Bypasses and Cardiac Troponin I in Predicting Post-Op Arrhythmia

Qasim¹,

Sharfi²,

Fajar³

et al. 2023

PJMHS

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Aim: The correlation of cardiopulmonary bypasses (CPB) and cardiac troponin I (cTnI) in predicting arrhythmia remain unclear. Aim of this study to investigate the correlation of cardiopulmonary bypasses duration and cardiac troponin I with the type of arrhythmias. Methods: This is a retrospective observational study took place in our hospital between May 2020-December 2021.The study included a total of thirty-three patients who underwent open-heart surgery. Patients between the age of 2 months and 14 years of both genders with the diagnosis of ventricular septal defect (VSD), atrioventricular defect (AVSD) and tetralogy of Fallot (TOF) were included in this study. Patients with preoperative a history of major intraoperative events and high-level of cardiac troponin I were excluded from the study. The accuracy was calculated using sensitivity and specificity. The area under the ROC curve (95% CI) and p-value were also calculated. Results: Out of thirty-three patients undergoing open-heart surgery, 58.1% were male and were one year of age or more (71%). A statistically significant correlation among arrhythmia, cardiac troponin I and cardiopulmonary bypasses was observed (p < 0.05). Cardiac troponin I predicted high-level sensitivity for arrhythmias, hospital stay, and intensive care unit stay, while low specificity was reported for cardiac troponin I compared to cardiopulmonary bypasses. Conclusion: The higher level of cardiac troponin I was correlated with the underlying burden of arrhythmias. A novel high- sensitivity cardiac troponin I assay can protectively recognize patients at low risk of arrhythmias. Keywords: Arrhythmia, Cardiac troponin I, Cardiopulmonary bypass, Sensitivity, Specificity

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Section: Discussionmentioning

confidence: 99%

Correlation of Cardiopulmonary Bypasses and Cardiac Troponin I in Predicting Post-Op Arrhythmia

Qasim¹,

Sharfi²,

Fajar³

et al. 2023

PJMHS

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“…Lactate was the second best diagnostic discriminator of myocardial injury with an optimal “cutoff” value of >2 mmol/L at immediately after aortic declamping (AUC, 0.89 [±SE 0.04, 95% CI: 0.80–0.96]; sensitivity 83.33%; specificity 80%; likelihood ratio (+) 4.16) [ Figure 8 ]. [ 29 30 31 ] cTn-I was the third best diagnostic discriminator of myocardial injury with an optimal “cutoff” value of > 2.1 ng/mL at immediately after aortic declamping (AUC, 0.88 [±SE 0.04, 95% CI: 0.80–0.95]; sensitivity 81.25%; specificity 80%; likelihood ratio (+) 4.06) [ Figure 8 ]. CK-MB was the fourth best diagnostic discriminator of myocardial injury with an optimal “cutoff” value of > 58 log units/mL after coming off bypass before decannulation (AUC, 0.85 [±SE 0.05, 95% CI: 0.78–0.94]; sensitivity 77.08%; specificity 80%; likelihood ratio (+) 3.85) [ Table 4 and Figure 8 ].…”

Section: Discussionmentioning

confidence: 99%

Short-term prognostic value of perioperative coronary sinus-derived-serum cardiac troponin-I, creatine kinase-MB, lactate, pyruvate, and lactate-pyruvate ratio in adult patients undergoing open heart surgery

et al. 2016

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Objectives:To investigate the release pattern of different cardiac metabolites and biomarkers directly from the coronary sinus (CS) and to establish the diagnostic discrimination limits of each marker protein and metabolites to evaluate perioperative myocardial injury in patients undergoing cardiac surgery under cardiopulmonary bypass (CPB).Patients and Methods:Sixty-eight patients undergoing first mitral and/or aortic valve replacements with/without coronary artery bypass grafting and Bentall procedure under CPB and blood cardioplegic arrest were studied. All cardiac metabolites and biomarkers were measured in serial CS-derived blood samples at pre-CPB, immediate post aortic declamping, 10 minutes post-CPB and 12 hrs post-CPB.Results:Receiver operating characteristic curve analysis of cardiac biomarkers indicated lactate-pyruvate ratio as the superior diagnostic discriminator of myocardial injury with an optimal “cut-off” value >10.8 immediately after aortic declamping (AUC, 0.92; 95% CI: 0.85-0.98). Lactate was the second best diagnostic discriminator of myocardial injury with an optimal “cut-off” value >2mmol/l at immediately after aortic declamping (AUC, 0.89; 95% CI: 0.80-0.96). Cardiac troponin-I was the third best diagnostic discriminator of myocardial injury with an optimal “cut-off” value >2.1ng/ml at immediately after aortic declamping (AUC, 0.88; 95% CI: 0.80-0.95). Creatine kinase-MB was the fourth best diagnostic discriminator of myocardial injury with an optimal “cut-off” value >58 log units/ml prior to decanulation (AUC, 0.85; 95% CI: 0.78-0.94).Conclusions:Measurable cardiac damage exists in all patients undergoing cardiac surgery under cardioplegic arrest. The degree of myocardial injury is more in patients with poor ventricular function and those requiring longer aortic clamp time. CS-derived lactate-pyruvate ratio, lactate, cTn-I served as superior diagnostic discriminators of peri-operative myocardial damage.

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“…1,2,5 Similarly, early detection of raised troponin level in blood can help in diagnosis and treatment of myocardial infarction. [22][23][24] We can adapt our technique for other rare analytes by replacing biotin with another binding antibody for the respective target analytes. target particles present within a complex mixture by either attracting or repelling these target particles from the electrodes.…”

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confidence: 99%

Negative dielectrophoresis spectroscopy for rare analyte quantification in biological samples

et al. 2017

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We propose the use of negative dielectrophoresis (DEP) spectroscopy as a technique to improve the detection limit of rare analytes in biological samples. We observe a significant dependence of the negative DEP force on functionalized polystyrene beads at the edges of interdigitated electrodes with respect to the frequency of the electric field. We measured this velocity of repulsion for 0% and 0.8% conjugation of avidin with biotin functionalized polystyrene beads with our automated software through real-time image processing that monitors the Rayleigh scattering from the beads. A significant difference in the velocity of the beads was observed in the presence of as little as 80 molecules of avidin per biotin functionalized bead. This technology can be applied in the detection and quantification of rare analytes that can be useful in the diagnosis and the treatment of diseases, such as cancer and myocardial infarction, with the use of polystyrene beads functionalized with antibodies for the target biomarkers.

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Troponin elevations in patients with chronic cardiovascular disease: An analysis of current evidence and significance

Cited by 8 publications

References 53 publications

Correlation of Cardiopulmonary Bypasses and Cardiac Troponin I in Predicting Post-Op Arrhythmia

Correlation of Cardiopulmonary Bypasses and Cardiac Troponin I in Predicting Post-Op Arrhythmia

Short-term prognostic value of perioperative coronary sinus-derived-serum cardiac troponin-I, creatine kinase-MB, lactate, pyruvate, and lactate-pyruvate ratio in adult patients undergoing open heart surgery

Negative dielectrophoresis spectroscopy for rare analyte quantification in biological samples

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