Use of the Centaur TnI-Ultra Assay for Detection of Myocardial Infarction and Adverse Events in Patients Presenting With Symptoms Suggestive of Acute Coronary Syndrome

Apple, Fred S.; Smith, Stephen W.; Pearce, Lesly A.; Ler, Ranka; Murakami, MaryAnn M.

doi:10.1373/clinchem.2007.097162

Cited by 148 publications

(93 citation statements)

References 20 publications

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“…35,37,38 The published 99th percentile limit for the Centaur Troponin I assay is 0.04 mg/L, whereas the corresponding value for the Elecsys Troponin T assay is 0.01 mg/L. 39,40 During the course of this study, both EDs used 0.05 mg/L as the threshold for identifying a positive test. As the goal of this study was to investigate outcomes in patients who were knowingly discharged with positive troponins, this mandated that we also use a threshold of 0.05 mg/L to identify TP patients in both troponin assays.…”

Section: Limitationsmentioning

confidence: 96%

Outcomes of non–acute coronary syndrome patients discharged from the emergency department with troponin positivity

Brunner

Scheuermeyer

Grafstein

et al. 2014

CJEM

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Background: Cardiac troponin elevation portends a worse prognosis in diverse patient populations. The significance of troponin elevation in patients discharged from emergency departments (EDs) without inpatient admission is not well known. Methods: Patients without a diagnosis of acute coronary syndrome discharged from two EDs between April 1, 2006, and December 31, 2007, with an abnormal cardiac troponin (troponin positive [TP]) were compared to a troponin-negative (TN) cohort matched for age, sex, and primary discharge diagnosis. Outcomes were obtained by linking with a regional ED and a provincial vital statistics database and adjusted for the following: estimated glomerular filtration rate, do-notresuscitate status, history of coronary artery disease, Canadian Triage and Acuity Scale, and left ventricular hypertrophy on electrocardiography. The primary outcome was a composite of death or admission to hospital within 1 year. Results: Our total cohort (n 5 344) consisted of 172 TP and 172 TN patients. In the univariate analysis, TP patients had a higher rate of the primary outcome (OR 3.2, 95% CI 2.1-5.0, p , 0.001) and both of its components (p , 0.001). After adjusting for covariates, positive troponin remained an independent predictor of the primary outcome (OR 2.1, 95% CI 1.3-3.4, p 5 0.005) and inpatient admission (OR 2.0, 95% CI 1.2-3.4, p 5 0.006). There was no significant difference in death (OR 1.3, 95% CI 0.6-2.9, p 5 0.5) after adjustment. Conclusions: A positive troponin assay during ED stay in discharged patients is an independent marker for risk of subsequent admission. Our findings suggest that the prognostic power of an abnormal troponin extends to patients discharged from the ED.

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Section: Limitationsmentioning

confidence: 96%

Outcomes of non–acute coronary syndrome patients discharged from the emergency department with troponin positivity

Brunner

Scheuermeyer

Grafstein

et al. 2014

CJEM

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“…For earlier detection of myocardial necrosis, high-sensitivity (hs) assays for cardiac troponin T (cTnT) have been successfully evaluated. Studies have shown that hs assays can detect cardiac troponin concentrations in serum of healthy individuals with the required imprecision (10,11 ). Guidelines recommend the use of the 99th percentile of troponin concentrations from a healthy reference population as a cutoff with a guideline-equitable imprecision of Ͻ10% (CV Ͻ10%) (4,12 ).…”

confidence: 99%

Release Kinetics of Cardiac Biomarkers in Patients Undergoing Transcoronary Ablation of Septal Hypertrophy

et al. 2012

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“…Myocardial injury has been reported to occur in critically ill humans and animals 1, 2, 3, 4, 5, 6, 7. Several noncardiac diseases can lead to secondary myocardial injury, which accentuates the importance of monitoring cardiac function.…”

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confidence: 99%

“…cTnI contributed significantly to the prognostic power of another scoring system for dogs with severe systemic diseases, the physiologic and laboratory evaluation (APPLE) full score in those patients 38. Using immunoassays with high sensitivity for cTnI improved the sensitivity for detection of myocardial injury as compared to older generation cTnI assays 7, 39, 40, 41…”

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confidence: 99%

Serum Cardiac Troponin I Concentrations in Dogs with Systemic Inflammatory Response Syndrome

Hamacher¹,

Dörfelt²,

Müller³

et al. 2015

Veterinary Internal Medicne

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BackgroundMyocardial injury can be detected by cardiac troponin I (cTnI) concentration, which appears to be a predictor of short‐term death in critically ill patients. It is unknown if the best prognostic indicator of short‐term survival is cTnI measurement at admission or at later time points.Hypothesis/ObjectivesMeasuring cTnI with a high‐sensitivity (HS) test at different time points after admission may be a better short‐term prognostic indicator than a single cTnI measurement at admission in dogs with systemic inflammatory response syndrome (SIRS).AnimalsProspective, observational clinical study of 60 dogs with SIRS.MethodsCardiac troponin I concentration was measured in 133 serum samples, collected at days 1, 2, 3, and 5. Additionally, the acute patient physiologic and laboratory evaluation (APPLE) fast score was evaluated at admission. Prognostic capabilities of cTnI measurement and APPLE fast score for 28‐day mortality were assessed by receiver operating characteristic curve analysis.ResultsForty‐one dogs with SIRS that survived 28 days had significantly lower serum cTnI concentrations at admission (median, 0.09 ng/mL; P = .004) and at the peak time point (median, 0.23 ng/mL; P = .01) compared to 19 nonsurvivors (median at admission, 0.63 ng/mL; median at peak, 1.22 ng/mL). Area under the curve to predict survival, using cTnI was similar at admission (0.732) and at peak (0.708), and was 0.754 for the APPLE fast score.Conclusions and Clinical ImportanceIncreased cTnI concentration in dogs with SIRS is associated with poor outcome. Daily follow‐up measurement of cTnI concentration provides no additional prognostic information for short‐term mortality.

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Use of the Centaur TnI-Ultra Assay for Detection of Myocardial Infarction and Adverse Events in Patients Presenting With Symptoms Suggestive of Acute Coronary Syndrome

Abstract: BACKGROUND:We determined the diagnostic accuracy of the Advia Centaur TnI-Ultra assay for detecting myocardial infarction (MI) and assessing risk of adverse events in patients presenting with ischemic symptoms suggestive of acute coronary syndrome.

Cited by 148 publications

References 20 publications

Outcomes of non–acute coronary syndrome patients discharged from the emergency department with troponin positivity

Outcomes of non–acute coronary syndrome patients discharged from the emergency department with troponin positivity

Release Kinetics of Cardiac Biomarkers in Patients Undergoing Transcoronary Ablation of Septal Hypertrophy

Serum Cardiac Troponin I Concentrations in Dogs with Systemic Inflammatory Response Syndrome

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