An evaluation of the quantitative analysis of troponin T (a new marker of coronary disease) was carried out in the 150 patients of cardiovascular department of Hautepierre Hospital, Strasbourg Medical University, France from January to August 1998. The results have shown that the value of troponin T was much higher than this of creatinine Kinase (CK) and CK- MB in the diagnosis of acute myocardial infarction. The possitive predict value was 90% and the negative predicts value was less than 50%.
Coronary Disease ; Troponin T

Humans ; Troponin I

No abstract available.
C-Reactive Protein* ; Emergencies* ; Emergency Service, Hospital* ; Troponin T* ; Troponin*

No abstract available.
C-Reactive Protein* ; Emergencies* ; Emergency Service, Hospital* ; Troponin T* ; Troponin*

BACKGROUND: The prognostic utility of cardiac biomarkers, high-sensitivity cardiac troponin I (hs-cTnI) and soluble suppression of tumorigenicity-2 (sST2), in non-cardiac surgery is not well-defined. We evaluated hs-cTnI and sST2 as predictors of 30-day major adverse cardiac events (MACE) in patients admitted to the surgical intensive care unit (SICU) following major non-cardiac surgery. METHODS: hs-cTnI and sST2 concentrations were measured in 175 SICU patients immediately following surgery and for three days postoperatively. The results were analyzed in relation to 30-day MACE and were compared with the revised Goldman cardiac risk index (RCRI) score. RESULTS: Overall, 30-day MACE was observed in 16 (9.1%) patients. hs-cTnI and sST2 concentrations differed significantly between the two groups with and without 30-day MACE (P < 0.05). The maximum concentration of sST2 was an independent predictor of 30-day MACE (odds ratio=1.016, P=0.008). The optimal cut-off values of hs-cTnI and sST2 for predicting 30-day MACE were 53.0 ng/L and 182.5 ng/mL, respectively. A combination of hs-cTnI and sST2 predicted 30-day MACE better than the RCRI score. Moreover, 30-day MACE was observed more frequently with increasing numbers of above-optimal cut-off hs-cTnI and sST2 values (P < 0.0001). Reclassification analyses indicated that the addition of biomarkers to RCRI scores improved the prediction of 30-day MACE. CONCLUSIONS: This study demonstrates the utility of hs-cTnI and sST2 in predicting 30-day MACE following non-cardiac surgery. Cardiac biomarkers would provide enhanced risk stratification in addition to clinical RCRI scores for patients undergoing major non-cardiac surgery.
Biomarkers ; Critical Care* ; Humans ; Prognosis ; Troponin I* ; Troponin*

Humans ; Myocardium ; chemistry ; Sensitivity and Specificity ; Troponin ; analysis

This paper introduces the troponin, a new gold standard for diagnosis of myocardial infarction and role of troponin in other diseases. The authors introduced also some new standards for diagnosis of the myocardial infarction such as cut-off value, isoenzyme CK-MB, GOT, myoglobin and LDH
Troponin ; Cardiomyopathies ; Infarction ; diagnosis ; Myocardial Infarction

BACKGROUND: More than 90% of acute stroke patients have measurable cardiovascular sequelae, but we have been often overlooked in formal discussions of treatment. If we estimate the incidence of myocardial injury in patient with spontaneous SAH, we may figure the possibility of cardiac dysfunction in such patients. This study was designed to investigate the incidence of myocardial injury in patients with spontaneous SAH using cardiac troponin I(cTnI). METHODS: A prospective single emergency center study was performed to determined preoperative incidence of unrecognized cardiac injury in patients suffering spontaneous SAH. We include the spontaneous SAH patients who underwent serum measurements of the cardic troponin I immediately upon admission last six month period. ECG, CK, CK-MB and myoglobin were also performed at admission. We excluded the spontaneous SAH patients who had past history of myocardial ischemia and ECG abnormality. RESULTS: Fifty-two patients(34 females, 18 males) with spontaneous SAH were studied prospectively. 18 patients(34.6% of the total study population) had cTnI level above 0.5ng/ml. ECG was performed in 52 patients and was abnormal in 15 of the 52 patients(28.8%). CONCLUSION: The measurement of cTnI has provided physicians with a myocardial marker that has a cardiac sensitivity for cardiac injury equal to that of CK-MB yet with greater specificity. So, cardiac troponin I is useful to estimate the incidence of myocardial injury in patients with spontaneous SAH. And we may estimate the possibility of cardiac dysfunction in such patients. This knowledge will hopefully aid in the care and improve the outcome.
Electrocardiography ; Emergencies ; Female ; Humans ; Incidence* ; Myocardial Ischemia ; Myoglobin ; Prospective Studies ; Sensitivity and Specificity ; Stroke ; Troponin I* ; Troponin*

PURPOSE: This study was designed to evaluate diagnostic accuracy of serial electrocardiograms(ECG), myocardial band of creatinine phosphokinase(CK)(CK-MB/CK ratio) and two dimensional echocardiography(ECHO) for myocardial injury in patients with blunt chest trauma. METHODS: We prospectively investigated 54 patients(male : 38, female : 16, mean age : 41) with severe blunt chest trauma. Presence of myocardial injury was determined by increase(>0.1ug/L) of peak serum troponin T(TnT) concentration from serial mesurements. RESULTS: Among 54 patients with blunt chest trauma, 23 patients(43%) had increased peak TnT level which suggested of myocardial injury. Among 23 patients with increased TnT, abnormal ECG findings were found in 18(78%) and echocardiographic abnormalities were observed in 17(74%). Cardiovascular events in 9(39%) of 23 patients with increase Tnt. There was no cardiovascular events in patients with normal TnT. CONCLUSION: Significant proprotion of patients with blunt chest trauma had elevated TnT value which suggested of myocardial injury. We recommend echocardiagraphy and serial tracing of ECG to verify the clinical significance of elevated TnT in patients with blunt chest trauma.
Creatinine ; Diagnosis* ; Echocardiography ; Electrocardiography ; Female ; Humans ; Prospective Studies ; Thorax* ; Trinitrotoluene ; Troponin ; Troponin T

BACKGROUND AND OBJECTIVES: Small myocardial infarction (MI) has been reported in 8 - 20% of patients undergoing percutaneous transluminal coronary angioplasty (PTCA). But neither appropriate threshold of cardiac enzyme nor useful biochemical marker for its detection has not yet been fully defined. We examined the cardiac enzyme to define more valuable biochemical marker for the detection of small MI after PTCA and to evaluate factors associated with small MI after PTCA. MATERIALS AND METHODS: This study population consisted of 209 consecutive patients who underwent PTCA. Cardiac enzyme levels were measured before and 8, 24 hours after PTCA for CK-MB, and before and 16 hours after PTCA for troponin T. We defined small MI when CK-MB levels were over 16U/L and/or troponin T levels were over 0.2 ng/ml. RESULTS: Incidence of small MI after PTCA was 28/209 (13.4%) and the most of those were non-Q MI (24/28, 86%). In the detection of small MI after PTCA, the sensitivity of troponin T was higher than CK-MB (92.9% vs 39.3%). Major complications (major dissection, acute coronary occlusion, and side branch occlusion) developed significantly more in patients with small MI than in patients without small MI (p=0.002). Three independent variables, which were significantly associated with small MI after PTCA, were age, total/subtotal occlusion, and acute coronary occlusion as complication (p=0.01, p=0.02, and p=0.04, respectively). CONCLUSIONS: Troponin T is more sensitive biochemical marker than CK-MB in the detection of small MI after PTCA. Major complications of angioplasty are frequently associated with small MI. Especially, age, total occlusion, and acute coronary occlusion as complication are independent factors significantly associated with small MI after PTCA.
Angioplasty ; Angioplasty, Balloon, Coronary* ; Biomarkers ; Coronary Occlusion ; Humans ; Incidence ; Myocardial Infarction ; Troponin T* ; Troponin*