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*

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

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

PURPOSE: Cardiac troponin I (cTnI) is a highly sensitive and specific marker for myocardial injury, and is used to predict the outcomes in patients with acute coronary syndromes. Cardiovascular complications are the leading cause of morbidity and mortality in patients who underwent vascular surgical procedures. The aim of the study was to evaluate the association between the postoperative cTnI levels and a perioperative myocardial injury (MI) within 6 months after the vascular surgical procedures. METHODS: Eighty patients who underwent vascular surgery including an arterial bypass, amputation and a thrombectomy were included in this study. The blood samples were analyzed for cTnI immediately after surgery and 1, 2, and 3 days after surgery. RESULTS: An elevated cTnI was defined as a serum concentrations > 0.4 ng/ml in any of 4 samples. Seven patients (8.7%) had postoperative cTnI levels of > 0.4 ng/ml, which was associated with a higher risk of a postoperative cardiac event (P< 0.001) and 6 month mortality (P< 0.001). However, only 2 out of the 75 patients (91.3%) who had postoperative cTnI levels of < 0.4 ng/ml developed postoperative MI. CONCLUSION: A serum cTnI level > or =0.4 ng/ml may indicate myocardial damage after vascular surgical procedures. Therefore, the routine postoperative measurement of cTnI might be a useful predictive value of the postoperative cardiac events after vascular surgical procedures.
Acute Coronary Syndrome ; Amputation ; Humans ; Mortality ; Thrombectomy ; Troponin I* ; Troponin* ; Vascular Surgical Procedures*

PURPOSE: TURP(transurethral resection of prostate) is the standard surgical treatment for BPH. However, myocardial damage is the most serious complication and has been postulated to develop as a result of irrigating fluid absorption during TURP. The aim of this study is to evaluate the relationship between the amount of irrigating fluid absorption and myocardial damage, and the factors that affect irrigating fluid absorption. MATERIALS AND METHODS: From March 2002 to January 2003, 52 patients who had undergone TURP were evaluated. TURP was performed under epidural anesthesia and URIONE(R) solution was used as the irrigating fluid. The amount of absorbed irrigating fluid was measured and serum troponin I was checked as a marker of perioperative myocardial damage. Resection time, weight of resected prostatic tissue, and the amount of blood loss were evaluated as the factors that affect the irrigating fluid absorption. RESULTS: Weight of resected prostatic tissue(r=0.566, p=0.001) and blood loss(r=0.339, p=0.01) were found to have moderate correlation with the amount of absorbed irrigating fluid, whereas the amount of irrigating fluid(r=0.293, p=0.11) and resection time(r=0.296, p=0.062) had no correlation. Myocardial damage was observed in 2 out of the 52 patients(3.8%), whosepostoperative serum troponin I was higher than 0.4microgram/L, and absorbed irrigating fluid being more than 1,000ml. CONCLUSIONS: Therefore, in the case of large prostate volume and excessive blood loss, the use of diuretics during TURP is recommended to reduce the incidence of myocardial damage.
Absorption* ; Anesthesia, Epidural ; Diuretics ; Humans ; Incidence ; Prostate ; Transurethral Resection of Prostate* ; Troponin ; Troponin I

BACKGROUND: Cardiac troponin I (cTnI) is a specific marker of myocardial injury. It is known that a higher level of cTnI is associated with a poor clinical outcome in patients with acute coronary syndrome. An elevation in cTnI is also observed in various noncardiac critical illnesses. This study evaluated whether cTnI is useful for predicting the prognosis in noncardiac critically ill patients. METHODS: From June 2003 to July 2004 at Gyeongsang National University Hospital, we enrolled 215 patients (male:142, female:73, mean age:63+/-15 years ) who were admitted for critical illness other than acute coronary syndrome at the medical intensive care unit(ICU). The severity score of critical illness (SAPS II and SOFA) was determined and serum cTnI level was measured within 24 hours after admission to the ICU. The mortality rate was compared between the cTnI-positive (> or =0.1microgram/L) and cTnI-negative (cTnI<0.1microgram/L) patients at the 10th and 30th day after admission to the ICU. The mean cTnI value was compared between the survivors and non-survivors at the 10th and 30th day after admission to the ICU in the cTnI-positive patients. The correlation between cTnI and the severity of the critical illness score (SAPS II and SOFA) was also analyzed in cTnI-positive patients. RESULTS: 1) The number of cTnI-negative and positive patients were 95(44%) and 120(56%), respectively. 2) The mortality rate at the 10th and 30th day after admission to the ICU was significantly higher in the cTnI-positive patients (29%, 41%) than in the cTnI-negative patients (12%, 21%)(p<0.01). 3) In the cTnI-positive patients, the mean value of the cTnI at the 10th and 30th day after admission to the ICU was significantly higher in the non-survivors (4.5 +/- 9.2 microgram/L, 3.5 +/- 7.9 microgram/L) than in the survivors( 1.8 +/- 3.6 microgram/L, 2.0 +/- 3.9 microgram/L) (p < 0.05). 4) In the cTnI-positive patients, the cTnI level was significantly correlated with the SAPS II score (r=0.24, p<0.001) and SOFA score (r=0.30, p<0.001). CONCLUSION: The cTnI may be a useful prognostic marker in noncardiac critically ill patients.
Acute Coronary Syndrome ; Critical Illness* ; Humans ; Critical Care ; Mortality ; Prognosis ; Survivors ; Troponin I* ; Troponin*