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*

OBJECTIVE: To evaluate the accuracy of cardiac troponin (cTn) levels in the diagnosis of acute myocardial infarction (AMI) in patients with chronic kidney disease (CKD) and explore a potential strategy for improving the diagnostic accuracy. METHODS: We retrospectively analyzed the data from patients with high-risk chest pain admitted in Zhujiang Hospital from January, 2018 to December, 2020, including 126 patients with and 272 patients without CKD, and 122 patients diagnosed to have AMI and 276 patients without AMI. The baseline clinical data of the patients and blood test results within 12 h after admission were collected. RESULTS: In patients without AMI, cTnT level was significantly higher in those with co-morbid CKD than in those without CKD (<i>Pi> < 0.001), and showed a moderate negative correlation with eGFR (<i>ri>_s=- 0.501, <i>Pi> < 0.001), while cTnI level did not differ significantly between the two groups (<i>Pi>=0.72). In patients with CKD, the optimal cutoff level was 0.177 μg/L for cTnT and 0.415 ng/mL for cTnI for diagnosis of AMI, for which cTnI had a higher specificity than cTnT. The diagnostic model combining both cTnT and cTnI levels [<i>Pi>=e^Y/(1+ e^Y), Y=6.928 (cTnT)-0.5 (cTnI)-1.491] had a higher AUC value than cTn level alone. CONCLUSION In CKD patients, the cutoff level of cTn is increased for diagnosing AMI, and cTnI has a higher diagnostic specificity than cTnT. The combination of cTnT and cTnI levels may further improve diagnostic efficacy for AMI.
Humans ; Retrospective Studies ; Myocardial Infarction/diagnosis* ; Comorbidity ; Troponin T ; Troponin I ; Renal Insufficiency, Chronic/diagnosis* ; Biomarkers

The Cardiac Troponin T and I are highly cardiac specific biochemical markers of myocardial injury. They are very sensitive markers to detect all kinds of myocardial injury, and are able to distinguish myocardial injury and skeletal injury. Furthermore, They are independent predictor of future cardiac events. Such markers are now widely used in the clinic practice. It is prospective to use them in Forensic Medical Science.
Biomarkers ; Forensic Medicine ; Humans ; Myocardial Infarction/blood* ; Myocardium/metabolism* ; Troponin I/blood* ; Troponin T/blood*

BACKGROUND: The inflammation is an important feature of atherosclerotic lesions, and peripheral monocytosis is known to be associated with increased coronary events and poor prognosis in acute myocardial infarction (AMI). The aim of this study was to determine the significance in clinical and angiographic outcomes, success rate of the percutaneous coronary intervention (PCI) and major adverse cardiac events and event-free survival rate after PCI according to the value of peripheral monocyte on admission. METHODS: A total of 127 patients with AMI who underwent PCI between June 2000 and June 2001 at Chonnam National University Hospital were divided into two groups: Group I (n=63, 61.7+/-10.9 years, male 71.4%) with normal monocyte count (<900/mm3, mean value=536+/-202/mm3) on admission and Group II (n=64, 61.7+/-13.4 years, male 78.1%) with elevated monocyte count ( 900/mm3, mean value=1,140+/-260/mm3) on admission. RESULTS: Baseline ejection fraction was lower in Group II than in Group I (Group I; 53.3+/-13.0% vs Group II; 45.0+/-11.7%, p=0.014). The value of C-reactive protein, troponin-T and troponin-I was higher in Group II than in Group I (Group I; 2.8+/-1.9 mg/dL, 1.98+/-1.53 ng/mL, 18.3+/-17.7 ng/mL vs Group II; 5.3+/-5.0 mg/dL, 3.34+/-2.54 ng/mL, 43.1+/-24.0 ng/mL, p=0.034, 0.020, 0.006, respectively). The incidence of target lesion revascularization was higher in Group II than in Group I during hospitalization and during 6-month clinical follow-up after PCI (1.6% vs 12.5%, 19.0% vs 31.3%, p=0.012, 0.015, respectively). The event-free survival rates were lower in Group II than in Group I during hospitalization and during 6-month follow-up after PCI (96.8% vs 84.4%, 71.4% vs 53.1%, p=0.006, 0.008, respectively). CONCLUSION: Peripheral monocytosis is associated with LV dysfunction and higher incidence of target lesion revascularization and worse mid-term event-free survival during hospitalization and at 6 months after PCI in patients with AMI.
Angioplasty ; C-Reactive Protein ; Coronary Disease ; Disease-Free Survival ; Follow-Up Studies ; Hospitalization ; Humans ; Incidence ; Inflammation ; Jeollanam-do ; Male ; Monocytes ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Prognosis ; Troponin I ; Troponin T

BACKGROUND: There are several risk factors in the development of arteriosclerosis, including lipid parameters, inflammatory markers, and hemostatic factors. Efforts should be undertaken to identify the relationship among risk factors and underlying mechanisms of arteriosclerosis to improve long-term survival in dialysis patients. This study was performed to evaluate correlations among these risk factors and cardiac troponin T (cTnT) in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). METHODS: Seventy-seven CAPD pateints (M: 50, F: 27; mean age 52.8+/-12.4 years) were enrolled in this study. We measured blood level of total cholesterol (TC), triglycerides (TG), HDL-cholesterol (HDL-C), apolipoprotein A-1 (apoA-1), apolipoprotein B (apoB), C-reactive protein (CRP), fibrinogen, d-dimer, von Willebrand factor (vWF), and cTnT monthly for three times. Thallium SPECT was performed in 32 of 77 patients. RESULTS: Significant positive correlation was found between CRP and fibrinogen (r=0.71, p<0.001). CRP was also positively correlated with vWF (r=0.29, p=0.01). Significant inverse correlation was observed between prealbumin and CRP (r=-0.33, p=0.004). HDL-C and apoA-1 were also inversely correlated with CRP (r=-0.26, p=0.04; r=-0,27, p=0.02) and apoB was positively correlated with CRP (r=0.24, p=0.02). Multivariate analysis revealed that fibrinogen, prealbumin, HDL-C, and apoA-1 correlated independently with CRP. In patients with diabetes (n=35), cTnT levels were sigificantly higher than those in patients without diabetes (p<0.001), whereas albumin and prealbumin levels were significantly lower in patients with diabetes than those in patients without diabetes (p<0.001, p=0.002). Serum apoB, triglyceride, and total cholesterol were higher among patients with positive results in thallium SPECT than those with negative results. CONCLUSION: It seems that inflammation is associated with an enhanced cardiovascular risk profile such as hemostatic factors and apolipoproteins. cTnT may be a useful predictive marker for mortality in dialysis patients.
Apolipoprotein A-I ; Apolipoproteins B ; Apolipoproteins* ; Arteriosclerosis ; C-Reactive Protein* ; Cholesterol ; Dialysis ; Fibrinogen ; Humans ; Inflammation ; Mortality ; Multivariate Analysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Prealbumin ; Risk Factors ; Thallium ; Tomography, Emission-Computed, Single-Photon ; Triglycerides ; Troponin T* ; Troponin* ; von Willebrand Factor

BACKGROUND AND OBJECTIVES: Myocardial injury after percutaneous coronary intervention (PCI) occurs frequently and it is associated with an adverse clinical outcome. Mechanical factors have been implicated in this complication and the role of inflammation has not yet been clearly determined. We evaluated the effect of an inflammatory response during PCI on periprocedural myocardial injury. SUBJECTS AND METHODS: We prospectively studied 231 patients (mean age: 62.8+/-10.6 years, males: 60.6%) who underwent elective coronary stenting. For the exclusion of mechanical injury to the myocardium, we excluded those patients who developed complications during PCI. Blood samples for measuring the high sensitivity C-reactive protein (hsCRP) and troponin T (TnT) were obtained before the procedure and at 6 hours and 24 hours after PCI. The inflammatory response to PCI was calculated as the difference between the peak postprocedural hsCRP level and the preprocedural hsCRP level (delta CRP). We divided the patients according to the median value of delta CRP: Group I <2.2 mg/dL and Group II > or =2.2 mg/dL. RESULTS: Postprocedural TnT elevation was were observed in 72 (31.2%) patients. The baseline clinical and angiographic characteristics were not difference between the two groups. The incidence of any TnT elevations was higher in the Group II than that in Group I (19.8% vs 42.6%, respectively, p<0.001). The incidences of TnT levels over 3 times the upper normal limit and 5 times the upper normal limit were also higher in Group II than in Group I (11.2% vs 21.7%, respectively, p=0.031, for a TnT level 3 times the upper normal limit, and 6.0% vs 13.9%, respectively, for a TnT level 5 times the upper normal limit). Multivariate analysis revealed that postprocedural hsCRP elevation and complex lesion were the significant independent predictors of postprocedural TnT elevation. CONCLUSION: Elevated hsCRP levels were associated with a higher risk of postprocedural troponin elevation in patients undergoing uncomplicated PCI. These results emphasized the role of inflammation in the pathogenesis of periprocedural myocardial injury.
Angioplasty ; C-Reactive Protein ; Humans ; Incidence ; Inflammation ; Multivariate Analysis ; Myocardium ; Percutaneous Coronary Intervention ; Prospective Studies ; Stents ; Trinitrotoluene ; Troponin ; Troponin T

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

BACKGROUND AND OBJECTIVES: Kawasaki disease (KD) is a febrile acute multi-systemic vasculitis, which develops into carditis and coronary aneurysm. This study was performed to investigate cardiac troponin T (cTnT), troponin I (cTnI) and creatinine kinase-MB fraction (CK-MB) for diagnostic and prognostic value in acute KD before IVGG (intravenous gamma globulin). SUBJECTS AND METHODS: The KD group comprised of 45 patients hospitalized between Jan. 2000 and Jul. 2003, with 25 non KD febrile illness subjects as controls. The KD group was subdivided into groups A (persistent normal coronary artery, n=20), B (abnormal coronary artery, n=19) and C (carditis, n=6) according to the initial echocardiography. The cTnT, cTnI and CK-MB levels were measured and compared. RESULTS: Comparing the KD and control subjects, the cTnT (0.0101+/-0.0030 vs. 0.0090+/-0.0000 ng/mL, p=0.025) and cTnI (0.0662+/-0.0581 vs. 0.0143+/-0.0112 ng/mL, p=0.000) were significantly elevated in the KD patients. However, all the data were within normal reference ranges. In a comparison among the KD groups, the number of infants, total fever duration and IVGG re-treatment were significantly higher in group B (p=0.021, 0.046 and 0.007, respectively). There were no significant differences in the cTnT, cTnI and CK-MB levels between the 3 groups. The CK-MB and cTnI levels were slightly elevated in group B compare to groups A+C, but these were not statistically significant. The CK-MB, cTnT and cTnI levels were slightly elevated in those with cardiac abnormalities (groups B+C) compare to group A, but these were not significant. The cTnT and cTnI levels were significantly decreased in the subacute phase (p=0.034 and 0.000, respectively). CONCLUSION: The levels of cTnT, cTnI, CK-MB were not very useful tools for detecting and predicting subsequent cardiac damage in KD patients. However, the cTnI level appears to be a more sensitive marker than the cTnT or CK-MB levels in KD patients.
Coronary Aneurysm ; Coronary Vessels ; Creatinine ; Echocardiography ; Fever ; Humans ; Infant ; Mucocutaneous Lymph Node Syndrome* ; Myocarditis ; Reference Values ; Troponin I* ; Troponin T* ; Troponin* ; Vasculitis

BACKGROUND AND OBJECTIVES: The purpose of the study was to evaluate the usefulness of cardiac troponin as a marker for the detection of minor myocardial injury following percutaneous coronary interverntion (PCI). SUBJECTS AND METHODS: In 79 patients who underwent successful PCI under the diagnosis of stable angina, serum creatinine kinase MB isoenzyme (CK-MB), cardiac troponin T (cTnT), and cardiac troponin I (cTnI) were measured before and at 6, 12 and 24 hours after PCI, and the angiographic findings and procedural characteristics of PCI were compared between the elevated and the normal enzyme groups. RESULTS: Abnormal values of one or more markers following PCI were observed in 17 patients (22%) ; 11 after stenting and 6 after balloon angioplasty alone. The frequency of abnormal cTnI levels was 19% and was significantly higher than that of CK-MB (6%, p < 0.01). No significant differences in target vessel number, target artery, ACC/AHA type, TIMI flow, stenting, time and number of ballooning, maximal inflation pressure or balloon diameter and length were observed between the two groups. Small side branch occlusions developed in 23% of the elevated enzyme group and in 3% of the normal enzyme group. CONCLUSION: Minor myocardial injury can be detected by cTnI and is observed frequently in patients with stable angina following PCI. A small side branch occlusion is related with elevated cTnI.
Angina Pectoris ; Angina, Stable ; Angioplasty, Balloon ; Arteries ; Coronary Disease ; Creatinine ; Diagnosis ; Humans ; Inflation, Economic ; Percutaneous Coronary Intervention* ; Phosphotransferases ; Stents ; Troponin I ; Troponin T ; Troponin*