scholarly journals Diagnostic Value of Soluble Urokinase-Type Plasminogen Activator Receptor in Addition to High-Sensitivity Troponin I in Early Diagnosis of Acute Myocardial Infarction

Biomolecules ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 108 ◽  
Author(s):  
Nils A. Sörensen ◽  
Günay Dönmez ◽  
Johannes T. Neumann ◽  
Julius Nikorowitsch ◽  
Nicole Rübsamen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Early Diagnosis ◽  
Troponin I ◽  
High Sensitivity ◽  
Diagnostic Value ◽  
High Sensitivity Troponin ◽  
Type Plasminogen Activator ◽  
Urokinase Type Plasminogen Activator ◽  
Plasminogen Activator Receptor

The soluble urokinase-type plasminogen activator receptor (suPAR) is a new marker for immune activation and inflammation and may provide diagnostic value on top of established biomarkers in patients with suspected acute myocardial infarction (AMI). Here, we evaluate the diagnostic potential of suPAR levels on top of high-sensitivity troponin I (hs-TnI) in a cohort of patients with suspected AMI. A total of 1220 patients presenting to the emergency department with suspected AMI were included, of whom 245 were diagnosed with AMI. Median suPAR levels at admission were elevated in subjects with AMI compared to non-AMI (3.8 ng/mL vs 3.3 ng/mL, p = 0.001). In C-statistics, the area under the curve (AUC) regarding the diagnosis of AMI was low (0.57 at an optimized cut-off of 3.7 ng/mL). Moreover, baseline suPAR levels on top of troponin values at admission and hour 1 reduced the number of patients who were correctly ruled-out as non-AMI, and who were correctly ruled-in as AMI. Our study shows that circulating levels of suPAR on top of high-sensitivity troponin I do not improve the early diagnosis of AMI.

scholarly journals Early diagnosis of acute myocardial infarction using high-sensitivity troponin I

PLoS ONE ◽  
2017 ◽  
Vol 12 (3) ◽  
pp. e0174288 ◽  
Author(s):  
Johannes Tobias Neumann ◽  
Nils Arne Sörensen ◽  
Francisco Ojeda ◽  
Thomas Renné ◽  
Renate B. Schnabel ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Early Diagnosis ◽  
Troponin I ◽  
High Sensitivity ◽  
High Sensitivity Troponin

scholarly journals Immediate Rule-Out of Acute Myocardial Infarction Using Electrocardiogram and Baseline High-Sensitivity Troponin I

2017 ◽  
Vol 63 (1) ◽  
pp. 394-402 ◽  
Author(s):  
Johannes Tobias Neumann ◽  
Nils Arne Sörensen ◽  
Francisco Ojeda ◽  
Tjark Schwemer ◽  
Jonas Lehmacher ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Troponin I ◽  
High Sensitivity ◽  
Low Risk ◽  
High Sensitivity Troponin ◽  
Testing Trial ◽  
Pain Symptoms ◽  
Electrocardiogram Ecg ◽  
Rule Out

Abstract AIMS Serial measurements of high-sensitivity troponin are used to rule out acute myocardial infarction (AMI) with an assay specific cutoff at the 99th percentile. Here, we evaluated the performance of a single admission troponin with a lower cutoff combined with a low risk electrocardiogram (ECG) to rule out AMI. METHODS Troponin I measured with a high-sensitivity assay (hs-TnI) was determined at admission in 1040 patients presenting with suspected AMI (BACC study). To rule out AMI we calculated the negative predictive value (NPV) utilizing the optimal hs-TnI cutoff combined with a low risk ECG. The results were validated in 3566 patients with suspected AMI [2-h Accelerated Diagnostic Protocol to Assess Patients With Chest Pain Symptoms Using Contemporary Troponins as the Only Biomarker (ADAPT) studies]. Patients were followed for 6 or 12 months. RESULTS 184 of all patients were diagnosed with AMI. An hs-TnI cutoff of 3 ng/L resulted in a NPV of 99.3% (CI 97.3–100.0), ruling out 35% of all non-AMI patients. Adding the information of a low risk ECG resulted in a 100% (CI 97.5–100.0) NPV (28% ruled out). The 2 validation cohorts replicated the high NPV of this approach. The follow-up mortality in the ruled out population was low (0 deaths in BACC and Stenocardia, 1 death in ADAPT). CONCLUSIONS A single hs-TnI measurement on admission combined with a low risk ECG appears to rule out AMI safely without need for serial troponin testing. Trial Registration: www.clinicaltrials.gov (NCT02355457).

scholarly journals Direct comparison of high-sensitivity-cardiac troponin I vs. T for the early diagnosis of acute myocardial infarction

2014 ◽  
Vol 35 (34) ◽  
pp. 2303-2311 ◽  
Author(s):  
M. Rubini Gimenez ◽  
R. Twerenbold ◽  
T. Reichlin ◽  
K. Wildi ◽  
P. Haaf ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Early Diagnosis ◽  
Cardiac Troponin ◽  
Troponin I ◽  
High Sensitivity ◽  
Cardiac Troponin I

scholarly journals Automatizáltan mérhető biomarkerek az akut myocardialis infarctus diagnosztikájában

2015 ◽  
Vol 156 (24) ◽  
pp. 964-971
Author(s):  
Ferenc Kovács ◽  
Ibolya Kocsis ◽  
Marina Varga ◽  
Enikő Sárváry ◽  
György Bicsák
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Troponin I ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Biomarkers ◽  
Fatty Acid Binding ◽  
High Sensitivity Troponin ◽  
Creatine Kinase Mb

Introduction: Cardiac biomarkers have a prominent role in the diagnosis of acute myocardial infarction. Aim: The aim of the authors was to study the diagnostic effectiveness of automated measurement of cardiac biomarkers. Method: Myeloperoxidase, high-sensitivity C-reactive protein, myoglobin, heart-type fatty acid binding protein, creatine kinase, creatine kinase MB, high-sensitivity troponin I and T were measured. Results: The high-sensitivity troponin I was the most effective (area under curve: 0.86; 95% confidence interval: 0.77–0.95; p<0.001) for the diagnosis of acute myocardial infarction. Considering a critical value of 0.35 ng/mL, its sensitivity and specificity were 81%, and 74%, respectively. Combined evaluation of the high-sensitivity troponin T and I, chest pain, and the electrocardiogram gave the best results for separation of acute myocardial infarction from other diseases (correct classification in 62.5% and 98.9% of patients, respectively). Conclusions: Until a more sensitive and specific cardiac biomarker becomes available, the best method for the diagnosis of acute myocardial infarction is to evaluate electrocardiogram and biomarker concentration and to repeat them after 3–6 hours. Orv. Hetil., 2015, 156(24), 964–971.

scholarly journals “30-minute-delta” of high-sensitivity troponin I improves diagnostic performance in acute myocardial infarction

2018 ◽  
Vol 71 (2) ◽  
pp. 144-148 ◽  
Author(s):  
Hiroaki Yokoyama ◽  
Takumi Higuma ◽  
Tomohide Endo ◽  
Fumie Nishizaki ◽  
Kenji Hanada ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Diagnostic Performance ◽  
Troponin I ◽  
High Sensitivity ◽  
High Sensitivity Troponin

Direct comparison of high-sensitivity cardiac troponin I versus T for the early diagnosis of acute myocardial infarction

2013 ◽  
Vol 34 (suppl_1) ◽  
Author(s):  
M. Rubini Gimenez ◽  
R. Twerenbold ◽  
T. Reichlin ◽  
B. Moehring ◽  
K. Wildi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Early Diagnosis ◽  
Cardiac Troponin ◽  
Troponin I ◽  
High Sensitivity ◽  
Cardiac Troponin I
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