Sex Differences in Cardiac Troponin Testing in Patients Presenting to the Emergency Department with Chest Pain

2018 ◽  
Vol 27 (11) ◽  
pp. 1327-1334 ◽  
Author(s):  
Karin H. Humphries ◽  
Min Gao ◽  
May K. Lee ◽  
Mona Izadnegahdar ◽  
Daniel T. Holmes ◽  
...  
Keyword(s):  
Emergency Department ◽  
Sex Differences ◽  
Chest Pain ◽  
Cardiac Troponin

scholarly journals Sex Differences in Diagnoses, Treatment, and Outcomes for Emergency Department Patients With Chest Pain and Elevated Cardiac Troponin

2018 ◽  
Vol 25 (4) ◽  
pp. 413-424 ◽  
Author(s):  
Karin H. Humphries ◽  
May K. Lee ◽  
Mona Izadnegahdar ◽  
Min Gao ◽  
Daniel T. Holmes ◽  
...  
Keyword(s):  
Emergency Department ◽  
Sex Differences ◽  
Chest Pain ◽  
Cardiac Troponin ◽  
Emergency Department Patients

scholarly journals Comparison of Myocardial Perfusion Imaging and Cardiac Troponin I in Patients Admitted to the Emergency Department With Chest Pain

Circulation ◽  
1999 ◽  
Vol 99 (16) ◽  
pp. 2073-2078 ◽  
Author(s):  
Michael C. Kontos ◽  
Robert L. Jesse ◽  
F. Philip Anderson ◽  
Kristin L. Schmidt ◽  
Joseph P. Ornato ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Myocardial Perfusion Imaging ◽  
Myocardial Perfusion ◽  
Perfusion Imaging ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Troponin I

scholarly journals Variation of Cardiac Troponin I and T Measured with Sensitive Assays in Emergency Department Patients with Noncardiac Chest Pain

2012 ◽  
Vol 58 (8) ◽  
pp. 1208-1214 ◽  
Author(s):  
Volkher Scharnhorst ◽  
Krisztina Krasznai ◽  
Marcel van 't Veer ◽  
Rolf H Michels
Keyword(s):  
Emergency Department ◽  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Cardiac Troponin ◽  
Myocardial Necrosis ◽  
High Sensitivity ◽  
Noncardiac Chest Pain ◽  
Short Term ◽  
Coronary Syndrome ◽  
Concentration Changes

Abstract BACKGROUND New-generation high-sensitivity assays for cardiac troponin have lower detection limits and less imprecision than earlier assays. Reference 99th-percentile cutoff values for these new assays are also lower, leading to higher frequencies of positive test results. When cardiac troponin concentrations are minimally increased, serial testing allows discrimination of myocardial infarction from other causes of increased cardiac troponin. We assessed various measures of short-term variation, including absolute concentration changes, reference change values (RCVs), and indices of individuality (II) for 2 cardiac troponin assays in emergency department (ED) patients. METHODS We collected blood from patients presenting with cardiac chest pain upon arrival in the ED and 2, 6, and 12 h later. Cardiac troponin was measured with the high-sensitivity cardiac troponin T (hs-cTnT) assay (Roche Diagnostics) and a sensitive cTnI assay (Siemens Diagnostics). Cardiac troponin results from 67 patients without acute coronary syndrome or stable angina were used in calculating absolute changes in cardiac troponin, RCVs, and II. RESULTS The 95th percentiles for absolute change in cardiac troponin were 8.3 ng/L for hs-cTnT and 28 ng/L for cTnI. Within-individual and total CVs were 11% and 14% for hs-cTnT and 18% and 21% for cTnI, respectively. RCVs were 38% (hs-cTnT) and 57% (cTnI). The corresponding log-normal RCVs were +46%/−32% for hs-cTnT and +76%/−43% for cTnI. II values were 0.31 (cTnI) and 0.12 (hs-cTnT). CONCLUSIONS The short-term variations and IIs of cardiac troponin were low in ED patients free of ischemic myocardial necrosis. The detection of cardiac troponin variation exceeding reference thresholds can help to identify ED patients with acute myocardial necrosis whereas variation within these limits renders acute coronary syndrome unlikely.

scholarly journals Combination of Goldman Risk and Initial Cardiac Troponin I for Emergency Department Chest Pain Patient Risk Stratification

2001 ◽  
Vol 8 (7) ◽  
pp. 696-702 ◽  
Author(s):  
Alex Limkakeng ◽  
W. Brian Gibler ◽  
Charles Pollack ◽  
James W. Hoekstra ◽  
Frank Sites ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Risk Stratification ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Troponin I ◽  
Pain Patient ◽  
Patient Risk ◽  
Chest Pain Patient

Autoantibody prevalence with an improved immunoassay for detecting cardiac troponin-specific autoantibodies

2014 ◽  
Vol 52 (2) ◽  
Author(s):  
Tanja Savukoski ◽  
Tuomo Ilva ◽  
Juha Lund ◽  
Pekka Porela ◽  
Noora Ristiniemi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Emergency Department ◽  
Chest Pain ◽  
Cardiac Troponin ◽  
Troponin I ◽  
State Of The Art ◽  
Cardiac Troponin I ◽  
High Prevalence ◽  
Sandwich Type ◽  
Pain Patients

AbstractCardiac troponin-specific autoantibodies (cTnAAb) can interfere with the measurement of cardiac troponin I (cTnI) by immunoassays used for the diagnosis of myocardial infarction (MI). Here, an improved version of a previous autoantibody assay was validated and used to evaluate the cTnAAb prevalence in a cohort of consecutive chest pain patients presenting to an emergency department.Admission samples from 510 patients with suspected MI were analyzed in parallel with two sandwich-type cTnAAb assays based on different cTnI epitopes used to capture cardiac troponin-bound cTnAAbs.Sample-specific backgrounds were lower for the new assay than for the old assay (median 1225 vs. 2693 counts, p<0.001). Net signals of cTnAAb-positive samples were higher for the new assay than for the old assay (median 5076 vs. 3921 counts, p<0.001). Of all patients, 9.2% were cTnAAb-positive for the new assay and 7.3% for the old assay (p=0.013). Previous cardiac problems were not associated with cTnAAb status and cTnAAb status did not correlate with the 12-month outcome.With our new and more sensitive autoantibody assay, approximately one out of ten patients who presented to the initial cardiac triage had detectable amounts of cTnAAbs in the circulation. Because these cTnAAbs can interfere with state-of-the-art cTnI assays, their high prevalence should be acknowledged by clinical chemists, physicians, and kit manufacturers.

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