scholarly journals Response by Siegerink et al to Letter Regarding Article, “Association Between High-Sensitivity Cardiac Troponin and Risk of Stroke in 96 702 Individuals: A Meta-Analysis”

Stroke ◽  
2020 ◽  
Author(s):  
Bob Siegerink ◽  
Leonie H.A. Broersen ◽  
Jan F. Scheitz
Keyword(s):  
Cardiac Troponin ◽  
Meta Analysis ◽  
High Sensitivity

scholarly journals PENINGKATAN HIGH-SENSITIVE CARDIAC TROPONIN (HS-CTN) SETELAH LATIHAN INTENSITAS TINGGI YANG INTENSIF

2019 ◽  
Author(s):  
Indira Vidiari J ◽  
Nila Wahyuni ◽  
I Putu Adiartha Griadhi
Keyword(s):  
High Intensity ◽  
Cardiac Troponin ◽  
Meta Analysis ◽  
Cardiac Injury ◽  
High Sensitivity ◽  
Cardiac Damage ◽  
Intensive Exercise ◽  
Different Types ◽  
Underlying Pathophysiology

ABSTRACTThe role of exercise as a strategy for prevention, management and therapy in cardiovascular disease has been well described, but in some studies, it has been suggested that there is an increase in biomarkers in cardiac damage or cardiac troponin (cTn) after intensive, high-intensity exercise in healthy individuals. Several studies have shown significant increases in cardiac troponins after different types of exercise. The latest meta-analysis, showing that high-sensitivity cardiac troponin (hs-cTn) increases in about 83% of individuals after long and intensive exercise. The current pathophysiology of hs-cTn is not well understood. Several hypotheses have been proposed, such as transmembrane leakage from cytoplasmic free cTnT and cTnI or decreased troponin clearance from plasma, both caused by overloading of free radicals, myocardial stretching, elevated core temperature, or alteration of pH. Further research is needed with a full prospective study to evaluate the underlying pathophysiology of enhancing high sentivity cardiac troponin (hs-cTn) is an effective strategy for preventing or limiting cardiac injury and sport exercise safe for heart.Keywords: cardiac Troponin (cTn), high sensitivity cardiac troponin (hs-cTn), high intensity intensive exercise

scholarly journals Association Between High-Sensitivity Cardiac Troponin and Risk of Stroke in 96 702 Individuals

Stroke ◽  
2020 ◽  
Vol 51 (4) ◽  
pp. 1085-1093 ◽  
Author(s):  
Leonie H.A. Broersen ◽  
Helena Stengl ◽  
Christian H. Nolte ◽  
Dirk Westermann ◽  
Matthias Endres ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
General Population ◽  
Cardiac Troponin ◽  
Meta Analysis ◽  
High Sensitivity ◽  
Hazard Ratio ◽  
Risk Of Bias ◽  
Adjusted Hazard Ratio ◽  
Previous Stroke

Background and Purpose— Our study aim was to estimate risk of incident stroke based on levels of hs-cTn (high-sensitivity cardiac troponin), a specific biomarker indicating myocardial injury, in the general population, patients with atrial fibrillation, and patients with previous stroke. Methods— Embase, PubMed, and Web of Science were searched until March 14, 2019 to identify relevant articles. Randomized controlled trials and cohort studies assessing the risk of incident stroke based on hs-cTn were eligible. Pooled adjusted hazard ratios including 95% CI were calculated using a random-effects model due to study heterogeneity per population, coding of hs-cTn (categorical/continuous data), per hs-cTn subunit (T or I), for low risk of bias, and for all-cause and ischemic stroke separately. Results— We included 17 articles with 96 702 participants. In studies conducted in the general population (n=12; 77 780 participants), the pooled adjusted hazard ratio for incident stroke was 1.25 (CI, 1.10–1.40) for high versus low hs-cTn (as defined by included studies) during an average follow-up of 1 to 20 years (median 10). When categorical data were used, this was increased to 1.58 (CI, 1.26–1.90). The results were robust when accounting for stroke classification (all-cause stroke/ischemic stroke), hs-cTn subunit, risk of bias, and coding of hs-cTn. In patients with atrial fibrillation (4 studies; 18 725 participants), the pooled adjusted hazard ratio for incident stroke was 1.95 (CI, 1.29–2.62) for high versus low hs-cTn. Due to lack of data (one study, 197 participants), no meta-analysis could be performed in patients with previous stroke. Conclusions— This meta-analysis suggests that hs-cTn can be regarded as a risk marker for incident stroke, with different effect size in different subgroups. More research about the association between hs-cTn and incident stroke in high-risk populations is needed, especially in patients with history of ischemic stroke.

scholarly journals Serial high-sensitivity cardiac troponin T measurements to rule out acute myocardial infarction and a single high baseline measurement for swift rule-in: A systematic review and meta-analysis

2019 ◽  
Vol 9 (1) ◽  
pp. 14-22 ◽  
Author(s):  
M Arslan ◽  
A Dedic ◽  
E Boersma ◽  
EA Dubois
Keyword(s):  
Myocardial Infarction ◽  
Systematic Review ◽  
Acute Myocardial Infarction ◽  
Cardiac Troponin ◽  
Troponin T ◽  
Meta Analysis ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
Single Baseline ◽  
Rule Out

Aims: The purpose of this study was to determine (a) the ability of serial high-sensitivity cardiac troponin T measurements to rule out acute myocardial infarction and (b) the ability of a single high baseline high-sensitivity cardiac troponin T measurement to rule in acute myocardial infarction in patients presenting to the emergency department with acute chest pain. Methods and results: Embase, Medline, Cochrane, Web of Science and Google scholar were searched for prospective cohort studies that evaluated parameters of diagnostic accuracy of serial high-sensitivity cardiac troponin T to rule out acute myocardial infarction and a single baseline high-sensitivity cardiac troponin T value>50 ng/l to rule in acute myocardial infarction. The search yielded 21 studies for the systematic review, of which 14 were included in the meta-analysis, with a total of 11,929 patients and an overall prevalence of acute myocardial infarction of 13.0%. For rule-out, six studies presented the sensitivity of serial measurements <14 ng/l. This cut-off classified 60.1% of patients as rule-out and the summary sensitivity was 96.7% (95% confidence interval: 92.3–99.3). Three studies presented the sensitivity of a one-hour algorithm with a baseline high-sensitivity cardiac troponin T value<12 ng/l and delta 1 hour <3 ng/l. This algorithm classified 60.2% of patients as rule-out and the summary sensitivity was 98.9% (96.4–100). For rule-in, six studies reported the specificity of baseline high-sensitivity cardiac troponin T value>50 ng/l. The summary specificity was 94.6% (91.5–97.1). Conclusion: Serial high-sensitivity cardiac troponin T measurement strategies to rule out acute myocardial infarction perform well, and a single baseline high-sensitivity cardiac troponin T value>50 ng/l to rule in acute myocardial infarction has a high specificity.

scholarly journals High‐Sensitivity Cardiac Troponin After Cardiac Stress Test: A Systematic Review and Meta‐Analysis

2019 ◽  
Vol 8 (6) ◽  
Author(s):  
Eslam Samaha ◽  
Audrey Avila ◽  
Mohammad A. Helwani ◽  
Arbi Ben Abdallah ◽  
Allan S. Jaffe ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Troponin ◽  
Meta Analysis ◽  
Stress Test ◽  
High Sensitivity ◽  
Cardiac Stress ◽  
Cardiac Stress Test

scholarly journals ASSOCIATION BETWEEN ELEVATED HIGH SENSITIVITY CARDIAC-TROPONIN I LEVELS AND INCREASE IN LEVELS OF C-REACTIVE PROTEIN, INTERLEUKIN-6, D-DIMER, AND CONSEQUENT CARDIAC INJURY AND MORTALITY FOR PATIENTS WITH CORONAVIRUS DISEASE 2019: A META-ANALYSIS

2021 ◽  
pp. 160-166
Author(s):  
DHEAA SHAMIH ZAGEER ◽  
SUNDUS FADHIL HANTOOSH ◽  
WATHIQ Q SH. ALI
Keyword(s):  
Interleukin 6 ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Meta Analysis ◽  
Cardiac Injury ◽  
High Sensitivity ◽  
Cardiac Troponin I ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
D Dimer

Objectives: This meta-analysis aims to investigate the role of high sensitivity-cardiac troponin I (hs-cTnI) as a prognostic factor for cardiac injury and as a risk factor of death for patients with coronavirus disease 2019 (COVID-19). This meta-analysis studies the impact of hs-cTnI elevated levels on C-reactive protein (C-RP) protein, interleukin-6 (IL-6), and D-dimer (DD) levels in COVID-19 affected individuals. Methods: Of 557 downloaded articles according to chosen criteria for this meta-analysis, 11 were finally chosen as they met the criteria. Results: Male and elderly individuals were noticeably prone to COVID-19 infection and considerably underwent death in comparison with female and young individuals. Levels of hs-cTn I, C-RP, IL-6, and DD were significantly higher among dead compare to survivors for COVID-19 affected individuals. Conclusions: Levels of C-RP, IL-6, and DD were considerably high and in linear relation with elevated hs-cTn I levels. Hs-cTn I can be considered a reliable marker for COVID-19 infection prognosis and potent predictor of decease.

scholarly journals Diagnostic accuracy of combined cardiac troponin and copeptin assessment for early rule-out of myocardial infarction: a systematic review and meta-analysis

2013 ◽  
Vol 3 (1) ◽  
pp. 18-27 ◽  
Author(s):  
Tatiana Raskovalova ◽  
Raphael Twerenbold ◽  
Paul O Collinson ◽  
Till Keller ◽  
Hélène Bouvaist ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Cardiac Troponin ◽  
Meta Analysis ◽  
Myocardial Necrosis ◽  
High Sensitivity ◽  
St Segment Elevation ◽  
Rule Out

Aims: This systematic review aimed to investigate the diagnostic accuracy of combined cardiac troponin (cTn) and copeptin assessment in comparison to cTn alone for early rule-out of acute myocardial infarction (AMI). Methods: Primary studies were eligible if they evaluated diagnostic accuracy for cTn with and without copeptin in patients with symptoms suggestive of AMI. AMI was defined according to the universal definition, using detection of cTn as a marker for myocardial necrosis. Eligible studies were identified by searching electronic databases (Medline, EMBASE, Science Citation Index Expanded, CINAHL, Pascal, and Cochrane) from inception to March 2013, reviewing conference proceedings and contacting field experts and the copeptin manufacturer. Results: In 15 studies totalling 8740 patients (prevalence of AMI 16%), adding copeptin improved the sensitivity of cTn assays (from 0.87 to 0.96, p=0.003) at the expense of lower specificity (from 0.84 to 0.56, p<0.001). In 12 studies providing data for 6988 patients without ST-segment elevation, the summary sensitivity and specificity estimates were 0.95 (95% CI 0.89 to 0.98) and 0.57 (95% CI 0.49 to 0.65) for the combined assessment of cTn and copeptin. When a high-sensitivity cTnT assay was used in combination with copeptin, the summary sensitivity and specificity estimates were 0.98 (95% CI 0.96 to 1.00) and 0.50 (95% CI 0.42 to 0.58). Conclusion: Despite substantial between-study heterogeneity, this meta-analysis demonstrates that copeptin significantly improves baseline cTn sensitivity. Management studies are needed to establish the effectiveness and safety of measuring copeptin in combination with high-sensitivity cTnT for early rule-out of AMI without serial testing.

High-sensitivity-cardiac troponin for accelerated diagnosis of acute myocardial infarction: A systematic review and meta-analysis

2020 ◽  
Vol 38 (7) ◽  
pp. 1402-1407
Author(s):  
Chien-Chang Lee ◽  
Sih-Shiang Huang ◽  
Yee Hui Yeo ◽  
Yi-Ting Hou ◽  
James Yeongjun Park ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Systematic Review ◽  
Acute Myocardial Infarction ◽  
Cardiac Troponin ◽  
Meta Analysis ◽  
High Sensitivity
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