Early diagnosis of MI using serial troponin measurements

The recent introduction of high sensitivity troponin assays (hsT) has improved the sensitivity of this assay for the detection of myocardial infarction, whilst simultaneously decreasing specificity.  To overcome this problem, the use of troponin kinetics – to identify acute myocardial damage  – has been proposed, either alone or in combination with other diagnostic markers of […]

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High-sensitivity troponin assay improves patient outcomes

In recent years clinical troponin assays have become increasingly sensitive, however whether this translates into improved clinical outcomes for patients with suspected acute coronary syndromes (ACS) has not previously been examined.  Mills et al. investigated whether the introduction a new, high-sensitivity, troponin assay led to an improvement in patient outcomes. […]

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Cardiac enzyme rises post CABG predict worse outcomes

The significance of myocardial enzyme elevations following coronary artery bypass surgery (CABG) remains controversial.  Although a ‘significant’ enzyme rise is felt to indicate a worse long-term prognosis, several smaller studies have suggested that even small enzyme rises within 24hours of surgery are significant.  This analysis aimed to define whether a threshold exists below which enzyme […]

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High sensitivity troponin detects subclinical cardiovascular disease

Although most commonly used in the setting of acute coronary syndromes, it is also recognised that elevated troponin levels are seen in other clinical scenarios such as chronic kidney disease, heart failure, and chronic kidney disease.  Troponin T (TnT) is occasionally detectable in individuals from the general population, and although this has been associated with […]

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New MI diagnosis criteria, same old risk

The traditional diagnosis of myocardial infarction (MI) used the World Health Organization definition and required the concentration of a cardiac biomarker to be above twice the upper limit of normal. However, more recent guidelines have defined a troponin level above the 99th percentile of normal as being diagnostic of MI. […]

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