Troponina Valor De Referência

Troponina Valor De Referência – Original article, Intensive Cardiotherapy / Emergency • Arch. Opa. cardiol 110 (1) • Jan 2018 • https://doi.org/10.5935/abc.20170182   copy

Troponin sensitivity In studies in patients with chest pain – association with severe disease with renal failure.

Troponina Valor De Referência

Troponina Valor De Referência

Alexandre de Matos Soeiro Clinical Emergency Department – InCor – HCFMUSP, São Paulo, SP – Brazil Postal address: Alexandre de Matos Soeiro, 870 João Moura Street, apto 192b. CEP 05412-002, Pinheiros, São Paulo, SP – Brazil. Email: [email protected] Danielle Menosi Gualandro Emergency Clinical Unit – InCor – HCFMUSP, São Paulo, SP – Brazil Aline Siqueira Bossa Emergency Clinical Unit – InCor – HCFMUSP, São Paulo, SP – Brazil Cindel Nogueira Zullino Clinical Emergency Department – InCor – HCFMUSP, São Paulo, SP – Brazil Clinical Emergency Department Bruno Biselli – InCor – HCFMUSP, São Paulo, SP – Brazil Clinical Emergency Department Maria Carolina Feres de Almeida Soeiro – InCor – HCFMUSP, São Paulo Paulo, SP – Brazil Tetiana de Carvalho Andreucci Torres Leal Clinical Clinical Emergency Department – InCor – HCFMUSP, São Paulo, SP – Brazil Carlos Vicente Serrano Jr. Emergency Hospital Unit – InCor – HCFMUSP, São Paulo, SP – Brazil Mucio Tavares de Oliveira Junior Emergency Hospital Unit – InCor – HCFMUSP, São Paulo, SP – BrazilAbout the authors

Pdf) A Troponina Como Marcador De Injúria Celular Miocárdica

Despite the high sensitivity compared to normal troponins, sensitive troponins have low specificity, especially in patients with heart failure.

A study to evaluate the sensitive levels of troponin I in patients with chest pain and to determine their relationship with the presence of severe heart disease.

Retractable, single core, monitor. The study included 991 patients who were divided into two groups: with (N = 681) and without (N = 310) significant complications. For further analysis, patients were divided into two other groups: with (N = 184) and without (N = 807) infection. Purchase ADVIA Centaur

The TnI-Ultra assay (Siemens Healthcare Diagnostics) was used. ROC curve analysis was performed to determine the sensitivity and specificity of the optimal cut-off point for troponin as a predictor of cardiovascular risk. . Associations were considered significant when p < 0.05.

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The average age is 63 years, 52% of patients are men. The area under the ROC curve between troponin and the number of heart diseases is 0.685 (95% CI: 0.65-0.72). In patients with heart failure, the area under the ROC curve was 0.703 (95% CI: 0.66-0.74) and 0.608 (95% CI: 0.52-0.70), respectively. The best values ​​for determining the presence of acute coronary syndrome are: in the general population, 0.605 ng/dL (sensitivity 63.4%; four special 67%); in patients without heart damage – 0.605 ng / dL (sensitivity – 62.7%; specificity – 71%); in patients with chronic kidney failure – 0.515 ng / dL (sensitive – 80.6%; specific – 42%).

In patients with chest pain, sensitive troponin I showed a positive association with severe heart disease when its level exceeded 0.605 ng/dL. In patients with heart failure, a significant decrease in the specificity of the relationship between the level of troponin and severe heart disease was observed.

Although more sensitive than normal troponins, sensitive troponins are less specific, especially in patients with heart failure.

Troponina Valor De Referência

Evaluate the value of troponin I sensitivity in patients with chest pain in relation to the presence of severe heart disease.

Biomarcadores En La Insuficiencia Cardiaca Aguda

Retrospective, single-center, randomized study. A total of 991 patients were included, divided into two groups: with (N = 681) and without heart disease (N = 310). For further analysis, patients were divided into two other groups: with (N = 184) or without heart (N = 807). The troponin used belongs to the commercial kit ADVIA Centaur

TnI-Ultra (Siemens Healthcare Diagnostics). The study was performed using the ROC curve to determine the sensitivity and specificity of the optimal cut-off point for troponin as a risk factors for coronary artery disease. Associations were considered significant when p < 0.05.

About 52% of the patients were men, and the average age of the sample was 63 years. The area under the ROC curve between the troponin value and the number of heart attacks is 0.685 (95% CI: 0.65 – 0.72). In patients with no physical problems, the AUC was 0.703 (95% CI: 0.66-0.74) and 0.608 (95% CI: 0.52-0.70), respectively. The most isolated values ​​for determining the presence of cardiovascular disease are: 0.605 ng / dL (sensitivity 63.4%, specificity 67%) in the general group, 0.605 ng / dL (sensitivity 62.7% % and specificity 71%) in patients without heart failure and 0.515 ng/dL (sensitivity 80.6% and specificity 42%) in the group with heart failure.

In the study of the population of patients with chest pain, troponin I sensitivity is positively associated with severe heart disease when it is higher than 0.605 ng/dL. In patients with heart failure, we observed a significant drop in the specificity in the correlation of values ​​with severe heart disease.

Biomarcadores Cardiacos En El Gato

In recent years, cardiology has witnessed the continuous development of several biomarkers, which combine modern sensitive troponins with high sensitivity, widely distributed in Brazil and Europe, 11 Hollander JE, Than M , Mueller C. State-of-the-art clinical trial of acute care patients with acute stroke. . Broadcast. 2016; 134 (7): 547-64. doi: 10.1161/CIRCULATIONAHA.116.021886. https://doi.org/10.1161/CIRCULATIONAHA.1…

However, despite the large increase in sensitivity that allows early detection of a small number of myocardial lesions in patients presenting to the emergency department with chest pain, it was there is a decrease in specificity, resulting in many patients who do not have heart problems or problems. because of the unnecessary and even disease-specific disease and disease stratification.22 Lipinski MJ, Baker NC, Escárcega RO, Torguson R, Chen F, Aldous SJ, et al. Comparison of normal and high-sensitivity troponin in patients with chest pain: a cohort study. Am Heart J. 2015; 169 (1): 6-16.e6. doi: 10.1016/j.ahj.2014.10.007. https://doi.org/10.1016/j.ahj.2014.10.00… 3 Freund, Y., Chenevier-Gobo, C., Bonnet, P., Klassens, Y.E., Allo, J.K., Dumenck B. and others. It is more sensitive compared to the normal troponin in the emergency department for the diagnosis of myocardial infarction. Important care. 2011;15(3):R147. doi: 10.1186/cc10270. https://doi.org/10.1186/cc10270… 4 Zeller, T., Tunstall-Pedo, H., Saarela, O., Ojeda, F., Schnabel, R.B., Tuovinen, T., et al. Cardiac troponin I levels in the general population measured in a highly sensitive study and cardiovascular risk assessment: the MORGAM Scottish Cohort Biomarker Project. Eur Heart J. 2014;35(5):271-81. doi: 10.1093/eurheartj/eht406. https://doi.org/10.1093/eurheartj/eht406…

55 Aldous S, Mark Richards A, George PM, Cullen L, Parsonage WA, Flaws D, et al. Comparison of a new method of using troponin with the high sensitivity of troponin in the diagnosis of myocardial infarction. Int J Cardiol. 2014;177(1):182-6. doi: 10.1016/j.ijcard.2014.09.026. https://doi.org/10.1016/j.ijcard.2014.09… The level of troponin should be taken into account for the correct interpretation of clinical results depending on the characteristics of the patient and the test of the troponin is used and should be specific for each service 22 Lipinski MJ, Baker NK, Escarcega RO, Torguson R, Chen F, Aldous SJ. etc. Comparison of normal and high-sensitivity troponin in patients with chest pain: a cohort study. Am Heart J. 2015; 169 (1): 6-16.e6. doi: 10.1016/j.ahj.2014.10.007. https://doi.org/10.1016/j.ahj.2014.10.00… 3 Freund, Y., Chenevier-Gobo, C., Bonnet, P., Klassens, Y.E., Allo, J.K., Dumenck B. and others. It is more sensitive compared to the normal troponin in the emergency department for the diagnosis of myocardial infarction. Important care. 2011;15(3):R147. doi: 10.1186/cc10270. https://doi.org/10.1186/cc10270…

Troponina Valor De Referência

44 Zeller T, Tunstall-Pedoe H, Saarela O, Ojeda F, Schnabel RB, Tuovinen T, et al. Cardiac troponin I levels in the general population measured in a highly sensitive study and cardiovascular risk assessment: the MORGAM Scottish Cohort Biomarker Project. Eur Heart J. 2014;35(5):271-81. doi: 10.1093/eurheartj/eht406. https://doi.org/10.1093/eurheartj/eht406…

Cuidados Com O Ensaio De Troponina

66 Carlton EW, Cullen L, Than M, Gamble J, Khattab A, Greaves K. A new diagnostic test to identify patients suitable for discharge after an elevated troponin. seeds 2015; 101 (13): 1041-6. doi: 10.1136/heartjnl-2014-307288. https://doi.org/10.1136/heartjnl-2014-30…

Therefore, this study aimed to evaluate the current sensitivity level of troponin I in patients with chest pain and to associate them with the presence of important diseases in the presence and lack of common disease in a selected sample.

This is a single cohort study that included 991 patients with chest pain who were admitted to the emergency department of an emergency department between May 2013 and May 2015.

All patients with chest pain and coronary angiography with suspected stable angina or ST-elevation myocardial infarction were included. The only criterion is the presence of ST segment elevation. Coronary involvement was considered significant if ≥ 70% on coronary angiography. Chronic renal failure is defined as a creatinine level > 1.5 mg/dL.

Marcadores Bioquímicos Cardíacos Troponina, Ck Mb, Mioglobina, Lactato Desidrogenase

Patients were divided into two groups: with (N = 681) and without (N = 310) severe heart disease. For the analysis of the ROC curve, patients were divided into two groups: with (N = 184) and without (N = 807) infection.

Percent value 0.04 ng/ml. The protocol for the management of all patients with chest pain met the guidelines established by the latest guidelines of the American Heart Association.77 O’Gara PT, Kushner FG, Ascheim DD, Casey DE Jr., Chung MK, de Lemos JA, et al.; American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. ACCF/AHA Guidelines for the Management of ST-Elevation Myocardial Infarction, 2013: A Report of the American College of Cardiology Foundation/American Heart Association Task Force

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