Publications by authors named "Dorien Kimenai"
Background: The Assessing cardiovascular risk using Scottish Intercollegiate Guidelines Network (ASSIGN) risk score, developed in 2006, is used in Scotland for estimating the 10-year risk of first atherosclerotic cardiovascular disease (ASCVD). Rates of ASCVD are decreasing, and an update is required. This study aimed to recalibrate ASSIGN (V.
View Article and Find Full Text PDFObjective: We hypothesise that subclinical myocardial injury during midlife, indexed by increases in cardiac troponin I, is associated with accelerated cognitive decline, smaller structural brain volume, and higher risk of dementia.
Design: Longitudinal cohort study.
Setting: Civil service departments in London (Whitehall II study).
Background: Many studies have explored whether individual plasma protein biomarkers improve cardiovascular disease risk prediction. We sought to investigate the use of a plasma proteomics-based approach in predicting different cardiovascular outcomes.
Methods: Among 51 859 UK Biobank participants (mean age, 56.
Background: Plasma growth differentiation factor 15 (GDF15) and N-terminal proB-type natriuretic peptide (NT-proBNP) are cardiovascular biomarkers that associate with a range of diseases. Epigenetic scores (EpiScores) for GDF15 and NT-proBNP may provide new routes for risk stratification.
Results: In the Generation Scotland cohort (N ≥ 16,963), GDF15 levels were associated with incident dementia, ischaemic stroke and type 2 diabetes, whereas NT-proBNP levels were associated with incident ischaemic heart disease, ischaemic stroke and type 2 diabetes (all P < 0.
Background: Frailty is increasingly present in patients with acute myocardial infarction. The electronic Frailty Index (eFI) is a validated method of identifying vulnerable older patients in the community from routine primary care data. Our aim was to assess the relationship between the eFI and outcomes in older patients hospitalised with acute myocardial infarction.
View Article and Find Full Text PDFArticle Synopsis
- A study was done in 13 hospitals in the UK to see how well doctors are using a blood test called high-sensitivity cardiac troponin to figure out if patients have heart problems and whether they can go home safely.
- The study included almost 138,000 patients, and it found that 44% were at low risk, 31% at intermediate risk, and 25% at high risk for having a heart issue.
- Most of the low-risk patients (about 66%) were sent home, but the numbers varied a lot depending on the hospital, and younger patients and those from less poor neighborhoods were more likely to be discharged.
Importance: Whether the diagnostic classifications proposed by the universal definition of myocardial infarction (MI) to identify type 1 MI due to atherothrombosis and type 2 MI due to myocardial oxygen supply-demand imbalance have been applied consistently in clinical practice is unknown.
Objective: To evaluate the application of the universal definition of MI in consecutive patients with possible MI across 2 health care systems.
Design, Setting, And Participants: This cohort study used data from 2 prospective cohorts enrolling consecutive patients with possible MI in Scotland (2013-2016) and Sweden (2011-2014) to assess accuracy of clinical diagnosis of MI recorded in hospital records for patients with an adjudicated diagnosis of type 1 or type 2 MI.
Background: Myocardial infarction can be ruled out in patients with a single cardiac troponin measurement. Whether use of a uniform rule-out threshold has resulted in sex differences in care remains unclear.
Objectives: The purpose of this study was to evaluate implementation of a uniform rule-out threshold in females and males with possible myocardial infarction, and to derive and validate sex-specific thresholds.
Background: Many studies have investigated whether single cardiac biomarkers improve cardiovascular risk prediction for primary prevention but whether a combined approach could further improve risk prediction is unclear. We aimed to test a sex-specific, combined cardiac biomarker approach for cardiovascular risk prediction.
Methods: In the Generation Scotland Scottish Family Health Study, N-terminal pro-B-type natriuretic peptide (NT-proBNP), growth differentiation factor-15 (GDF-15), cardiac troponin I (cTnI), cardiac troponin T (cTnT), and C-reactive protein (CRP) were measured in stored serum using automated immunoassays.
Objective: To evaluate the impact of implementing a high sensitivity assay for cardiac troponin I on long term outcomes in patients with suspected acute coronary syndrome.
Design: Secondary observational analysis of a stepped wedge, cluster randomised controlled trial.
Setting: 10 secondary and tertiary care centres in Scotland, UK.
Moderate to severe frailty is a predictor of a poor outcome after transcatheter aortic valve replacement (TAVR), but little is known about the prognostic importance of different geriatric frailty markers in an overall fit or pre-frail geriatric population undergoing TAVR. This retrospective study aimed to examine the incremental value of adding patient frailty markers to conventional surgical risk score to predict all-cause mortality in relatively fit elderly patients undergoing TAVR. Overall patient frailty was assessed using the comprehensive geriatric assessment frailty index (CGA-FI).
View Article and Find Full Text PDFBackground: Cardiac troponin is used for risk stratification of patients with acute coronary syndromes; however, the role of testing in other settings remains unclear.
Objectives: The aim of this study was to evaluate whether cardiac troponin testing could enhance risk stratification in patients with chronic coronary artery disease independent of disease severity and conventional risk measures.
Methods: In a prospective cohort of consecutive patients with symptoms suggestive of stable angina attending for outpatient coronary angiography, high-sensitivity cardiac troponin I was measured before angiography, and clinicians were blinded to the results.
Aims: Whether a single cardiac troponin measurement can safely rule out myocardial infarction in patients presenting within a few hours of symptom onset is uncertain. The study aim was to assess the performance of troponin in early presenters.
Methods And Results: In patients with possible myocardial infarction, the diagnostic performance of a single measurement of high-sensitivity cardiac troponin I at presentation was evaluated and externally validated in those tested ≤3, 4-12, and >12 h from symptom onset.
Background: High-sensitivity cardiac troponin testing is a promising tool for cardiovascular risk prediction, but whether serial testing can dynamically predict risk is uncertain. We evaluated the trajectory of cardiac troponin I in the years prior to a cardiovascular event in the general population, and determine whether serial measurements could track risk within individuals.
Methods: In the Whitehall II cohort, high-sensitivity cardiac troponin I concentrations were measured on three occasions over a 15-year period.
Background: Concentrations of cardiac troponin predict risk of cardiovascular disease and death in the general population. There is limited evidence on changing patterns of cardiac troponin in the years preceding cardiovascular events.
Methods: We analyzed cardiac troponin I (cTnI) with a high-sensitivity assay in 3272 participants in the Trøndelag Health (HUNT) Study at study visit 4 (2017-2019).
Article Synopsis
- Cardiac troponin levels are generally lower in women compared to men, and this study evaluates how these levels change with age and risk factors, focusing on both sexes over a 15-year period.
- Researchers used the Whitehall II cohort, measuring troponin levels in 2,142 women and 5,151 men to see how these levels relate to cardiovascular outcomes like heart attacks and strokes.
- Results showed that while women had consistently lower troponin levels, their levels increased more with age compared to men, and changes in troponin levels were linked to cardiovascular outcomes, particularly in women.
Background: Despite poor cardiovascular outcomes, there are no dedicated, validated risk stratification tools to guide investigation or treatment in type 2 myocardial infarction.
Objectives: The goal of this study was to derive and validate a risk stratification tool for the prediction of death or future myocardial infarction in patients with type 2 myocardial infarction.
Methods: The T2-risk score was developed in a prospective multicenter cohort of consecutive patients with type 2 myocardial infarction.