Diagnosis of acute myocardial infarction in patients with renal failure using high-sensitivity cardiac troponin T.

Aims: Diagnosing myocardial infarction (MI) in patients with chronic kidney disease (CKD) is difficult as they often have increased high-sensitivity cardiac troponin T (hs-cTnT) concentrations.

Methods And Results: Observational US cohort study of emergency department patients undergoing hs-cTnT measurement. Cases with ≥1 hs-cTnT increase > 99th percentile were adjudicated following the Fourth Universal Definition of MI.

High Baseline High-Sensitivity Cardiac Troponin T Concentrations and Risk of Index Acute Myocardial Infarction.

Objective: To evaluate the diagnostic performance of the previously recommended baseline high-sensitivity cardiac troponin T (hs-cTnT) thresholds of 52 and 100 ng/L in identifying patients at high risk of acute myocardial infarction (AMI).

Patients And Methods: This study compared the positive predictive value (PPV) for index AMI of these high-risk hs-cTnT thresholds in adult patients in the emergency department undergoing hs-cTnT measurement.

Results: The adjudicated MAyo Southwest Wisconsin 5th Gen Troponin T ImplementatiON cohort included 2053 patients, with 157 (7.

Use of the HEAR Score for 30-Day Risk-Stratification in Emergency Department Patients.

Background: The 2021 American College of Cardiology/American Heart Association chest pain guidelines recommend risk scores such as HEAR (History, Electrocardiogram, Age, Risk factors) for short-term risk stratification, yet limited data exist integrating them with high-sensitivity cardiac troponin T (hs-cTnT).

Methods: Retrospective, multicenter (n = 2), observational, US cohort study of consecutive emergency department patients without ST-elevation myocardial infarction who had at least one hs-cTnT (limit of quantitation [LoQ] <6 ng/L, and sex-specific 99th percentiles of 10 ng/L for women and 15 ng/L for men) measurement on clinical indications in whom HEAR scores (0-8) were calculated. The composite major adverse cardiovascular event (MACE) outcome was 30-day prognosis.

Diagnosis and Prognosis of Type 2 Myocardial Infarction Using Objective Evidence of Acute Myocardial Ischemia: A Validation Study.

Background: Differentiating type 2 myocardial infarction from myocardial injury can be difficult. In addition, the presence of objective evidence of myocardial ischemia may facilitate identification of high-risk type 2 myocardial infarction patients.

Methods: This was an observational cohort study of adult emergency department patients undergoing high-sensitivity cardiac troponin T (hs-cTnT) measurement.

Mitral stenosis in a teenager after rheumatic mitral valve regurgitation valve repair: A case report.

Introduction: Mitral stenosis (MS) is a widely known complication of mitral valve repair for non-rheumatic mitral regurgitation (MR). Few reports are available on the occurrence of MS after mitral valve repair for rheumatic MR in young populations.

Case Summary: A 14-year-old girl presented with orthopnea, abdominal distension, and bilateral lower-limb edema.

Artificial intelligence-augmented electrocardiography for left ventricular systolic dysfunction in patients undergoing high-sensitivity cardiac troponin T.

Aims: Our goal was to evaluate a previously validated artificial intelligence-augmented electrocardiography (AI-ECG) screening tool for left ventricular systolic dysfunction (LVSD) in patients undergoing high-sensitivity-cardiac troponin T (hs-cTnT).

Methods And Results: Retrospective application of AI-ECG for LVSD in emergency department (ED) patients undergoing hs-cTnT. AI-ECG scores (0-1) for probability of LVSD (left ventricular ejection fraction ≤ 35%) were obtained.

Major adverse cardiovascular events after diagnosis of myocardial injury and types 1 and 2 myocardial infarction.

Aims: Limited US outcome data exist among patients with myocardial injury and types 1 and 2 myocardial infarction (MI) evaluated with high-sensitivity cardiac troponin (hs-cTn).

Methods And Results: This is an observational US cohort study of emergency department (ED) patients undergoing hs-cTnT measurement. Cases with ≥1 hs-cTnT increase >99th percentile were adjudicated following the Fourth Universal Definition of MI.

Rapid Exclusion of Acute Myocardial Injury and Infarction With a Single High-Sensitivity Cardiac Troponin T in the Emergency Department: A Multicenter United States Evaluation.

Background: There are good data to support using a single high-sensitivity cardiac troponin T (hs-cTnT) below the limit of detection of 5 ng/L to exclude acute myocardial infarction. Per the US Food and Drug Administration, hs-cTnT can only report to the limit of quantitation of 6 ng/L, a threshold for which there are limited data. Our goal was to determine whether a single hs-cTnT below the limit of quantitation of 6 ng/L is a safe strategy to identify patients at low risk for acute myocardial injury and infarction.

Looking Back and Going Forward: Roles of Varenicline and Electronic Cigarettes in Smoking Cessation.

Tobacco use is the single largest preventable cause of death in the United States (US). The national goal of reducing the prevalence of adult cigarette smoking to 12% was retained for 20 years due to non-attainment. Meanwhile, varenicline and electronic cigarettes (ECs) became available in the US in 2006 and 2007, respectively, and have been used by many smokers wanting to quit.

Clinical Impact of High-Sensitivity Cardiac Troponin T Implementation in the Community.

Background: Limited U.S. data exist regarding high-sensitivity cardiac troponin (cTn) implementation.

High-Sensitivity Cardiac Troponin T for the Detection of Myocardial Injury and Risk Stratification in COVID-19.

Background: Limited data exist on high-sensitivity cardiac troponin (hs-cTn) for risk-stratification in COVID-19.

Methods: We conducted a multicenter, retrospective, observational, US-based study of COVID-19 patients undergoing hs-cTnT. Outcomes included short-term mortality (in-hospital and 30-days post-discharge) and a composite of major adverse events, including respiratory failure requiring mechanical ventilation, cardiac arrest, and shock within the index presentation and/or mortality during the index hospitalization or within 30-days post-discharge.

Single Coronary Artery Anomaly in a Woman With Acute ST-Segment Elevation Myocardial Infarction.

A 65-year-old woman presented with an acute inferior ST-segment elevation myocardial infarction and was found to have a rare single coronary artery anomaly on coronary angiography. A complete occlusion at the mid right coronary artery was identified as the culprit lesion and underwent successful percutaneous revascularization with stenting. ().

Prognostic Utility of Troponin I and N Terminal-ProBNP among Patients with Heart Failure due to Non-Ischemic Cardiomyopathy and Important Correlations.

Background: Heart Failure (HF) is accompanied by a high cost of care and gloomy prognosis despite recent advances in its management. Therefore, efforts to minimize HF rehospitalizations is a major focus of several studies.

Methods: We conducted a retrospective cohort study of 140 patients 18 years and above who had baseline clinical parameters, echocardiography, NT-ProBNP, troponin I and other laboratory parameters following a 3-year electronic medical record review.

Electronic Cigarette Use among Survivors of Smoking-Related Cancers in the United States.

Background: The prevalence of electronic cigarette (e-cigarette) use and its impact on smoking cessation among cancer survivors in the United States is largely unknown. We sought to estimate the prevalence of e-cigarette use and examine its associations with cigarette smoking and smoking quit attempts among smoking-related cancer survivors in the United States.

Methods: We obtained data from the 2014-2017 annual cycles of the National Health Interview Survey for participants with self-reported history of smoking-related cancer(s).

Pseudo-Wellens Syndrome in a Patient with Hypertension and Left Ventricular Hypertrophy.

BACKGROUND Wellens syndrome is a form of unstable angina that warrants a timely intervention to prevent extensive myocardial infarction. A few conditions can lead to electrocardiogram (EKG) changes mimicking Wellens syndrome. CASE REPORT A 61-year-old African American man with no significant medical history was admitted for chest pain and new biphasic EKG changes in leads V2 through V6 concerning for Wellens' syndrome.

Brugada Phenocopy Induced by Recreational Drug Use.

Recreational drugs are commonly abused in all age groups. Intoxication with these substances can induce silent but significant electrocardiographic signs which may lead to sudden death. In this case study, we present a 49-year-old male with no medical comorbidities who came to the emergency department requesting opioid detoxification.

Left Ventricular Aneurysm May Not Manifest as Persistent ST Elevation on Electrocardiogram.

BACKGROUND Electrocardiographic presentations of left ventricle aneurysms are diverse; however, a persistent ST segment elevation post myocardial infarction is most commonly reported. CASE REPORT The authors present a case of a 67-year-old man who presented to the emergency department after three days of chest pain and was found to have an acute myocardial infarction with an incidental finding of a left ventricular aneurysm. His surface electrocardiogram, however, demonstrated only inverted T waves in the precordial leads.