Article
Cardiac & Cardiovascular Systems
Yader Sandoval, Fred S. Apple, Simon A. Mahler, Richard Body, Paul O. Collinson, Allan S. Jaffe
Summary: The guidelines for the evaluation and diagnosis of acute chest pain released by multiple associations in 2021 provide important recommendations, including the use of high-sensitivity cardiac troponin (hs-cTn) as the preferred biomarker, defining myocardial injury with 99th percentile upper reference limits, and utilizing clinical decision pathways. However, the guidelines do not extensively address the details of integrating hs-cTn into clinical practice, and clinicians need to be aware of analytical aspects related to hs-cTn assays and how to best use it with clinical decision pathways.
Review
Cardiac & Cardiovascular Systems
Thomas E. Kaier, Bashir Alaour, Michael Marber
Summary: The 4th Universal Definition of Myocardial Infarction has sparked debates aiming to define types of myocardial injury from a pathophysiological perspective, with necessary adjustments in clinical guidelines for real-world patient triage.
CARDIOVASCULAR RESEARCH
(2021)
Review
Cardiac & Cardiovascular Systems
Thomas E. Kaier, Bashir Alaour, Michael Marber
Summary: The 4th Universal Definition of Myocardial Infarction aims to define types of myocardial injury based on their pathophysiology, sparking debates and leading to necessary pragmatic adjustments in clinical guidelines to improve triage of real-world patients.
CARDIOVASCULAR RESEARCH
(2021)
Article
Cardiac & Cardiovascular Systems
Yader Sandoval, Bradley R. Lewis, Ramila A. Mehta, Olatunde Ola, Jonathan D. Knott, Laura De Michieli, Ashok Akula, Ronstan Lobo, Eric H. Yang, S. Michael Gharacholou, Marshall Dworak, Erika Crockford, Nicholas Rastas, Eric Grube, Swetha Karturi, Scott Wohlrab, David O. Hodge, Tahir Tak, Charles Cagin, Rajiv Gulati, Allan S. Jaffe
Summary: Using a single hs-cTnT below the limit of quantitation of 6 ng/L is a safe and rapid method to identify a substantial number of patients at very low risk for acute myocardial injury and infarction.
Article
Cardiac & Cardiovascular Systems
Ehsan Khan, Kristina Lambrakis, Sheraz A. Nazir, Anthony Chuang, Amera Halabi, Kathryn Tiver, Tom Briffa, Louise A. Cullen, Matthew Horsfall, John K. French, Benjamin C. Sun, Derek P. Chew
Summary: The study found that the widespread implementation of high-sensitivity cardiac troponin T (hs-cTnT) assay in medical services can significantly reduce patients' length of stay without causing a significant impact on clinical outcomes. Compared to the standard testing method, hs-cTnT can more accurately identify a safer cohort with non-elevated cTnT.
INTERNATIONAL JOURNAL OF CARDIOLOGY
(2022)
Article
Medical Laboratory Technology
Ola Hammarsten, Janet V. Warner, Leo Lam, Peter Kavsak, Bertil Lindahl, Kristin M. Aakre, Paul Collinson, Allan S. Jaffe, Amy K. Saenger, Richard Body, Nicholas L. Mills, Torbjorn Omland, Jordi Ordonez-Llanos, Fred S. Apple
Summary: The IFCC C-CB provides educational materials to help interpret and use cardiac biomarkers in clinical laboratories and practice. Their aim is to improve understanding of key analytical and clinical aspects of cardiac biomarkers and their interplay. Two emerging analytical issues causing falsely high cTn concentrations are antibody-mediated assay interference (macrotroponin) and crosslinking antibodies (heterophilic antibodies). They provide an overview of these interference issues and recommendations on confirmation and interpretation of results.
CLINICAL CHEMISTRY AND LABORATORY MEDICINE
(2023)
Article
Engineering, Chemical
Mugashini Vasudevan, Melvin J. Y. Tai, Veeradasan Perumal, Subash C. B. Gopinath, Satisvar Sundera Murthe, Mark Ovinis, Norani Muti Mohamed, Nirav Joshi
Summary: The novel aptamer-based CA-MoS2 hybrid biosensor showed excellent detection performance and selectivity for AMI diagnosis, with the potential to revolutionize medical diagnosis by enabling multiple biomolecule detection on a single sensing platform.
JOURNAL OF THE TAIWAN INSTITUTE OF CHEMICAL ENGINEERS
(2021)
Article
Cardiac & Cardiovascular Systems
Matthew T. H. Lowry, Dimitrios Doudesis, Jasper Boeddinghaus, Dorien M. Kimenai, Anda Bularga, Caelan Taggart, Ryan Wereski, Amy Ferry, Stacey D. Stewart, Christopher Tuck, Luca Koechlin, Thomas Nestelberger, Pedro Lopez-Ayala, Gabrielle Hure, Kuan Ken Lee, Andrew R. Chapman, David E. Newby, Atul Anand, Paul O. Collinson, Christian Mueller, Nicholas L. Mills, High-STEACS Investigators
Summary: This study aimed to assess the diagnostic performance of cardiac troponin in early presenters. The sensitivity and negative predictive value of a single measurement of high-sensitivity cardiac troponin were compared using different thresholds. The results showed that in early presenters, a cardiac troponin level below the limit of detection can safely rule out myocardial infarction.
EUROPEAN HEART JOURNAL
(2023)
Article
Cardiac & Cardiovascular Systems
Olatunde Ola, Ashok Akula, Laura De Michieli, Marshall Dworak, Erika Crockford, Ronstan Lobo, Nicholas Rastas, Jonathan D. Knott, Ramila A. Mehta, David O. Hodge, Eric Grube, Swetha Karturi, Scott Wohlrab, Tahir Tak, Charles Cagin, Rajiv Gulati, Allan S. Jaffe, Yader Sandoval
Summary: This study evaluated the impact of high-sensitivity cardiac troponin T (cTnT) implementation in U.S. emergency department patients, showing a marked increase in myocardial injury and MI post-implementation, particularly in women and patients with type 2 MI.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2021)
Article
Cardiac & Cardiovascular Systems
Rasmus Bo Hasselbalch, Martin Schultz, Philip Andreas Schytz, Jonas Henrik Kristensen, Nina Strandkjaer, Mia Pries-Heje, Nicholas Carlson, Morten Schou, Henning Bundgaard, Christian Torp-Pedersen, Kasper Karmark Iversen
Summary: This study compared the prognostic and predictive ability of different cardiac troponin (cTn) assays in patients with acute coronary syndrome. The results showed that Siemens Vista cTnI was the strongest predictor of myocardial infarction, while high sensitivity cTnT was the strongest predictor of mortality. An inverted U-shape relationship was observed between cTn concentration and non-cardiovascular mortality.
EUROPEAN HEART JOURNAL-QUALITY OF CARE AND CLINICAL OUTCOMES
(2023)
Article
Cardiac & Cardiovascular Systems
Fred S. Apple, Stephen W. Smith, Jaimi H. Greenslade, Yader Sandoval, William Parsonage, Isuru Ranasinghe, Niranjan Gaikwad, Karen Schulz, Laura Stephensen, Christian W. Schmidt, Brynn Okeson, Louise Cullen
Summary: By using a rapid point-of-care whole-blood hs-cTnI assay, it is possible to safely exclude the possibility of myocardial infarction and expedite discharge from the emergency department.
Article
Cardiac & Cardiovascular Systems
Thomas E. Kaier, Raphael Twerenbold, Pedro Lopez-Ayala, Thomas Nestelberger, Jasper Boeddinghaus, Bashir Alaour, Iris-Martina Huber, Yuan Zhi, Luca Koechlin, Desiree Wussler, Karin Wildi, Samyut Shrestha, Ivo Strebel, Oscar Miro, Javier F. Martin-Sanchez, Michael Christ, Damien Kawecki, Dagmar Keller, Maria Rubini Gimenez, Michael Marber, Christian Mueller
Summary: Cardiac myosin-binding protein C (cMyC) has shown high diagnostic accuracy in the early detection of non-ST-elevation myocardial infarction (NSTEMI). Its dynamic release kinetics may enable a more effective 0/1h-decision algorithm compared to current ESC hs-cTnT/I algorithm.
EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE
(2022)
Article
Cardiac & Cardiovascular Systems
Jeanne du Fay de Lavallaz, Alexandra Prepoudis, Maria Janina Wendebourg, Eva Kesenheimer, Diego Kyburz, Thomas Daikeler, Philip Haaf, Julia Wanschitz, Wolfgang N. Loescher, Bettina Schreiner, Mira Katan, Hans H. Jung, Britta Maurer, Angelika Hammerer-Lercher, Agnes Mayr, Danielle M. Gualandro, Annemarie Acket, Christian Puelacher, Jasper Boeddinghaus, Thomas Nestelberger, Pedro Lopez-Ayala, Noemi Glarner, Samyut Shrestha, Robert Manka, Joanna Gawinecka, Salvatore Piscuoglio, John Gallon, Sophia Wiedemann, Michael Sinnreich, Christian Mueller
Summary: This study aimed to confirm the cardiac specificity of cTnT in patients with various skeletal muscle disorders (SMDs). The results showed that elevations in cTnT concentrations in patients with active chronic SMDs are common and not attributable to cardiac disease, while this phenomenon was not observed for cTnI. The re-expression of cTnT in skeletal muscle may partially explain this.
Article
Medical Laboratory Technology
Kristin M. Aakre, Amy K. Saenger, Rick Body, Paul Collinson, Ola Hammarsten, Allan S. Jaffe, Pete Kavsak, Torbjorn Omland, Jordi Ordonez-Lianos, Fred S. Apple
Summary: The International Federation of Clinical Chemistry Committee on Clinical Application of Cardiac Bio-Markers provides educational documents to promote uniform interpretation and utilization of cardiac biomarkers. The measurement of high-sensitivity cardiac troponin plays a crucial role in evaluating patients with symptoms and/or signs of acute cardiac ischemia.
CLINICAL CHEMISTRY
(2022)
Article
Medical Laboratory Technology
Xiaoying Li, Xuchu Wang, Tao Sun, Ying Ping, Yibei Dai, Zhenping Liu, Yiyun Wang, Danhua Wang, Xiaofen Xia, Hongbo Shan, Weiqun Zhang, Zhihua Tao
Summary: The newly developed chemiluminescent immune-based assay for detecting S100A1 showed potential for clinical use in the early identification and prognostic assessment of acute myocardial infarction. This method demonstrated high analytical sensitivity, a wide linear range, and good repeatability, with higher diagnostic sensitivity compared to conventional cardiac biomarkers.
CLINICA CHIMICA ACTA
(2021)
Article
Cardiac & Cardiovascular Systems
Patrick Badertscher, Jeanne du Fay de Lavallaz, Angelika Hammerer-Lercher, Christian Mueller
JOURNAL OF CARDIOVASCULAR TRANSLATIONAL RESEARCH
(2023)
Review
Cardiac & Cardiovascular Systems
Baris Gencer, Chris P. Gale, Suleman Aktaa, Sigrun Halvorsen, Ben Beska, Magdy Abdelhamid, Christian Mueller, Oktay Tutarel, Paul McGreavy, Henrik Schirmer, Tobias Geissler, Henrik Sillesen, Alexander Niessner, Kai Zacharowski, Julinda Mehilli, Tatjana Potpara
Summary: This study aims to establish quality indicators for the cardiovascular assessment and management of patients undergoing non-cardiac surgery. The researchers followed a systematic methodology to develop the indicators, including constructing a conceptual framework, conducting literature reviews, and using a modified Delphi method. The findings are important for improving the cardiovascular care of patients undergoing non-cardiac surgery.
EUROPEAN HEART JOURNAL-QUALITY OF CARE AND CLINICAL OUTCOMES
(2023)
Article
Cardiac & Cardiovascular Systems
Emmanuelle Duceppe, Flavia K. Borges, Maria Tiboni, Rupert Pearse, Matthew T. V. Chan, Sadeesh Srinathan, Peter A. Kavsak, Amit X. Garg, Daniel I. Sessler, Robert Sapsford, Diane Heels-Ansdell, Shirley Pettit, Javiera Vasquez, Christian Mueller, Micheal Walsh, Wojciech Szczeklik, Reitze Rodseth, Manoj Lalu, Lehana Thabane, Gordon Guyatt, P. J. Devereaux
Summary: Elevation of hs-cTnI within the first 3 days after noncardiac surgery independently predicts major cardiac events and death at 30 days. Patients with postoperative hs-cTnI levels > 60 ng/L had a > 7-fold increase in the risk of subsequent major cardiac events and mortality at 30 days.
CANADIAN JOURNAL OF CARDIOLOGY
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Christian Mueller, Tamar S. Muench-Gerber, Rudolf A. de Boer
EUROPEAN HEART JOURNAL
(2023)
Article
Oncology
Mohamed E. Elsesy, Su Jung Oh-Hohenhorst, Christoph Oing, Alicia Eckhardt, Susanne Burdak-Rothkamm, Malik Alawi, Christian Mueller, Ulrich Schueller, Tobias Maurer, Gunhild von Amsberg, Cordula Petersen, Kai Rothkamm, Wael Y. Mansour
Summary: This study provides preclinical models for castration-resistant prostate cancer (CRPC) that can predict homologous recombination repair (HRR) defects and the sensitivity to olaparib and cisplatin. These models recapitulate the features of primary tumors, enabling individualized drug screening for tailored therapy recommendations.
MOLECULAR ONCOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Martin Segeroth, David Jean Winkel, Ivo Strebel, Shan Yang, Jan Gerrit van der Stouwe, Jude Formambuh, Patrick Badertscher, Joshy Cyriac, Jakob Wasserthal, Federico Caobelli, Antonio Madaffari, Pedro Lopez-Ayala, Michael Zellweger, Alexander Sauter, Christian Mueller, Jens Bremerich, Philip Haaf
Summary: The aim of the study was to quantify pulmonary transit time (PTT) in routine cardiovascular magnetic resonance imaging perfusion sequences. PTT was found to be significantly associated with left and right ventricular ejection fraction. The study suggests that PTT can be used as a non-invasive biomarker to evaluate patients with dyspnea and heart failure.
EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Sigrun Halvorsen, Julinda Mehilli, Christian Mueller
EUROPEAN HEART JOURNAL
(2023)
Article
Cardiac & Cardiovascular Systems
Matthew T. H. Lowry, Dimitrios Doudesis, Jasper Boeddinghaus, Dorien M. Kimenai, Anda Bularga, Caelan Taggart, Ryan Wereski, Amy Ferry, Stacey D. Stewart, Christopher Tuck, Luca Koechlin, Thomas Nestelberger, Pedro Lopez-Ayala, Gabrielle Hure, Kuan Ken Lee, Andrew R. Chapman, David E. Newby, Atul Anand, Paul O. Collinson, Christian Mueller, Nicholas L. Mills, High-STEACS Investigators
Summary: This study aimed to assess the diagnostic performance of cardiac troponin in early presenters. The sensitivity and negative predictive value of a single measurement of high-sensitivity cardiac troponin were compared using different thresholds. The results showed that in early presenters, a cardiac troponin level below the limit of detection can safely rule out myocardial infarction.
EUROPEAN HEART JOURNAL
(2023)
Article
Emergency Medicine
Lluis Llauger, Begona Espinosa, Zubaid Rafique, Stephen Boone, Greg Beuhler, Javier Millan-Soria, Victor Gil, Javier Jacob, Aitor Alquezar-Arbe, Maria Campos-Meneses, Rosa Escoda, Josep Tost, Enrique Martin-Mojarro, Alfons Aguirre, Maria Luisa Lopez-Grima, Julio Nunez, Wilfried Mullens, Pedro Lopez-Ayala, Christian Mueller, Pere Llorens, Frank Peacock, Oscar Miro
Summary: The deterioration of renal function upon arrival at the emergency department is associated with increased risk of death and prolonged hospitalization in patients with acute heart failure. Even a slight increase in creatinine levels can indicate a higher risk.
EUROPEAN JOURNAL OF EMERGENCY MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Jasper Boeddinghaus, Thomas Nestelberger, Luca Koechlin, Pedro Lopez-Ayala, Desiree Wussler, Maximilian Mais, Luca Zwimpfer, Tobias Zimmermann, Karin Wildi, Maria Rubini Gimenez, Ivo Strebel, Oscar Miro, F. Javier Martin-Sanchez, Jiri Parenica, Dagmar Keller, Danielle M. Gualandro, Christian H. Nickel, Roland Bingisser, Michael Christ, Christian Mueller
Summary: Accompanying dyspnoea is common in patients presenting with acute chest pain/discomfort to the emergency department, and it is associated with cardiac, non-coronary disease. The presence of dyspnoea does not affect the diagnostic accuracy of high-sensitivity cardiac troponin and the safety of the diagnostic work-up, but it is an independent predictor for cardiovascular and all-cause death.
EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE
(2023)
Article
Cardiac & Cardiovascular Systems
David A. Morrow, Nicholas L. Mills, Christian Mueller
EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Christian Puelacher, Nicholas L. Mills, Christian Mueller
EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE
(2023)
Letter
Cardiac & Cardiovascular Systems
Desiree Wussler, Maria Belkin, Christian Mueller
Editorial Material
Cardiac & Cardiovascular Systems
Jonas Glaeser, Pedro Lopez-Ayala, Christian Mueller
Summary: This commentary discusses the randomized trial by C. Camaro et al. on ruling out non-ST-segment elevation acute coronary syndrome through a single, pre-hospital troponin measurement, as well as their discussion piece on the need for more prospective randomized controlled trials in this area.
EUROPEAN HEART JOURNAL
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Evangelos Giannitsis, Nicholas L. Mills, Christian Mueller
EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE
(2023)
