Article
Cardiac & Cardiovascular Systems
John Hung, Andreas Roos, Erik Kadesjo, David A. McAllister, Dorien M. Kimenai, Anoop S. Shah, Atul Anand, Fiona E. Strachan, Keith A. A. Fox, Nicholas L. Mills, Andrew R. Chapman, Martin J. Holzmann
Summary: The GRACE 2.0 score showed good discrimination for predicting all-cause death at 1 year in patients with type 1 myocardial infarction, but only moderate discrimination for those with type 2 myocardial infarction.
EUROPEAN HEART JOURNAL
(2021)
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)
Review
Cardiac & Cardiovascular Systems
Mario Gaudino, Antonino Di Franco, Cristiano Spadaccio, Mohamed Rahouma, N. Bryce Robinson, Michelle Demetres, Stephen Fremes, Torsten Doenst
Summary: This study investigates the association between spontaneous myocardial infarction (SMI) reduction and survival benefit in coronary artery bypass (CABG) compared with percutaneous interventions (PCI). The results show that CABG is associated with a lower incidence of SMI and higher survival rate compared to PCI.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
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
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.
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
Shun Furusawa, Masataka Ikeda, Tomomi Ide, Takuya Kanamura, Hiroko Deguchi Miyamoto, Ko Abe, Kosei Ishimaru, Masatsugu Watanabe, Yoshitomo Tsutsui, Ryo Miyake, Satoshi Fujita, Takeshi Tohyama, Shouji Matsushima, Yoshihiro Baba, Hiroyuki Tsutsui
Summary: The study established a murine model of cAAb-positive HF post-MI, showing that targeting cAAbs can improve cardiac inflammation, remodeling, and HF in post-MI HF.
CIRCULATION-HEART FAILURE
(2023)
Article
Medicine, General & Internal
Andrea Carlo Merlo, Roberta Della Bona, Pietro Ameri, Italo Porto
Summary: In the expanding world of cardiovascular diseases, the main focus is on coronary atherosclerosis, but middle-aged male patients with acute myocardial infarction are no longer as common. Due to higher life expectancy and medical advances, physicians are now treating older and frailer individuals. Myocardial ischaemia and infarction often result from an imbalance between myocardial oxygen supply and demand, known as type 2 myocardial infarction. However, T2MI is still underdiagnosed and undertreated.
INTERNAL AND EMERGENCY MEDICINE
(2022)
Article
Biochemistry & Molecular Biology
Sohyen Kwon, Sang-Hyun Park, Sora Mun, Jiyeong Lee, Hee-Gyoo Kang
Summary: Classifying myocardial infarction by subtype is essential, and troponin is not specific enough to distinguish subtypes. Therefore, we identified new markers using mass spectrometry to differentiate type 1 myocardial infarction from other diseases characterized by elevated troponin. We found that α-1 acid glycoprotein 2, corticosteroid-binding globulin, and serotransferrin could potentially serve as distinguishing markers.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Cardiac & Cardiovascular Systems
Pedro Lopez-Ayala, Thomas Nestelberger, Jasper Boeddinghaus, Luca Koechlin, Paul David Ratmann, Ivo Strebel, Juliane Gehrke, Severin Meier, Joan Walter, Maria Rubini Gimenez, Eugenio Mutschler, Oscar Miro, Beatriz Lopez-Barbeito, Francisco Javier Martin-Sanchez, Esther Rodriguez-Adrada, Dagmar I. Keller, L. Kristin Newby, Raphael Twerenbold, Evangelos Giannitsis, Bertil Lindahl, Christian Mueller
Summary: The study validated the ESC NSTEMI guidelines for the observe-zone of the 0/1h hs-cTnT algorithm and proposed new 0/3h criteria, which can more accurately rule out or rule in NSTEMI by measuring hs-cTnT concentrations and changes.
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
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
Vikram Sharma, Kevin Chen, Shehab A. R. Alansari, Beni Verma, Edward G. Soltesz, Douglas R. Johnston, Michael Zhen-Yu Tong, Eric E. Roselli, Per Wierup, Gosta B. Pettersson, A. Marc Gillinov, Stephen G. Ellis, Conrad Simpfendorfer, Eugene H. Blackstone, Samir Kapadia, Lars G. Svensson, Faisal G. Bakaeen
Summary: Patients undergoing interventional treatment for suspected coronary ischemia within 3 weeks after cardiac surgery are rare, but have a high mortality rate, especially in cases other than STEMI/non-STEMI. Troponin T is not a reliable marker of underlying coronary or graft obstruction in patients with symptoms of myocardial ischemia after cardiac surgery, but is a strong predictor of 1-year mortality.
ANNALS OF THORACIC SURGERY
(2021)
Article
Medicine, General & Internal
Ayesha Khan, Muhammad S. Saleem, Keith D. Willner, Luke Sullivan, Elsie Yu, Osama Mahmoud, Amro Alsaid, Martin E. Matsumura
Summary: Accelerated diagnostic protocols (ADPs) using high-sensitivity troponin levels have excellent sensitivity and negative predictive value for rapid risk stratification of chest pain patients. Patients discharged following ADP with discordant results had significantly higher rates of major adverse cardiac events, especially among those with a peak hsTnT level between 12 and 51 ng/L. Application of a HEART score of 4 or greater may help in discharge decisions for patients with ADP-discordant troponin series.
Article
Cardiac & Cardiovascular Systems
Ananya Singh, Jacek Kwiecinski, Sebastien Cadet, Aditya Killekar, Evangelos Tzolos, Michelle C. Williams, Marc R. Dweck, David E. Newby, Damini Dey, Piotr J. Slomka
Summary: This study aimed to develop a novel fully automated method to register coronary F-18-sodium-fluoride (F-18-NaF) positron emission tomography (PET) to CT angiography using pseudo-CT generated by generative adversarial networks (GAN). Non-rigid registration was used to align PET with CT angiography and the results were compared between observer and automated alignment in terms of translations, maximal standard uptake value (SUVmax), and target to background ratio (TBRmax) at the location of plaques.
JOURNAL OF NUCLEAR CARDIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Mohammed N. Meah, Ryan Wereski, Anda Bularga, Edwin J. R. van Beek, Marc R. Dweck, Nicholas L. Mills, David E. Newby, Damini Dey, Michelle Claire Williams, Kuan Ken Lee
Summary: In patients with acute chest pain, plasma cardiac troponin I concentrations >= 5 ng/L, even without myocardial infarction, are associated with a higher burden of low-attenuation coronary plaque. This suggests that cardiac troponin may be indicative of future adverse cardiovascular events in these patients.
Article
Cardiac & Cardiovascular Systems
Praveen Thokala, Steve Goodacre, Katherine Oatey, Rachel O'Brien, David E. Newby, Alasdair Gray
Summary: This study aimed to estimate the cost-effectiveness of early CT coronary angiography (CTCA) for intermediate risk patients with suspected acute coronary syndrome (ACS), compared with standard care. The results showed that within the trial, there were no significant differences in costs or QALYs between early CTCA and standard care. Long-term economic analysis suggested higher long-term costs with CTCA and uncertain effect on long-term QALYs, making routine use of CTCA for suspected ACS unlikely to be a cost-effective use of NHS resources.
Review
Cardiac & Cardiovascular Systems
Natasha Corballis, Vasiliki Tsampasian, Ioannis Merinopoulis, Tharusha Gunawardena, U. Bhalraam, Simon Eccleshall, Marc R. Dweck, Vassilios Vassiliou
Summary: Computed tomography coronary angiography (CTCA) is a safe strategy for investigating patients with stable angina, showing no increased risk of major adverse cardiovascular events (MACE) compared to invasive coronary angiography (ICA), and a reduction in the need for revascularization.
Review
Radiology, Nuclear Medicine & Medical Imaging
Beth Whittington, Marc R. R. Dweck, Edwin J. R. van Beek, David Newby, Michelle C. C. Williams
Summary: PET-MRI combines MRI's anatomical detail and tissue characterization with PET's functional information, allowing for the identification of biological activity and high-risk plaque features within the coronary arteries. It can also provide information on myocardial perfusion, viability, and function, characterizing the downstream effects of coronary artery disease on the myocardium.
JOURNAL OF MAGNETIC RESONANCE IMAGING
(2023)
Article
Cardiac & Cardiovascular Systems
Jonathan R. Weir-McCall, Michelle C. Williams, Anoop S. V. Shah, Giles Roditi, James H. F. Rudd, David E. Newby, Edward D. Nicol
Summary: This study aimed to assess the impact of the CG95 guidelines. The results showed an increase in the use of CCTA recommended by the CG95 guidelines, no change in myocardial perfusion imaging, and a modest reduction in invasive coronary angiography. Moreover, the increase in CCTA use was associated with a reduction in cardiovascular mortality.
JACC-CARDIOVASCULAR IMAGING
(2023)
Article
Medicine, General & Internal
Elaine Butterly, Peter Hanlon, Anoop S. V. H. Shah, Laurie Hannigan, Emma S. McIntosh, Jim M. Lewsey, Sarah Wild, Bruce J. Guthrie, Frances A. Mair, David Kent, Sofia Dias, Nicky Welton, David McAllister
Summary: This study aimed to investigate the impact of multimorbidity on quality of life. The results showed that a higher comorbidity count was associated with lower baseline quality of life and a decline over time. However, treatment effects on quality of life were not modified by multimorbidity.
Article
Emergency Medicine
Jamie G. Cooper, James Ferguson, Lorna A. Donaldson, Kim M. M. Black, Kate J. Livock, Judith L. Horrill, Elaine M. Davidson, Neil W. Scott, Amanda J. Lee, Takeshi Fujisawa, Kuan Ken Lee, Atul Anand, Anoop S. Shah, Nicholas L. Mills
Summary: The study aimed to investigate whether the HEART score can be used by paramedics in a prehospital setting with high-sensitivity cardiac troponin testing available. The results showed that a HEART score derived by paramedics in the prehospital setting, even when modified to harness the precision of a high-sensitivity assay, does not allow safe rule-out of myocardial infarction or enhanced rule-in compared with cardiac troponin testing alone.
EMERGENCY MEDICINE JOURNAL
(2023)
Review
Cardiac & Cardiovascular Systems
Muhammad Shahzeb Khan, Muhammad Shariq Usman, Khawaja M. Talha, Harriette G. C. Van Spall, Stephen J. Greene, Muthiah Vaduganathan, Sadiya S. Khan, Nicholas L. Mills, Ziad A. Ali, Robert J. Mentz, Gregg C. Fonarow, Sunil Rao, John A. Spertus, Matthew T. Roe, Stefan D. Anker, Stefan K. James, Javed Butler, Darren K. McGuire
Summary: Embedding RCTs into electronic health records or wearable sensors can simplify trial processes. The use of web-enabled devices and internet connectivity enables data collection on cardiovascular health. Robust mechanisms and standardized data definitions are needed to capture data from different databases. Clinical research guidelines, ethics oversight, and regulatory requirements need to adapt. This review discusses the potential of routinely generated data for RCTs.
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
Cardiac & Cardiovascular Systems
Henry W. West, Muhammad Siddique, Michelle C. Williams, Lucrezia Volpe, Ria Desai, Maria Lyasheva, Sheena Thomas, Katerina Dangas, Christos P. Kotanidis, Pete Tomlins, Ciara Mahon, Attila Kardos, David Adlam, John Graby, Jonathan C. L. Rodrigues, Cheerag Shirodaria, John Deanfield, Nehal N. Mehta, Stefan Neubauer, Keith M. Channon, Milind Y. Desai, Edward D. Nicol, David E. Newby, Charalambos Antoniades
Summary: A deep-learning network has been developed to automate the quantification of epicardial adipose tissue (EAT) volume in coronary computed tomography angiograms (CCTA), which is applicable to patients with challenging anatomy. EAT volume is a powerful marker of metabolically unhealthy visceral obesity and has prognostic value in cardiovascular risk stratification.
JACC-CARDIOVASCULAR IMAGING
(2023)
Article
Hematology
Jacek Kwiecinski, Marton Kolossvary, Evangelos Tzolos, Mohammed N. Meah, Philip D. Adamson, Nikhil V. Joshi, Michelle C. Williams, Edwin J. R. van Beek, Daniel S. Berman, Pal Maurovich-Horvat, David E. Newby, Marc R. Dweck, Damini Dey, Piotr J. Slomka
Summary: This study investigated the predictive ability of F-18-sodium fluoride positron emission tomography and radiomics-based precision coronary plaque phenotyping derived from coronary computed tomography angiography in risk stratification of patients with coronary artery disease. The results showed that the morphological features of coronary plaques, quantitative plaque volumes, and disease activity on F-18-sodium fluoride positron emission tomography were additive predictors of myocardial infarction.
ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY
(2023)
Letter
Medicine, General & Internal
Dorien M. Kimenai, Nicholas L. Mills
Article
Cardiac & Cardiovascular Systems
Jessica Artico, Hunain Shiwani, James C. Moon, Miroslawa Gorecka, Gerry P. McCann, Giles Roditi, Andrew Morrow, Kenneth Mangion, Elena Lukaschuk, Mayooran Shanmuganathan, Christopher A. Miller, Amedeo Chiribiri, Sanjay K. Prasad, Robert D. Adam, Trisha Singh, Chiara Bucciarelli-Ducci, Dana Dawson, Daniel Knight, Marianna Fontana, Charlotte Manisty, Thomas A. Treibel, Eylem Levelt, Ranjit Arnold, Peter W. Macfarlane, Robin Young, Alex McConnachie, Stefan Neubauer, Stefan K. Piechnik, Rhodri H. Davies, Vanessa M. Ferreira, Marc R. Dweck, Colin Berry, John P. Greenwood
Summary: This study aimed to assess the presence, nature, and extent of myocardial damage in hospitalized patients with troponin elevation and COVID-19. The study found that patients with COVID-19 and elevated cardiac troponin levels had more ventricular impairment and myocardial scar compared to the control group. However, the proportion of myocarditis was low and scar pathogenesis was diverse.