جستجوی مقالات مرتبط با کلیدواژه "cardiac troponin i" در نشریات گروه "پزشکی"

Cardiac troponin I (cTn I) has been demonstrated as a possible useful biomarker for myocardial injuries. The present study aimed to evaluate potential relationships between this biomarker and neonatal morbidities among preterm neonates.

This cohort study was carried out at an Iranian Hospital (Tehran-Iran; 2021). Newly-born preterm neonates entered the study. Blood sampling was performed immediately after neonatal intensive care unit (NICU)  admission and sent to the laboratory to detect levels of plasma cTnI. The correlations between the levels of plasma Tn I and each neonatal outcome were evaluated as the primary outcome.

A total of 101  NICU hospitalized neonates with the mean gestational age, 1st, and 5th minutes Apgar scores of 33.750±2.125 (Range: 29-37) weeks, 7.6471±1.766, and 9.188±1.205 entered the study. The mean and median of Troponin I levels were 0.131±0.126 and 0.0920 ng/ml. The results pointed out that neonates who died during hospitalization or required CPR (cardiopulmonary resuscitation) had lower troponin I in comparison with their controls; nonetheless, the differences were not significant (P=0.950 & P=0.557). The mean±SD of troponin I was not significantly different between neonates with and without PDA (p=0.741), asphyxia (P=0.298), and intubation (P=0.212). The occurrences of necrotizing enterocolitis, respiratory distress syndrome, bronchopulmonary dysplasia, intraventricular hemorrhage, and sepsis were not also significant factors for the alteration of troponin I (P>0.05).

Since there were no relationships between cTn I and neonatal outcomes, great caution should be implemented regarding the use of single cTn I value as a diagnostic marker for short-term neonatal adverse outcomes. Further investigations with larger sample sizes are strongly suggested.

Thrombolytic therapy is a key in the management of ST elevated myocardial infarction (STEMI). Metformin implies a series of cardioprotective effects. We aimed to investigate how pretreatment with metformin could affect cardiac troponin I (cTnI) levels following reteplase therapy amid STEMI patients.

A pilot randomized clinical trial was carried out in 80 STEMI patients undergoing thrombolytic therapy with reteplase. The metformin group (n = 40) received a single dose of 1000 mg metformin orally before receiving reteplase, while the control group (n = 40) received only reteplase. The serum level of cTnI was measured at baseline, 8, 16, 24, and 32 hours after the admission to assess myocardial damage.

There was no significant difference in cTnI levels at baseline (p = 0.657), 8 (p = 0.93), 16 (p = 0.690), 24 (p = 0.217), and 32 (p = 0.517) hours after STEMI diagnosis between two groups. The mean differences were also not significant for changes of cTnI at baseline and other time frames.

The results of the present study demonstrated that early use of 1000 mg metformin prior to reteplase could not reduce the level of cTnI in STEMI patients.

Evaluation of the effect of 8 weeks of High-Intensity Interval Training (HIIT) on the serum level of cardiac troponin T (cTnT) in sedentary obese young men.

Thirty sedentary men were randomly divided into 3 groups: the 30s HIIT training group (n=10), the 60s training group (n=10), and the control group (no exercise) (n=10). Interval training with 90 %VO2peak was done in 3 sessions for 8 weeks. cTnT was measured 5 times; pre-exercise, 4hrs, and 24hrs after the first session (4hF, 24hF), and 4hrs and 24hrs after the last training session (4hL, 24hL). ANOVA with repeated measures and Bonferroni post-hoc tests were used by SPSS 23 with a significance level of (P< 0.05).

The significant increase in serum levels of cTnT in the post-tests of the 60s HIIT compared to the first 24hrs and the last 24hrs (P= 0.0001). But in the 30s group it was not significant compared to the other measurements (P≥ 0/05). In the 2 training groups, serum levels of cTnT in the last 4hr post-tests of the last week were not significantly different from the 4hrs post-tests of the first week (P≥ 0.05).

It seems that none of these activities cause heart damage sustained, and changes in cTnT levels in two 4hrs compared to the first and last 24hrs of the 60s group may be due to reversible leakage of cardiac cell membranes, and may continuous exercise will reduce this reduction.

Acute exacerbations are the important reasons for hospitalization and death in chronic obstructive pulmonary disease (COPD) patients. We aimed to evaluate the relationship between serum concentrations of cardiac troponin I (cTnI) and the outcome of COPD patients visiting the emergency department with acute exacerbation of COPD (AECOPD). In this study, we included 90 AECOPD patients between October 2018 and October 2019. Serum cTnI was measured during the first 24 and 48 hours after admission. Patients were categorized into two groups positive cTnI values (≥0.3 ng/dl) and negative cTnI (<0.3 ng/dl). The outcomes of patients were compared between the two groups. Patients in Positive cTnI group in the first 24 hours and 48 hours compared to patients in negative group had significantly higher rate of in-hospital [(66.7% vs. 3.7%, P<0.001) and (50.0% vs. 3.8%, P<0.001), respectively)] and 30-day mortality rates [(88.9% vs. 3.3%, P<0.001) and (66.7% vs. 5.1%, P<0.001), respectively)]. The number of cases requiring intubation [(100% vs. 12.3%, P<0.001) and (75.0% vs. 12.8%, P<0.001), respectively)] and cardiopulmonary resuscitation (CPR) [(100.0% vs. 5.5%, P<0.05) and (100.0% vs. 5.5%, P<0.001), respectively)] as well as the duration of intensive care unit (ICU) stay [(37.00±14.61 vs 9.83±4.93 days, P<0.001) and (37.00±14.61 vs 9.83±4.93 days, P<0.001), respectively)] were also higher in cTnI positive patients. Increased cTnI during AECOPD is associated with higher rates of CPR, need for mechanical ventilation and in-hospital, short-term mortalities, and a longer ICU stay.

There are arguments regarding the relationship between the level of cardiac troponin I (cTnI) and presence of cardiac diseases in end-stage renal disease (ESRD) patients. This study aimed to determine the relationship between positivity of cTnI and cause of admission and patients’ outcome in ESRD patients.

In this cross-sectional study, all ESRD patients who had checked cTnI and admitted to two university hospitals in Isfahan, Iran were enrolled. The patients’ demographic characteristics, cause of admission, and outcome were correlated with cTnI positivity.

Out of a total of 348 ESRD patients, 100 subjects had positive cTnI. There was a positive correlation between age and admission in Al-Zahra hospital with positive cTnI. In contrast, vascular access complication and hypertension had a negative correlation with positivity of cTnI. The results of multiple logistic regression analysis showed that factors including age (OR: 1.04; 95% CI: 1.01 - 1.07; P: 0.004) and infections (OR: 3.1; 95% CI: 1.3 - 7.3; P: 0.009) were associated with increased risk of in-hospital mortality. In contrary, exit site infection (OR: 0.11; 95% CI: 0.01 - 0.8; P: 0.03) and hypertension (OR = 0.32; 95% CI: 0.14 - 0.77; P = 0.01) were associated with decreased risk of mortality. Although cTnI positivity correlated with patients’ in-hospital mortality (OR = 2.038).

Although positive cTnI had a borderline association with in-hospital mortality in ESRD patients, further multicenter studies with larger sample size are required to confirm the results.

Pulmonary embolism (PE) is among the deadliest diseases in that it can cause sudden death. The present study aimed to determine cardiac troponin I (CTnI) variation trends in patients with acute PE referred to Rajaie Cardiovascular Medical and Research Center.

This cross-sectional descriptive-analytical study consecutively enrolled 54 patients with acute PE. Variation trends of CTnI were measured in the study population at 5 different time points: upon admission and subsequently 8, 24, 48, and 72 hours post-admission. The relationships between CTnI variation trends and computed tomography angiography, echocardiography, and electrocardiography findings were investigated. CTnI variation trends were compared between a group undergoing catheter-directed thrombolysis (CDT) and a group receiving the conventional anticoagulant treatment. The data were analyzed using the SPSS software, version 20.

A reduction was observed in the CTnI variation trends of all the samples. Both groups exhibited a decline in CTnI levels, but the slope of this reduction was steeper in the CDT group (P=0.04). Additionally, a significant relationship was also detected between CTnI reduction and right ventricular function improvement (P=0.04). No significant association was observed between systolic pulmonary artery pressure changes and CTnI variation trends.

The results indicated a significant relationship between reduced CTnI levels and improved right ventricular function. Additionally, the CDT group showed a significant fall in the CTnI level compared with the anticoagulant-only group. (Iranian Heart Journal 2022; 23(1): 198-204)

 Cardiac troponin I (CTnI) is recognized as a proper marker for early detection of cardiac damage. Generalized tonic-clonic (GTC) seizures may lead to cardiac ischemia or myocardial injury associated with elevated CTnI. The present study aimed at evaluating the level of CTnI in children with status GTC seizures.

 50 patients with GTC seizures and a normal cardiac function referred to Amirkabir Hospital, Arak, Iran were evaluated. The medical history of all patients was taken, and clinical examinations were performed. For all patients were performed Serum CTnI measurements, electroencephalography (EEG), electrocardiography (ECG), and echocardiography.

 The patients’ mean age was 7.80 ± 4.01 years and 26 (52%) children were female (female: male ratio, 1.08). the mean duration of seizure was 31.54 ± 1.56 minutes. Abnormal EEG patterns were documented in 83 (86%) patients, while abnormal CT scan was not found in any of the patients. The mean level of CTnI was at the high end of the range in patients (57.02 ± 10.80 ng/mL). There was a positive correlation between serum CTnI and age (P = 0.001, R = 0.492). Also, the serum level of CTnI was significantly correlated with the onset of GTC seizure (R = 0.004, P = 0.001).

 The serum CTnI level exceeded the normal level in children with seizures. Therefore, cardiac monitoring of patients with status GTC seizures may be helpful in the ictal and postictal phases for evaluating cardiac injury, especially in children with risk factors for coronary diseases, such as Kawasaki disease, cardiomyopathy, or coronary anomalies.
 

To investigate the expression levels of microRNA-146b (miR-146b) and cardiac troponin I (anti-cTnI) in serum of children with viral myocarditis and their clinical significance.

Forty-eight children with viral myocarditis (patient group) and 40 healthy physical examinees (healthy group), who were diagnosed in Jinan City People’s Hospital Affiliated to Shandong First Medical University, China from Feb 2018 to May 2019, were enrolled as study subjects. Reverse transcription polymerase chain reaction (RT-PCR) was used to detect the level of miR-146b in serum of children. ELISA was used to detect the expression of anti-cTnI in serum of children. Pearson was used to analyze the correlation between the level of miR-146b and the level of anti-cTnI, and the factors affecting the prognosis.

The levels of miR-146b and anti-cTnI in serum of children in patient group were statistically significantly higher than those of healthy group (P<0.01). The AUC of miR-146b was 0.741, (95% CI: 0.638-0.843), the specificity was 62.50%, the sensitivity was 82.50%, and the AUC of anti-cTnI was 0.720 (95% CI: 0.608-0.832), the specificity was 64.58% and the sensitivity was 92.50%. The level of miR-146b was positively correlated with the level of anti-cTnI (r=0.601, P<0.05). CK-MB, LVEF, miR-146b and anti-cTnI expression were independent risk factors affecting the prognosis.

The levels of miR-146b and anti-cTnI increased in serum of patients with viral myocarditis. They were related to the degree of myocardial injury, which indicated that miR-146b and anti-cTnI might be involved in the pathological process of viral myocarditis.

Infection with the novel coronavirus, named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), producing a clinical syndrome known as COVID-19, is a budding infectious disease that first manifested in December 2019 in China and subsequently spread worldwide.

We performed an analysis of cardiac injurymarkers to determine their usefulness as predictors of severity andmortality

In a retrospective study, we enrolled 73 patients with confirmed diagnoses of COVID-19, from March 21, 2020, to April 24, 2020. Serial tests of cardiac injury markers, including cardiac troponin I (cTnI), N-terminal pro-brain natriuretic peptide (NTproBNP), and Lactate dehydrogenase (LDH), were considered for the analysis of potential cardiac damage.

Among 149 patients with confirmed COVID-19, data from 73 patients were studied. Of them, 58 (79.46%) patients were discharged, and 15 (20.54 %) patients died. The mean age was 58.50 (14.66) years. Patients were classified into mild (39 cases), severe (17 cases), and critical (17 cases) groups. The peak cardiac troponin I level (0.11 ng/mL [IQR: 0.33–0.20]), peak NT-pro BNP level (5840.35 pg/mL [IQR: 1609.39 – 10071.32]), and peak LDH level (578.65 UI/l[IQR: 313.40 – 843.90]) were significantly higher in the critical group, and the three cardiac injury parameters were significantly higher in the death group, suggesting that they are significantly associated with a higher risk of in-hospital mortality.

The understanding of cardiovascular system injury caused by SARS-CoV-2 and its underlying mechanisms is of great importance for the early clinical management of these patients and mortality reduction.

The aim of this study was to assess the validity of using early cardiac troponin (cTn) levels for the identification of postoperative myocardial infarction (MI) in patients undergoing off‑pump coronary artery bypass (OPCAB) graft surgery, identify influencing factors, and determine optimal cut‑off values for early identification.

Patients undergoing OPCAB by a single surgical unit from January 2018 to January 2020 were included in this prospective study. Their preoperative and intraoperative characteristics were noted. The cTn was collected at 12 h and the in-hospital outcome was studied.

A total of 370 patients were included in the study. Eleven patients had MI determined by other criteria (2.9%), but 220 patients (60%) were identified using cTn consensus cut‑off value, as per the universal definition of MI. This indicated significant mislabelling of coronary artery bypass graft‑related MI and need for the recalculation to have a realistic cut-off value. The optimal cut-off levels at for identifying postoperative MI was found to be 1.8 ng/ml at 12 h, with a higher negative predictive value to exclude mislabeling. Using a cTn range, rather than a single cut-off value, would be more helpful. The factors causing significant mislabeled elevation of postoperative cTn were found to be preoperative high levels and intraoperative findings of iatrogenic hematoma secondary to suction stabilizer, surgical maneuvers for intramyocardial target vessels.

The cTn levels were affected by the various patient and operative factors and measurements using higher cut-offs were needed to rule out MI. Certain factors peculiar to OPCAB were found to be significantly responsible. It will help identify patients needing earlier invasive re‑intervention or focused intensive care.

End-stage renal disease is a situation that predisposes the patients to cardiovascular disease, especially myocardial infarction (MI). A valuable biomarker for the diagnosis of this event is cardiac troponin. Although some asymptomatic patients show high plasma levels of cardiac troponin I, it is still the most sensitive variable in MI. All patients more than 18-year-old, on chronic ambulatory peritoneal dialysis (CAPD) for at least three months, and did not have a history of acute myocardial infarction or hospitalization for CVD during last month are included in a cross-sectional descriptive study. Troponin I serum level was measured by VIDAS Troponin I Ultra (TNIU) Assay. Correlation between serum troponin level and cardiovascular risk factors are evaluated. In this study, 52% of patients were male. The mean cTnI level was 0.025±0.044 ng/mL, less than 0.11 ng/mL, and only five patients had cTnI level more than the laboratory threshold. The cut-off level of cTnI for diagnosing cardiovascular disease must be re-evaluated and maybe increase to 0.3 ng/mL. Indeed, the asymptomatic patient may need more close observation for cardiovascular disease.

Shift work can be considered a cause of health problems and a risk factor for developing cardiovascular diseases.

The purpose of the present study was to evaluate the effect of aerobic physical activity on cTNI, visceral fat and plasma biomarkers of cardiovascular disease risk among shift workers of Sarir Plast Industrial Group.

The present research is a semi-experimental research that was carried out on the shift workers of the Sarir Plast Industrial Group. Thirty workers, with an average of 5 years of shift work history, were selected through judgmental sampling technique and were then randomly assigned to the two groups of aerobic physical activity (n = 15) and control group (n = 15). Based on the schedule, the experimental group performed 8 weeks, 3 sessions per week with 50% - 70% THR intensity. Both before and immediately after the plan, the activity, height, BW, VF, cTNI, TC, TG, HDL, LDL, vLDL and VO2, max were measured. For data analysis, Kolmogorov-Smirnov test, Levene’s test, Mbox-test, and ANCOVA were employed (P < 0.05).

The BW, VF, TC, TG, and LDL significantly decreased in the post-test for the experimental group, while the value of HDL and VO2, max increased. However, cTNI and vLDL did not change significantly (P < 0.05).

Aerobic physical activity was effective in reducing the risk factors of CVD in shift workers. It appeared that aerobic physical activity could be used as a non-pharmacological approach to prevent CVD in shift workers.

In patients undergoing Cardiopulmonary Bypass (CPB) with extracorporeal circulation, the rapid restoration of blood flow to the ischemic tissue induces cardiac damage termed as myocardial Ischemic Reperfusion (I/R) injury.

In the current study, the researchers hypothesized that Dexmedetomidine (DEX) modulates I/R injury in Coronary Artery Bypass Graft Surgery (CABG) with Cardiopulmonary Bypass (CPB).

This randomized, double-blind, clinical trial took place in a university affiliated Hospital, Gilan, Iran. From April 2016 to March 2017, 114 eligible patients undergoing elective and isolated CABG were randomized to receive either DEX infusion 0.3 to 0.5 µg/kg/hour before induction of anesthesia till 12 hours postoperatively (group D) or normal saline as placebo (group C). The endpoints were used to assess creatinine phosphokinase-MB (CKMB) and cardiac troponin I (CTnI) levels at four measurement time points, including baseline (T0) and 6, 12, 24, and 48 hours after the operation (T0 - T4).

Overall, 114 patients’ data were analyzed; group D (n = 58) and group C (n = 56). No significant differences were found between the two groups, in view of baseline characteristics. Following CPB, a marked increase in CKMB and CTnI plasma levels was observed in both groups compared with baseline (P = 0.0001). Serum CKMB levels increased from 2.27 ± 0.59 to 7.81 ± 1.39, and 2.22 ± 0.64 to 7.46 ± 1.25 and CTnI levels from 10.22 ± 0.17 to 4.89 ± 1.1, and 0.27 ± 0.28 to 4.5 ± 1.4 in groups C and D, respectively (P = 0.0001). According to CKMB, there was a significant difference between the two groups at T2 (P = 0.002) and T3 (P = 0.0001), and based on CTnI at T2 (P = 0.004) and T3 (P = 0.0001). However, no significant difference was observed at the other measurement point times. No adverse effect was recorded due to this intervention.

Perioperative DEX in cardiac surgery appears safe, with properties to alleviate I/R injury. Obviously, future standard trials are required to find optimal intervention strategies.