Will new higher-precision troponins lead to clarity or confusion?

Abstract:

PURPOSE OF REVIEW:Troponins are a cornerstone for the diagnosis of myocardial infarction, assessment of risk and prognosis, and determination of antithrombotic and a revascularization strategy in patients with acute coronary syndromes. Newer assays with higher precision for detection of troponin levels are about to enter clinical practice. The present review discusses the implications of the new assays for patients. RECENT FINDINGS:Several studies have found that higher-precision troponin assays can determine prognosis at lower cutpoints than currently used in patients with acute coronary syndromes and that about a third of patients 6 months after admission have detectable low levels of troponins. Elevation of troponins can also be detected with the new assays at about 2 h after the onset of ischemic symptoms. This could result in earlier triage to an invasive strategy, and the findings of a repeat normal level at an earlier time point than currently recommended could lead to earlier discharge from the emergency department and cost savings. Elevated high-precision troponin levels have also been found in the community and in patients with heart failure. SUMMARY:The new high-precision assays will enable better determination of risk and new paradigms will be developed about detection of elevated troponin levels in patients with chronic stable angina and the normal population. Patients with acute coronary syndromes will be able to be triaged earlier and patient care will be improved.

journal_name

Curr Opin Cardiol

authors

White HD

doi

10.1097/HCO.0b013e3283050808

subject

Has Abstract

pub_date

2008-07-01 00:00:00

pages

292-5

issue

4

eissn

0268-4705

issn

1531-7080

pii

00001573-200807000-00003

journal_volume

23

pub_type

杂志文章,评审
  • Evidence supporting secondary prevention strategies.

    abstract::Currently 14 million individuals in the United States have coronary disease. Within the next 2 decades, this number is expected to increase to 21 million persons. To minimize the excessive risk of recurrent cardiac events in these people, evidence-based, cost-effective prevention strategies must be developed. This rev...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199907000-00005

    authors: Blazing MA,O'Connor CM

    更新日期:1999-07-01 00:00:00

  • Pediatric electrophysiology.

    abstract::Our understanding of pediatric arrhythmias continues to evolve through natural history studies of paroxysmal supraventricular tachycardia, the congenital long QT syndrome, and postoperative atrial and ventricular tachyarrhythmias. The influence of the autonomic nervous system on cardiovascular function may play a rol...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199301000-00015

    authors: Kanter RJ

    更新日期:1993-01-01 00:00:00

  • Incidence, definition, diagnosis, and management of the cardiac resynchronization therapy nonresponder.

    abstract:PURPOSE OF REVIEW:Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in patients with mild-to-severe heart failure. However, up to 40% of CRT recipients are nonresponders. This review addresses important aspects with regard to the identification and management of CRT nonresponders. RECENT FINDINGS...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,meta分析,评审

    doi:10.1097/HCO.0000000000000140

    authors: Zhang Q,Zhou Y,Yu CM

    更新日期:2015-01-01 00:00:00

  • Future pharmacological therapy in hypertension.

    abstract:PURPOSE OF REVIEW:Hypertension (HTN) is a widespread and growing disease, with medication intolerance and side-effect present among many. To address these obstacles novel pharmacotherapy is an active area of drug development. This review seeks to explore future drug therapy for HTN in the preclinical and clinical arena...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000529

    authors: Stewart MH,Lavie CJ,Ventura HO

    更新日期:2018-07-01 00:00:00

  • The use of electrocardiography as a diagnostic and prognostic tool in coronary artery disease.

    abstract::The ECG is the most widely used noninvasive diagnostic and prognostic test administered to patients with suspected or proven coronary artery disease. When considering appropriate use of the electrocardiogram, physicians need to examine the clinical question being asked, the additional information that can be derived,...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199208000-00008

    authors: Al-Joundi B,Chaitman BR

    更新日期:1992-08-01 00:00:00

  • Hybrid palliation in hypoplastic left heart syndrome.

    abstract:PURPOSE OF REVIEW:Despite progressive improvement in surgical results, hypoplastic left heart syndrome remains one of the congenital heart abnormalities with the greatest morbidity and mortality. Hybrid approaches to management, combining surgical and interventional catheterization procedures, have been introduced to m...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e328014d945

    authors: Gutgesell HP,Lim DS

    更新日期:2007-03-01 00:00:00

  • The role of tricuspid valve repair and replacement in right heart failure.

    abstract:PURPOSE OF REVIEW:The presence of tricuspid regurgitation in the setting of right ventricular dysfunction is associated with poor prognosis. The purpose of this review is to describe the pathophysiology of functional tricuspid regurgitation, summarize the current reports favoring a more aggressive approach toward tricu...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e3283512051

    authors: Pinney SP

    更新日期:2012-05-01 00:00:00

  • An update in the management of acute decompensated heart failure.

    abstract:PURPOSE OF REVIEW:This review will provide an overview of recent advances in the management of acute decompensated heart failure, focusing on major publications from the past few years. RECENT FINDINGS:There have been several publications investigating different strategies in the management of acute decompensated hear...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000038

    authors: Maze R,Haddad H

    更新日期:2014-03-01 00:00:00

  • E-counseling as an emerging preventive strategy for hypertension.

    abstract:PURPOSE OF REVIEW:Lifestyle counseling that includes exercise training, diet modification, and medication adherence is critical to hypertension management. This article summarizes the efficacy of lifestyle counseling interventions in face-to-face, telehealth, and e-counseling settings. It also discusses the therapeutic...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000080

    authors: Nolan RP,Liu S,Payne AY

    更新日期:2014-07-01 00:00:00

  • Nutrition and physical activity recommendations from the United States and European cardiovascular guidelines: a comparative review.

    abstract:PURPOSE OF REVIEW:A healthy lifestyle throughout one's lifespan is the core foundation for both primary and secondary prevention of cardiovascular disease (CVD). Risk-based decisions for pharmacological therapy is added on-top of lifestyle management. Thus, understanding lifestyle-based recommendations is central to CV...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000763

    authors: Ferraro RA,Fischer NM,Xun H,Michos ED

    更新日期:2020-09-01 00:00:00

  • The role of coronary angiography after thrombolysis.

    abstract::Intravenous thrombolysis has become a primary mode of reperfusion therapy for selected patients with acute myocardial infarction. The timing and potential benefits of cardiac angiography and coronary revascularization after thrombolysis in patients experiencing an uncomplicated myocardial infarction have been extensiv...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199507000-00007

    authors: Aguirre FV,Merritt RF,Carollo SC

    更新日期:1995-07-01 00:00:00

  • Recent advances in stress echocardiography.

    abstract:PURPOSE OF REVIEW:This article reviews the recent advances in stress echocardiography, with particular attention to articles published in 2010 and 2011. It summarizes the developments in the diagnostic and prognostic capabilities of stress echocardiography, discusses new data regarding the safety of stress echocardiogr...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e328349035b

    authors: Cullen MW,Pellikka PA

    更新日期:2011-09-01 00:00:00

  • Drug therapy of chronic heart failure in the elderly: the current state of clinical-trial evidence.

    abstract:PURPOSE OF REVIEW:beta-Blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, aldosterone receptor antagonists, and digoxin are the most common drug classes used to treat chronic heart failure. We examine current clinical trial evidence concerning heart-failure management in the elderly. ...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/01.hco.0000231411.15049.20

    authors: Dulin BR,Krum H

    更新日期:2006-07-01 00:00:00

  • Congenital heart surgery.

    abstract::In reviewing selected publications on congenital heart disease management for 1990 and 1991, some topics have been chosen for discussion, including isolated patent ductus arteriosus, coarctation of the aorta, critical aortic stenosis in early infancy, hypoplastic left-heart syndrome, pulmonary artery banding, Fontan p...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199204000-00010

    authors: Mee RB

    更新日期:1992-04-01 00:00:00

  • Transient receptor potential vanilloid channels in hypertension, inflammation, and end organ damage: an imminent target of therapy for cardiovascular disease?

    abstract:PURPOSE OF REVIEW:The possible role of several neurohormonal factors in pathogenesis of hypertension has been studied extensively both in humans and in experimental animal models. However, controversial data from some previous studies are indecisive and call for reassessment and development of new targets. This mini-re...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e32830460ad

    authors: Wang DH

    更新日期:2008-07-01 00:00:00

  • Cardiac allograft vasculopathy: pathology, prevention and treatment.

    abstract:PURPOSE OF REVIEW:Cardiac transplantation is a recognized therapy for end-stage heart failure. Graft coronary artery disease is a chief determinant of long-term survival following cardiac transplantation. There are multiple purported etiologies for graft coronary artery disease including both immunologic and nonimmunol...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/01.hco.0000203184.89158.16

    authors: Kass M,Haddad H

    更新日期:2006-03-01 00:00:00

  • Update of implantable cardioverter/defibrillator and cardiac resynchronization therapy in heart failure.

    abstract:PURPOSE OF REVIEW:Heart failure prevalence is reaching epidemic proportion in the United States and is associated with significant morbidity and mortality. A large proportion of the mortality is the result of sudden cardiac death (SCD). Clinical trials have demonstrated the superiority of the implantable cardioverter/d...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-200405000-00012

    authors: Rami T,Shih HT

    更新日期:2004-05-01 00:00:00

  • Vitamin D and cardiovascular disease risk: emerging evidence.

    abstract:PURPOSE OF REVIEW:Vitamin D deficiency is common throughout the world, with a particularly high prevalence in northern latitudes and colder climates. Although the best known sequelae of vitamin D deficiency involve the musculoskeletal system, a growing body of evidence suggests that vitamin D status may influence cardi...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e32833cd491

    authors: Swales HH,Wang TJ

    更新日期:2010-09-01 00:00:00

  • An overview of combined heart and kidney transplantation.

    abstract::This review describes to date the experience with combined heart-kidney transplant (HNTx) from a single donor. HNTxs are very uncommon relative to single-organ transplants of the heart and kidney, as well as combined kidney-pancreas and combined kidney-liver transplants. Two groups of patients seem to be candidates fo...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199903000-00008

    authors: Castillo-Lugo JA,Brinker KR

    更新日期:1999-03-01 00:00:00

  • Management of aortic dissection.

    abstract::Patients with aortic dissection are divided into two main groups: those with hypertension and those with syndromes involving hereditary defects of the aortic wall. The common finding in the setting of both Marfan syndrome and hypertension is dilatation of the aorta. The biological events that may lead to dissection ar...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:

    authors: Westaby S

    更新日期:1995-09-01 00:00:00

  • Venous thromboembolism prophylaxis in medical patients.

    abstract:PURPOSE OF REVIEW:Venous thromboembolism, including deep vein thrombosis and pulmonary embolism, represents a significant source of morbidity and mortality in the United States and worldwide. Most acutely ill medical patients are at risk for venous thromboembolism, and prophylaxis is recommended. However, acutely ill m...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/01.hco.0000141266.88385.67

    authors: Michota FA

    更新日期:2004-11-01 00:00:00

  • Pharmacologic therapies for acute cardiogenic shock.

    abstract:PURPOSE OF REVIEW:The natural history of cardiogenic shock has improved significantly with the utilization of revascularization and mechanical circulatory support. Despite the interest in identifying new pharmacological agents, the medical therapy to restore perfusion is limited by their side-effects and no solid evide...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000057

    authors: Nativi-Nicolau J,Selzman CH,Fang JC,Stehlik J

    更新日期:2014-05-01 00:00:00

  • New advances in class III antiarrhythmic drug therapy.

    abstract::In the past 2 years, significant advances have been made in class III antiarrhythmic drug therapy. In patients with ventricular arrhythmias and implantable cardioverter defibrillators (ICDs), antiarrhythmic agents are increasingly being used as adjunct therapy to decrease the frequency of ICD discharges. Sotalol was r...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-200001000-00006

    authors: Sager PT

    更新日期:2000-01-01 00:00:00

  • Aortic valve disease.

    abstract::Management of aortic valve disease follows traditional algorithms: initial gross diagnosis, noninvasive imaging and quantitation, possible catheterization or angiography, and medical treatment until symptoms of prognosis prediction indicates surgery. Most advances in this subject reflect improved technology and additi...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199403000-00003

    authors: Baxley WA

    更新日期:1994-03-01 00:00:00

  • Minimally invasive pediatric cardiac surgery.

    abstract::Minimally invasive cardiac surgery has evolved in response to the intrinsic irony facing cardiac surgeons: that we must injure our patients to treat them. In recent years, advances in fiberoptic imaging technology, applied to other surgical specialties, suggested the possibility that cardiac surgery might also be perf...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199901000-00011

    authors: Burke RP

    更新日期:1999-01-01 00:00:00

  • Myocardial contrast echocardiography in acute coronary syndromes.

    abstract::Myocardial contrast echocardiography (MCE) is an emerging technique in which microbubble contrast agents are visualized in the coronary microvasculature. MCE is an ideal modality for the noninvasive evaluation of acute coronary syndromes because it provides portable, simultaneous assessment of regional wall motion and...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-200209000-00003

    authors: Ward RP,Lang RM

    更新日期:2002-09-01 00:00:00

  • Etiology of valvular heart disease.

    abstract::The incidence of congenital valvular heart disease has not significantly altered in recent decades. Major factors contributing to altered profiles of acquired valvular heart disease in the past few decades include an increased elderly segment of the population and increasing recognition of nonrheumatic forms of valvul...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199603000-00002

    authors: Rose AG

    更新日期:1996-03-01 00:00:00

  • Trials of cardiovascular risk factor management in type 2 diabetes.

    abstract:PURPOSE OF REVIEW:To provide an overview of recent clinical trial findings relevant to cardiovascular risk management in patients with diabetes. RECENT FINDINGS:Recent trial evidence has demonstrated benefits of routine blood pressure (BP) lowering, regardless of initial BP levels, in people with type 2 diabetes. In a...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e32832a7b01

    authors: Patel A,Joshi R,de Galan B

    更新日期:2009-07-01 00:00:00

  • Endocarditis.

    abstract::Endocarditis remains a major worldwide problem despite significant advances in diagnostic and therapeutic interventions. This review centers on the recent studies that have been published in the past year concerning the epidemiologic, diagnostic, and therapeutic aspects of infective and noninfective endocarditis in bo...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199703000-00006

    authors: Farmer JA,Torre G

    更新日期:1997-03-01 00:00:00

  • Aortic root rupture: implications of catheter-guided aortic valve replacement.

    abstract:PURPOSE OF REVIEW:The safety and efficiency of trans catheter aortic valve implantation (TAVI) has been clearly demonstrated. In high-risk patients, the number of procedures is constantly increasing and in western European countries this procedure is employed in more than 30% of isolated aortic valve replacements. The ...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e3283655bb5

    authors: Berdajs D

    更新日期:2013-11-01 00:00:00