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Worcester researchers develop heart attack predictor

Researchers at the University of Worcester have discovered a new method to identify patients at risk of second heart attacks.

Worcestershire , United-kingdom , Steven-coles , Cardiology-department , International-journal-of-cardiology , University-of-worcester , Acute-coronary-syndrome , Worcestershire-acute-hospitals , International-journal ,

Exploring the Global Prasugrel Hydrochloride Market: Size,

Exploring the Global Prasugrel Hydrochloride Market: Size,
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Acute-coronary-syndrome ,

Firehouse stress and takotsubo syndrome: Making the connection

Firehouse stress and takotsubo syndrome: Making the connection
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Attention Deficit Hyperactivity Disorder (ADHD)

Attention Deficit Hyperactivity Disorder (ADHD)
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Market-definition , Acute-coronary-syndrome , Drug-pipeline-landscape , Pipeline-landscape ,

Clinical significance of PCSK9 and soluble P-selectin in predicting major adverse cardiovascular events

Clinical significance of PCSK9 and soluble P-selectin in predicting major adverse cardiovascular events
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Yao , Receiver-operating-characteristic-curves , Without-adjustment , Established-risk , Cardiovascular-innovations , Clinical-significance , Solublep-selectin , Acute-coronary-syndrome ,

Researchers say polyurethane mattresses dangerous to human existence

Researchers say polyurethane mattresses dangerous to human existence
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Anaba , Kaduna , Nigeria , Netherlands , Dutch , Yael-dubowski , Philips , Health-administration , California-institute-of-technology , Occupational-safety , Acute-coronary-syndrome , Environmental-science

Abid Ali achieves milestone during President's Trophy

The 36-year-old scored 106 runs during the match against PTV

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The impact of implementing a high sensitivity assay for cardiac troponin I on long term outcomes in patients with suspected acute coronary syndrome

Researchers from the United Kingdom evaluated the use of a high-sensitivity assay to measure cardiac troponin I and its impact on myocardial infarction (MI) risk or other long-term outcomes such as death at five years in individuals with suspected acute coronary syndrome.

United-kingdom , Scotland , Universal-definition , Myocardial-infarction , High-sensitivity-troponin , Acute-coronary-syndrome , Ssay , Yndrome , Roponin , Yocardial-infarction ,

Implementation of a high sensitivity cardiac troponin I assay and risk of myocardial infarction or death at five years: observational analysis of a stepped wedge, cluster randomised controlled trial

Objective To evaluate the impact of implementing a high sensitivity assay for cardiac troponin I on long term outcomes in patients with suspected acute coronary syndrome.

Design Secondary observational analysis of a stepped wedge, cluster randomised controlled trial.

Setting 10 secondary and tertiary care centres in Scotland, UK.

Participants 48 282 consecutive patients with suspected acute coronary syndrome. Myocardial injury was defined as any high sensitivity assay result for cardiac troponin I >99th centile of 16 ng/L in women and 34 ng/L in men.

Intervention Hospital sites were randomly allocated to either early (n=5 hospitals) or late (n=5 hospitals) implementation of a high sensitivity cardiac troponin I assay with sex specific diagnostic thresholds.

Main outcome measure The main outcome was myocardial infarction or death at five years.

Results 10 360 patients had cardiac troponin concentrations greater than the 99th centile, of whom 1771 (17.1%) were reclassified by the high sensitivity assay. The five year incidence of subsequent myocardial infarction or death before and after implementation of the high sensitivity assay was 29.4% (5588/18 978) v 25.9% (7591/29 304), respectively, in all patients (adjusted hazard ratio 0.97, 95% confidence interval 0.93 to 1.01), and 63.0% (456/720) v 53.9% (567/1051), respectively, in those reclassified by the high sensitivity assay (0.82, 0.72 to 0.94). After implementation of the high sensitivity assay, a reduction in subsequent myocardial infarction or death was observed in patients with non-ischaemic myocardial injury (0.83, 0.75 to 0.91) but not in those with type 1 or type 2 myocardial infarction (0.92, 0.83 to 1.01 and 0.98, 0.84 to 1.14).

Conclusions Implementation of a high sensitivity cardiac troponin I assay in the assessment of patients with suspected acute coronary syndrome was associated with a reduced risk of subsequent myocardial infarction or death at five years in those reclassified by the high sensitivity assay. Improvements in outcome were greatest in patients with non-ischaemic myocardial injury, suggesting a broader benefit beyond the identification of myocardial infarction.

Trial registration ClinicalTrials.gov [NCT01852123][1].

The High-STEACS trial makes use of several routine electronic healthcare data sources that are linked, deidentified, and held in a national safe haven, which is accessible by approved individuals who have undertaken the necessary governance training. Summary data can be made available upon request to the corresponding author.

[1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT01852123&atom=%2Fbmj%2F383%2Fbmj-2023-075009.atom

Roma , Lazio , Italy , Lothian , Midlothian , United-kingdom , Edinburgh , City-of , Glasgow , Glasgow-city , Scotland , British

Do high sensitivity cardiac troponin assays improve patient outcomes?

New study reports benefits for some patients with suspected acute coronary syndrome

Cardiac troponins have replaced other blood biomarkers for the diagnosis of myocardial injury. They are widely used to risk stratify patients towards safe early discharge or further investigation of coronary anatomy when clinical and electrocardiographic features are suggestive of acute coronary syndrome.

High sensitivity assays can detect lower concentrations of cardiac troponin than older assays, improving test sensitivity and enabling earlier detection of myocardial injury. In practice, use of high sensitivity assays leads to earlier discharge from emergency departments1 and improved detection of myocardial injury that may require further investigation. Although use of high sensitivity assays is increasing in line with guideline recommendations,23 it remains unknown whether use in emergency departments improves long term clinical outcomes for patients with suspected acute coronary syndrome. The linked paper by Lee and colleagues (doi:10.1136/bmj-2023-075009) addresses this important knowledge gap by reporting a secondary observational analysis of the High-Sensitivity Troponin in the Evaluation of patients with suspected Acute Coronary Syndrome (High-STEACS) clinical trial.4

The original cluster randomised stepped wedged trial design included 48 282 patients presenting to emergency departments at 10 Scottish hospitals with suspected acute coronary syndrome.5 All patients …

Carl-schultz , Marc-sim , Abadik-gebre , High-sensitivity-troponin , Acute-coronary-syndrome ,