Clinical chemistry
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Comparative Study
Troponin T measurements by high-sensitivity vs conventional assays for risk stratification in acute dyspnea.
Cardiac troponin T measured by a high-sensitivity assay (hs-cTnT) recently proved to be of prognostic value in several populations. The hs-cTnT assay may also improve risk stratification in acute dyspnea. ⋯ hs-cTnT is associated with mortality in patients presenting with acute dyspnea. hs-cTnT concentrations provide additional prognostic information to cTnT and NT-proBNP testing in patients with cTnT concentrations below the detection limit. In particular, the hs-cTnT cutoff of 0.016 μg/L enables identification of low-risk patients.
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Comparative Study
Comparison of midregional pro-A-type natriuretic peptide and the N-terminal pro-B-type natriuretic peptide for predicting mortality and cardiovascular events.
N-terminal pro-B-type natriuretic peptide (NT-proBNP) provides prognostic information on mortality and future cardiovascular events for individuals from the general population. A novel immunoassay was recently developed that measures a midregional fragment of pro-A-type natriuretic peptide (MR-proANP). We compared the capabilities of MR-proANP and NT-proBNP for predicting mortality and cardiovascular events in a population-based study. ⋯ MR-proANP was as efficient as NT-proBNP in predicting all-cause mortality, cardiovascular mortality, and cardiovascular events; however, its association with cardiovascular mortality was not independent from other confounders.
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Most outcome studies of patients presenting early to the emergency department with potential acute coronary syndromes have focused on either the index diagnosis of myocardial infarction (MI) or a composite end point at a later time frame (30 days or 1 year). We investigated the performance of 9 biomarkers for an early serious outcome. ⋯ The optimal cutoffs for predicting serious cardiac outcomes in this low-risk population are different from the published 99th percentiles. Larger studies are required to verify these findings.
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Midregional proadrenomedullin (MR-proADM) is a newly identified prognostic marker in heart failure. We evaluated the prognostic impact of MR-proADM in a cohort of patients with symptomatic coronary artery disease according to their clinical presentation. ⋯ MR-proADM is an independent predictor for future cardiovascular events in patients with symptomatic coronary artery disease, providing information comparable to NT-proBNP for secondary risk stratification.
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Historical Article
Aspirin in the primary prevention of myocardial infarction.