Clin Lab
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Multicenter Study Comparative Study Clinical Trial Controlled Clinical Trial
Quantitative bedside testing of troponin T: is it equal to laboratory testing? The Cardiac Reader Troponin T (CARE T) study.
The progressive evolution of cardiac marker testing in patients with acute coronary syndromes has extended their role into risk stratification and guidance of therapeutic regimen. To provide utilization of cardiac markers around the clock and facilitate the diagnostic work-up of patients with acute chest pain in the emergency room, a point-of-care system for quantitative troponin T and myoglobin testing in whole blood samples was developed. Aim of this multicenter study was to evaluate bedside quantitative determination of myoglobin and troponin T in chest pain patients in a clinical routine setting. ⋯ The results show that the cardiac reader system represents a promising alternative to central laboratory testing with an accuracy sufficiently for rapid decision making in the emergency room. Myoglobin results in this study did not add supplementary information to the cardiac reader troponin result. However, point-of-care testing of troponin T is advantageous whenever marker results could positively effect initial triage decisions and interventional management choices.
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Review Comparative Study
Comparison of cardiac troponin T and troponin I assays--implications of analytical and biochemical differences on clinical performance.
The usefulness of cardiac troponins for detection of myocardial cell necrosis and risk stratification has been established beyond doubt. Cardiac troponin testing is a key diagnostic element for the diagnosis and management of patients with acute coronary syndromes without ST segment elevation and is increasingly used in non-coronary diseases to indicate prognostically important cardiac damage. ⋯ In fact, recent studies in patients with end-stage renal disease under chronic hemodialysis have readdressed the issue whether cTnT and cTnI are really comparable. The present review will provide a state-of-the-art overview on the performance of cardiac troponins in acute coronary disease and other clinical conditions.
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Although it seems to be rather unlikely, it still remains unclear whether hepatitis G virus (HGV) is involved in post-transfusion hepatitis. Prevalence of HGV viremia and persistence in blood donors was determined. ALT and AST values of viremic and non-viremic donations of the donors were compared. 25,006 blood donations were tested for the presence of HGV RNA by reverse transcriptase polymerase chain reaction. ⋯ Patients have a significantly higher prevalence of HGV viremia compared to blood donors. In blood donors no liver affection by means of ALT or AST elevation can be seen. Long persistence of HGV viremia is common and the presence of anti-E2 does not exclude viremia.