Medical Dialogues
  • Dermatology
Login Register
This site is intended for healthcare professionals only
Login Register
  • MD Brand Connect
  • Vaccine Hub
  • MDTV
    • Breaking News
    • Medical News Today
    • Health News Today
    • Latest
    • Journal Club
    • Medico Legal Update
    • Latest Webinars
    • MD Shorts
    • Health Dialogues
  • Fact Check
  • Health Dialogues
Medical Dialogues
  • Medical News & Guidelines
      • Anesthesiology
      • Cardiology and CTVS
      • Critical Care
      • Dentistry
      • Dermatology
      • Diabetes and Endocrinology
      • ENT
      • Gastroenterology
      • Medicine
      • Nephrology
      • Neurology
      • Obstretics-Gynaecology
      • Oncology
      • Ophthalmology
      • Orthopaedics
      • Pediatrics-Neonatology
      • Psychiatry
      • Pulmonology
      • Radiology
      • Surgery
      • Urology
      • Laboratory Medicine
      • Diet
      • Nursing
      • Paramedical
      • Physiotherapy
  • Health news
      • Doctor News
      • Government Policies
      • Hospital & Diagnostics
      • International Health News
      • Medical Organization News
      • Medico Legal News
      • NBE News
      • NMC News
  • Fact Check
      • Bone Health Fact Check
      • Brain Health Fact Check
      • Cancer Related Fact Check
      • Child Care Fact Check
      • Dental and oral health fact check
      • Diabetes and metabolic health fact check
      • Diet and Nutrition Fact Check
      • Eye and ENT Care Fact Check
      • Fitness fact check
      • Gut health fact check
      • Heart health fact check
      • Kidney health fact check
      • Medical education fact check
      • Men's health fact check
      • Respiratory fact check
      • Skin and hair care fact check
      • Vaccine and Immunization fact check
      • Women's health fact check
  • AYUSH
    • Ayurveda
    • Homeopathy
    • Siddha
    • Unani
    • Yoga
  • State News
      • Andaman and Nicobar Islands
      • Andhra Pradesh
      • Arunachal Pradesh
      • Assam
      • Bihar
      • Chandigarh
      • Chattisgarh
      • Dadra and Nagar Haveli
      • Daman and Diu
      • Delhi
      • Goa
      • Gujarat
      • Haryana
      • Himachal Pradesh
      • Jammu & Kashmir
      • Jharkhand
      • Karnataka
      • Kerala
      • Ladakh
      • Lakshadweep
      • Madhya Pradesh
      • Maharashtra
      • Manipur
      • Meghalaya
      • Mizoram
      • Nagaland
      • Odisha
      • Puducherry
      • Punjab
      • Rajasthan
      • Sikkim
      • Tamil Nadu
      • Telangana
      • Tripura
      • Uttar Pradesh
      • Uttrakhand
      • West Bengal
  • Medical Education
      • Ayush Education News
      • Dentistry Education News
      • Medical Admission News
      • Medical Colleges News
      • Medical Courses News
      • Medical Universities News
      • Nursing education News
      • Paramedical Education News
      • Study Abroad
  • Industry
      • Health Investment News
      • Health Startup News
      • Medical Devices News
      • Pharma News
      • Pharmacy Education News
      • Industry Perspective
  • MDTV
      • Health Dialogues MDTV
      • Health News today MDTV
      • Latest Videos MDTV
      • Latest Webinars MDTV
      • MD shorts MDTV
      • Medical News Today MDTV
      • Medico Legal Update MDTV
      • Top Videos MDTV
      • Health Perspectives MDTV
      • Journal Club MDTV
      • Medical Dialogues Show
This site is intended for healthcare professionals only
LoginRegister
Medical Dialogues
LoginRegister
  • Home
  • Medical news & Guidelines
    • Anesthesiology
    • Cardiology and CTVS
    • Critical Care
    • Dentistry
    • Dermatology
    • Diabetes and Endocrinology
    • ENT
    • Gastroenterology
    • Medicine
    • Nephrology
    • Neurology
    • Obstretics-Gynaecology
    • Oncology
    • Ophthalmology
    • Orthopaedics
    • Pediatrics-Neonatology
    • Psychiatry
    • Pulmonology
    • Radiology
    • Surgery
    • Urology
    • Laboratory Medicine
    • Diet
    • Nursing
    • Paramedical
    • Physiotherapy
  • Health news
    • Doctor News
    • Government Policies
    • Hospital & Diagnostics
    • International Health News
    • Medical Organization News
    • Medico Legal News
    • NBE News
    • NMC News
  • Fact Check
    • Bone Health Fact Check
    • Brain Health Fact Check
    • Cancer Related Fact Check
    • Child Care Fact Check
    • Dental and oral health fact check
    • Diabetes and metabolic health fact check
    • Diet and Nutrition Fact Check
    • Eye and ENT Care Fact Check
    • Fitness fact check
    • Gut health fact check
    • Heart health fact check
    • Kidney health fact check
    • Medical education fact check
    • Men's health fact check
    • Respiratory fact check
    • Skin and hair care fact check
    • Vaccine and Immunization fact check
    • Women's health fact check
  • AYUSH
    • Ayurveda
      • Ayurveda Giuidelines
      • Ayurveda News
    • Homeopathy
      • Homeopathy Guidelines
      • Homeopathy News
    • Siddha
      • Siddha Guidelines
      • Siddha News
    • Unani
      • Unani Guidelines
      • Unani News
    • Yoga
      • Yoga Guidelines
      • Yoga News
  • State News
    • Andaman and Nicobar Islands
    • Andhra Pradesh
    • Arunachal Pradesh
    • Assam
    • Bihar
    • Chandigarh
    • Chattisgarh
    • Dadra and Nagar Haveli
    • Daman and Diu
    • Delhi
    • Goa
    • Gujarat
    • Haryana
    • Himachal Pradesh
    • Jammu & Kashmir
    • Jharkhand
    • Karnataka
    • Kerala
    • Ladakh
    • Lakshadweep
    • Madhya Pradesh
    • Maharashtra
    • Manipur
    • Meghalaya
    • Mizoram
    • Nagaland
    • Odisha
    • Puducherry
    • Punjab
    • Rajasthan
    • Sikkim
    • Tamil Nadu
    • Telangana
    • Tripura
    • Uttar Pradesh
    • Uttrakhand
    • West Bengal
  • Medical Education
    • Ayush Education News
    • Dentistry Education News
    • Medical Admission News
    • Medical Colleges News
    • Medical Courses News
    • Medical Universities News
    • Nursing education News
    • Paramedical Education News
    • Study Abroad
  • Industry
    • Health Investment News
    • Health Startup News
    • Medical Devices News
    • Pharma News
      • CDSCO (Central Drugs Standard Control Organisation) News
    • Pharmacy Education News
    • Industry Perspective
  • Home
  • Cardiology-CTVS
  • Cardiology & CTVS News
  • High-sensitivity...

High-sensitivity cardiac troponin test may overestimate risk in pulmonary embolism: JAMA

Written By : Medha Baranwal |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-11-24T10:15:44+05:30  |  Updated On 24 Nov 2023 12:11 PM IST
High-sensitivity cardiac troponin test may overestimate risk in pulmonary embolism: JAMA
  • facebook
  • twitter
  • linkedin
  • whatsapp
  • Telegram
  • Email

Spain: Replacing cardiac troponin I (cTnI) with high-sensitivity-cTnI (hs-cTnI) may lead to an increase in the number of patients with positive troponin results but is not likely to improve the prediction of complicated course, a recent study published in JAMA Cardiology has shown.

In the cohort study of 834 patients with hemodynamically stable pulmonary embolism (PE), hs-cTnI, compared with cTnI, more frequently detected elevated values, but did not predict the 30-day risk of a complicated course.

Novel data from an exploratory analysis of the PROTECT study suggests that thresholds of hs-cTnI for acute myocardial infarction diagnosis may not be applicable to patients with PE. The results indicate lower specificity of hs-cTnI than cTnI in identifying patients with PE at risk of a complicated course.

High-sensitivity troponin tests can detect even milder cardiac troponin increases in plasma, beyond the threshold of conventional troponin tests. However, there is no clarity on whether detecting low-grade cardiac troponin elevation is tied to outcomes of patients with hemodynamically stable PE and helps with risk stratification.

To clarify the same, Behnood Bikdeli, Harvard Medical School, Boston, Massachusetts, and colleagues aimed to determine the association between hs-cTnI compared with conventional cTnI and PE risk designations according to the European Society of Cardiology (ESC) 2019 classification scheme and clinical outcomes in patients with hemodynamically stable pulmonary embolism.

For this purpose, the researchers performed a post hoc analysis of data from the PROTECT cohort study enrolling patients from 12 hospital emergency departments in Spain. In the analysis, they compared cTnI and hs-cTnI concerning ESC risk designation and the association between troponin values and a complicated course after PE diagnosis was evaluated.

In the analysis, 98.3% had hsTnI and cTnI values available and were included from 848 patients enrolled in PROTECT. Outcomes included a complicated course, defined as hemodynamic collapse, recurrent PE, or all-cause death, within 30 days after PE.

The study led to the following findings:

  • Of 834 patients (mean age, 67.5 years; 50.8% female), 16.7% had elevated cTnI and 31.7% elevated hs-TnI, respectively.
  • During follow-up, 62 patients had a complicated course.
  • Analyzing troponin elevation as a binary variable, elevated cTnI (odds ratio [OR], 2.84) but not hs-cTnI (OR, 1.12) was associated with increased odds of a complicated course.
  • Of 125 patients who had elevated hs-cTnI but normal cTnI, none developed a complicated course.
  • Using the 2019 ESC risk stratification scheme, hs-TnI classified fewer patients as low risk compared with cTnI.
  • Among 78 patients designated as ESC low risk when using cTnI but not with hsTnI, none (0) had a complicated course.

In the study of patients with hemodynamically stable PE, hs-cTnI identified modest increases in cardiac troponin levels. However, the results failed to provide additive clinical value compared with cTnI.

"These findings suggest that hs-cTnI use may result in overestimation of the risk in patients with stable PE," the researchers wrote.

"Future studies should investigate whether using high-sensitivity troponin assays, rather than sensitive assays, results in excess in the use of advanced therapies in routine practice," they concluded.

Reference:

Bikdeli B, Muriel A, Rodríguez C, et al. High-Sensitivity vs Conventional Troponin Cutoffs for Risk Stratification in Patients With Acute Pulmonary Embolism. JAMA Cardiol. Published online November 22, 2023. doi:10.1001/jamacardio.2023.4356


JAMA CardiologyPulmonary EmbolismHigh-sensitivity cardiac troponin
Source : JAMA Cardiology
Medha Baranwal
Medha Baranwal

    MSc. Biotechnology

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

    Show Full Article
    Next Story

    Editorial

    ABYSS Trial Finds Elevated BP, HR & Deleterious CV Outcomes After Beta blocker Withdrawal Post-MI: EuroPCR 2025 Update

    ABYSS Trial Finds Elevated BP, HR & Deleterious CV Outcomes After Beta blocker Withdrawal Post-MI:...

    Aspirin Use in Male Smokers Aged 40-45 Years with Hypertension: Identifying the Ideal Candidates

    Aspirin Use in Male Smokers Aged 40-45 Years with Hypertension: Identifying the Ideal Candidates

    National Consensus 2025 on Role of Bisoprolol Across CV Continuum in Women: Top 10 Takeaways

    National Consensus 2025 on Role of Bisoprolol Across CV Continuum in Women: Top 10 Takeaways

    Relevance of Pioglitazone in Indian T2DM Care Continuum

    Relevance of Pioglitazone in Indian T2DM Care Continuum

    Azmarda Outperforms Generic Sacubitril/Valsartan in HFrEF Management, says new study

    Azmarda Outperforms Generic Sacubitril/Valsartan in HFrEF Management, says new study

    View All

    Journal Club Today

    Not Losing Weight? Study Finds Healthy Diet May Still Bring Major Health Gains

    Not Losing Weight? Study Finds Healthy Diet May Still Bring Major Health Gains

    View All

    Health News Today

    Health Bulletin 07/June/2025

    Health Bulletin 07/June/2025

    View All
    © 2022 All Rights Reserved.
    Powered By: Hocalwire
    X
    We use cookies for analytics, advertising and to improve our site. You agree to our use of cookies by continuing to use our site. To know more, see our Cookie Policy and Cookie Settings.Ok