High-sensitivity cardiac troponin(hs-cTn) assays are increasingly being used in many countries worldwide,however,a generally accepted definition of high-sen-sitivity is still pending.These assays enable cTn mea-sureme...High-sensitivity cardiac troponin(hs-cTn) assays are increasingly being used in many countries worldwide,however,a generally accepted definition of high-sen-sitivity is still pending.These assays enable cTn mea-surement with a high degree of analytical sensitivity with a low analytical imprecision at the low measuring range of cTn assays(coefficient of variation of < 10% at the 99th percentile upper reference limit).One of the most important advantages of these new assays is that they allow novel,more rapid approaches to rule in or rule out acute coronary syndromes(ACSs) than with previous cTn assay generations which are still more commonly used in practice worldwide.hs-cTn is also more sensitive for the detection of myocardial damage unrelated to acute myocardial ischemia.Therefore,the increase in early diagnostic sensitivity of hs-cTn assays for ACS comes at the cost of a reduced ACS specificity,because more patients with other causes of acute or chronic myocardial injury without overt myocardial isch-emia are detected than with previous cTn assays.As hs-cTn assays are increasingly being adopted in clinical practice and more hs-cTn assays are being developed,this review attempts to synthesize the available clinical data to make recommendations for their everyday clini-cal routine use.展开更多
It is often challenging to diagnose acute myocardial infarction(AMI)in patients with elevated high-sensitivity cardiac troponin T(hs-cTnT)before observing a significant rise and/or fall in hs-cTnT.The current study ai...It is often challenging to diagnose acute myocardial infarction(AMI)in patients with elevated high-sensitivity cardiac troponin T(hs-cTnT)before observing a significant rise and/or fall in hs-cTnT.The current study aimed to identify an optimal cut-off to rule in AMI.A total of 76411 patients with elevated hs-cTnT were included.The predictive cut-off values for diagnosing ST-segment elevation myocardial infarction(STEMI)and non-STsegment elevation myocardial infarction(NSTEMI)were assessed using the area under the receiver operating characteristic curve(AUC).Among the patients,50466(66.0%)had non-cardiac diseases,25945(34.0%)had cardiac diseases,and 15502(20.3%)had AMI,including 816(1.1%)with STEMI and 14686(19.2%)with NSTEMI.The median hs-cTnT level was 3788.0 ng/L in STEMI patients and 67.2 ng/L in NSTEMI patients.The optimal cut-off for diagnosing STEMI was 251.9 ng/L,with a sensitivity of 90.7%,specificity of 86.5%,and an AUC of 0.942;the optimal cut-off for diagnosing NSTEMI was 130.5 ng/L,with a sensitivity of 40.9%,specificity of 83.8%,and an AUC of 0.638.Collectively,optimizing the cut-off values for diagnosing STEMI and NSTEMI to 251.9 ng/L and 130.5 ng/L,respectively,demonstrated high accuracy in a large cohort of Chinese patients with elevated hs-cTnT.展开更多
Ambient air pollution is increasingly being recognized as a risk factor for heart failure;however,its effects on cardiac biomarkers remain unclear.This scoping review assessed the existing evidence on the association ...Ambient air pollution is increasingly being recognized as a risk factor for heart failure;however,its effects on cardiac biomarkers remain unclear.This scoping review assessed the existing evidence on the association between air pollution and cardiac biomarkers in heart failure,described the key concepts,synthesized data,and identified research gaps.Following the PRISMA-ScR guidelines,PubMed,Embase,Web of Science,and CNKI databases were searched for studies on air pollution,heart failure,and biomarkers.A total of 765 records were screened,and 81 full texts were assessed for eligibility,resulting in 15 studies.The results showed that the exposure to particulate matter was associated with elevated N-terminal pro-B-type natriuretic peptide and troponin levels.Several studies have linked particulate matter exposure to a higher cardiovascular risk and heart failure biomarkers.Inflammatory and oxidative stress markers were consistently elevated across studies,supporting the biological relevance of these associations.However,few studies have focused specifically on populations with heart failure or clinically relevant biomarkers,and the evidence for gaseous pollutants remains inconclusive.These findings highlight the need to integrate environmental risk assessment into heart failure care and inform policy efforts to reduce the pollutionrelated cardiovascular burden.Further research should address these gaps through improved exposure assessments and the integration of mechanistic evidence.展开更多
Supraventricular tachycardia(SVT)is a frequent cause of emergency presentations.Troponin elevation is common,but its clinical significance remains uncertain and may trigger unnecessary downstream testing.In this mini-...Supraventricular tachycardia(SVT)is a frequent cause of emergency presentations.Troponin elevation is common,but its clinical significance remains uncertain and may trigger unnecessary downstream testing.In this mini-review,we aimed to review the prevalence,mechanisms,prognostic relevance,and management of troponin elevation in adult paroxysmal SVT.A narrative review was conducted using PubMed and EMBASE(2000-2025)with MeSH terms related to SVT and troponin.Eligible studies included original research or registry analyses in adults with paroxysmal SVT.Pediatric and atrial fibrillation/flutter cohorts were excluded.Additional data were obtained from reference lists and expert commentaries.Troponin elevation occurs in approximately 30%-50%of adult SVT cases,primarily reflecting a tachycardia-induced supply-demand imbalance or myocardial stretch,rather than plaque rupture.Short-term registry data suggest potential prognostic associations,but long-term outcomes remain inconsistent and are largely determined by comorbidities and underlying coronary artery disease.Troponin-driven management often leads to increased admissions,consultations,and additional testing without a demonstrable benefit.Troponin elevation in SVT is frequent but usually benign.Routine measurement in all patients is not justified.A selective,risk-based approach–focused on ischemic symptoms,electrocardiogram changes,or high-risk clinical features–offers more appropriate,efficient,and patient-centered care.展开更多
Background Patients with acute ischemic stroke(AIS)frequently present with subclinical cardiac injury.Current clinical assessments predominantly focus on neurological deficits,while the systematic identification and r...Background Patients with acute ischemic stroke(AIS)frequently present with subclinical cardiac injury.Current clinical assessments predominantly focus on neurological deficits,while the systematic identification and risk stratification of early cardiac complications remain inadequate.Myocardial injury markers and electrocardiographic abnormalities reflect biochemical myocardial damage and electrophysiological disturbances,respectively.Their combined use may provide a more comprehensive evaluation of cardiac involvement following AIS,thereby compensating for the limitations of neurological assessment alone.However,their synergistic value in predicting the prognosis of AIS patients requires further clarification.Methods A retrospective analysis was conducted on the medical records of 204 AIS patients admitted to our hospital from July 2023 to July 2025.Based on cardiac troponin I(cTnI)and creatine kinase-MB(CK-MB)levels,as well as electrocardiographic findings within 72 hours of onset,patients were categorized into a myocardial injury group(n=87)and a non-myocardial injury group(n=117).Both groups received standardized treatment.The modified Rankin Scale(mRS)scores at 90 days post-onset and the incidence of in-hospital major adverse cardiovascular events(MACE)were compared between the groups.Independent prognostic factors were analyzed,and the predictive performance of these factors was evaluated.Results Among the 204 patients,myocardial injury markers were elevated in 42.65%(87/204)of them.The incidence of electrocardiographic abnormalities,such as ST T changes(38.24%,78/204)and arrhythmias(24.02%,49/204),was significantly higher in the injury group than in the non injury group(all P<0.05).Elevated cTnI level(OR=1.052),prolonged QTc interval(OR=1.049),and a high National Institutes of Health Stroke Scale(NIHSS)score(OR=1.458)were identified as independent risk factors for poor prognosis at 90 days(all P<0.05),whereas CK-MB level was not an independent risk factor(P>0.05).The combination of NIHSS score,cTnI,and QTc interval demonstrated an area under the curve(AUC)of 0.920,with a specificity of 96.80%and a sensitivity of 70.89%,in predicting poor prognosis.Conclusions Patients with AIS frequently exhibit concomitant myocardial injury and electrocardiographic abnormalities.Elevated cTnI levels and prolonged QTc intervals are independently associated with poor 90-day prognosis,serving as significant predictive biomarkers.Early monitoring of these indicators contributes to risk stratification and personalized management.展开更多
Background Kawasaki disease(KD)is a common acute systemic vasculitis in children,with coronary artery injury being its most serious complication.Currently,intravenous immunoglobulin(IVIG)serves as the standard first l...Background Kawasaki disease(KD)is a common acute systemic vasculitis in children,with coronary artery injury being its most serious complication.Currently,intravenous immunoglobulin(IVIG)serves as the standard first line treatment.However,approximately 10%-20%of patients do not respond to initial IVIG therapy,leading to difficulties in inflammation control,increased risk of coronary artery lesions,and a lack of reliable early predictive indicators.Existing scoring systems(such as the Kobayashi and Egami scores)for predicting IVIG nonresponse are predominantly based on clinical features and conventional inflammatory markers,and thus have limited ability to specifically reflect the extent of myocardial involvement and cardiac functional impairment.Therefore,identifying biomarkers capable of predicting IVIG responsiveness is of significant importance for clinical decision making and improving patients'outcomes.Brain natriuretic peptide(BNP)and cardiac troponin I(cTnI),which reflect cardiac function and myocardial injury respectively,may serve as potential indicators for evaluating IVIG treatment response.Combining these two cardiac specific biomarkers with traditional scoring systems could provide a more comprehensive and accurate tool for early identification of IVIG nonresponsive patients.Methods A retrospective analysis was conducted on the clinical data of 80 children with KD who were admitted to Longyan First Hospital from January 2024 to October 2025.All patients received IVIG therapy.Based on treatment response,they were divided into an IVIG-responsive group and an IVIG-nonresponsive group.General information and laboratory parameters were collected from both groups.Univariate and multivariate logistic regression analyses were employed to screen for independent risk factors affecting the efficacy of IVIG in KD patients.Additionally,receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of BNP and cTnI for IVIG treatment response.Results After standard IVIG treatment,all KD children were categorized based on treatment response into an IVIG-responsive group(n=68,85.00%)and an IVIG-nonresponsive group(n=12,15.00%).The Kobayashi score,ESR,BNP,and cTnI levels were significantly higher in the IVIG-nonresponsive group compared to the IVIGresponsive group(P<0.05).Multivariate logistic regression analysis identified Kobayashi score,BNP,and cTnI as independent risk factors affecting IVIG treatment efficacy.Furthermore,ROC curve analysis demonstrated that both BNP and cTnI exhibited predictive value for IVIG treatment outcomes.Conclusions The Kobayashi score,serum BNP level,and serum cTnI level were all independent risk factors influencing the efficacy of IVIG therapy in children with KD.Both serum BNP and cTnI levels demonstrated certain predictive value for IVIG treatment outcomes.展开更多
Cardiac troponin I(cTnI),a widely used biomarker for assessing cardiovascular risk,can provide a window for the evaluation of drug-induced myocardial injury.Label-free biosensors are promising candidates for detecting...Cardiac troponin I(cTnI),a widely used biomarker for assessing cardiovascular risk,can provide a window for the evaluation of drug-induced myocardial injury.Label-free biosensors are promising candidates for detecting cell secretomes,since they do not require labor-intensive processes.In this work,a label-free electrochemical aptasensor is developed for in situ monitoring of cardiac cell secre-tomes in cell culture media based on target-induced strand displacement.The aptasensing system contains an aptamer-functionalized signal nanoprobe facing trimetallic metal-organic framework nanosheets and a gold nanoparticle-based detection working electrode modified with DNA nanotetrahedron-based complementary DNA for indirect target detection.The signal nanoprobes(termed CAHA)consisted of copper-based metal-organic frameworks,AuPt nanoparticles,horseradish peroxidase,and an aptamer.When the aptasensor is exposed to cardiac cell secretomes,cTnI competi-tively binds to the aptamer,resulting in the release of signal nanoprobes from the biorecognition interface and electrochemical signal changes.The aptasensor exhibited rapid response times,a low detection limit of 0.31 pg/mL,and a wide linear range of 0.001-100 ng/mL.We successfully used this aptasensor to measure cTnI concentrations among secreted cardiac markers during antitumor drug treatment.In general,aptasensors can be used to monitor a variety of cardiac biomarkers in the eval-uation of cardiotoxicity.展开更多
OBJECTIVE:To evaluate the effect of Yiqi Liangxue Shengji prescription(益气凉血生肌方,YQLXSJ)on cardiac function and outcomes in acute myocardial infarction(AMI)patients with myocardial ischemiareperfusion injury(MIRI...OBJECTIVE:To evaluate the effect of Yiqi Liangxue Shengji prescription(益气凉血生肌方,YQLXSJ)on cardiac function and outcomes in acute myocardial infarction(AMI)patients with myocardial ischemiareperfusion injury(MIRI)and to determine its clinical efficacy.METHODS:This prospective,randomized,double-blind,placebo-controlled trial enrolled hospitalized patients with AMI who underwent percutaneous coronary intervention and experienced MIRI either intraoperatively or postoperatively.Participants were randomly allocated to the treatment group,which received YQLXSJ,or the control group,which received a placebo,concurrent with standard Western Medicine therapy.The intervention period lasted 8 weeks.The primary outcome measure was left ventricular ejection fraction(LVEF),determined by echocardiography.Secondary outcomes included Nterminal pro brain natriuretic peptide(NT-pro BNP)and cardiac troponin I(cTnI)levels,left ventricular internal diameter,major adverse cardiovascular events(MACE),angina pectoris scores,and Chinese medicine evidence scores.RESULTS:Following 8 weeks of intervention,the treatment group demonstrated a significant increase in LVEF and a marked reduction in NT-pro BNP when compared to the control group.There was also a significant decrease in peak cTnI levels,Chinese medicine evidence scores,and angina pectoris scores.The control group's left ventricular end-systolic diameter(LVESD)significantly increased compared to baseline after 8 weeks(P<0.05),whereas the treatment group's LVESD showed no significant change from baseline(P>0.05).Although the treatment group showed a downward trend in MACE incidence compared to the control group,this difference was not statistically significant(P>0.05).CONCLUSIONS:This study demonstrated that the addition of YQLXSJ to standard therapy can improve cardiac function and alleviate clinical symptoms in AMI patients with MIRI,and also showed a potential to mitigate the incidence of MACE.Furthermore,YQLXSJ displayed a favorable safety profile in clinical application.展开更多
BACKGROUND Identification of myocardial injury has traditionally relied on high-sensitivity troponin T(hs-TnT)levels exceeding the 99th percentile threshold.However,patients with detectable hs-TnT levels below this th...BACKGROUND Identification of myocardial injury has traditionally relied on high-sensitivity troponin T(hs-TnT)levels exceeding the 99th percentile threshold.However,patients with detectable hs-TnT levels below this threshold represent a heterogeneous group with an inadequately characterized risk profile.AIM To investigate the association between hs-TnT levels below the 99th percentile and the presence of diabetic kidney disease(DKD)in patients with diabetes mellitus.METHODS This study analyzed data from the National Health and Nutrition Examination Survey obtained between 1999 and 2004,focusing on adults with type 2 diabetes mellitus.Serum hs-TnT concentrations were evaluated.DKD was defined as impaired glomerular filtration rate(<60 mL/minute/1.73 m^(2)),proteinuria(urinary albumin-to-creatinine ratio of≥30 mg/g),or both conditions in patients with diabetes mellitus.Weighted multivariable logistic regression analysis and restricted cubic spline analyses were employed to examine the independent association between hs-TnT and DKD,with the likelihood ratio test being used to evaluate nonlinearity.RESULTS The study included 2505 patients with a mean age of 55.02(standard error:0.72)years,of whom 44.87%were females.Among the participants,909(32.34%)were diagnosed with DKD.Multivariable logistic regression analysis indicated that,compared to the lowest tertile of hs-TnT(<5.93 ng/L),tertile 2(5.94-9.79 ng/L)had an odds ratio of 1.25(95%confidence interval:0.77-2.02,P=0.350),while tertile 3(9.80-21.88 ng/L)had an odds ratio of 2.07(95%confidence interval:1.13-3.80,P=0.022),with a significant trend(P for trend=0.022).Smoothed curve fitting demonstrated a linear association between hs-TnT levels and DKD in the overall population(P=0.061 for nonlinearity)and in male(P=0.136 for nonlinearity)and female(P=0.067 for nonlinearity)subgroups.Further stratification and sensitivity analyses yielded consistent conclusions.CONCLUSION Our study findings suggest that in individuals with type 2 diabetes,detectable hs-TnT levels below the 99th percentile are associated with DKD.展开更多
Cardiac troponin-I （cTnI） and -T （cTnT） are sensitive and specific markers of myocardial injury. However, the role of increased cTnI and cTnT in percutaneous coronary intervention （PCI）-related myocardial injury...Cardiac troponin-I （cTnI） and -T （cTnT） are sensitive and specific markers of myocardial injury. However, the role of increased cTnI and cTnT in percutaneous coronary intervention （PCI）-related myocardial injury remains controversial. In this prospective, single-center and double-blind study, we aimed to determine the diagnostic and prognostic value of cTnI as well as cTnT （cTns） in PCI-related myocardial injury in a Chinese population. A total of 1,008 patients with stable angina pectoris and non-ST-segment elevation acute coronary syndrome were recruited. The levels of cTnI and cTnT were examined before and after PCI. All patients were followed up for 26± 9 months to observe the incidence of major adverse cardiac events （MACEs）. Our results showed that post- PCI cTnI and/or cTnT levels were increased to more than the 99^th percentile upper reference limit （URL） in 133 （13.2%） patients, among which 22 （2.2%） were more than 5 × 99^th percentile URL. By univariate analysis, an elevation in cTns after PCI was not an independent predictor of increased MACEs, HR 1.35 （P = 0.33, 95% CI： 0.74-2.46）. In conclusion, our data demonstrate that the incidence of PCI-related myocardial injury is not common in a Chinese population and minor elevated cTns levels may not be a sensitive prognostic marker for MACEs.展开更多
文摘High-sensitivity cardiac troponin(hs-cTn) assays are increasingly being used in many countries worldwide,however,a generally accepted definition of high-sen-sitivity is still pending.These assays enable cTn mea-surement with a high degree of analytical sensitivity with a low analytical imprecision at the low measuring range of cTn assays(coefficient of variation of < 10% at the 99th percentile upper reference limit).One of the most important advantages of these new assays is that they allow novel,more rapid approaches to rule in or rule out acute coronary syndromes(ACSs) than with previous cTn assay generations which are still more commonly used in practice worldwide.hs-cTn is also more sensitive for the detection of myocardial damage unrelated to acute myocardial ischemia.Therefore,the increase in early diagnostic sensitivity of hs-cTn assays for ACS comes at the cost of a reduced ACS specificity,because more patients with other causes of acute or chronic myocardial injury without overt myocardial isch-emia are detected than with previous cTn assays.As hs-cTn assays are increasingly being adopted in clinical practice and more hs-cTn assays are being developed,this review attempts to synthesize the available clinical data to make recommendations for their everyday clini-cal routine use.
基金funded in part by the National Key R&D Program of China(Grant No.2022YFC2402404)the National Natural Science Foundation of China(Grant Nos.82170351 and 82370342)+1 种基金the Natural Science Foundation of Jiangsu Province(Grant Nos.BK20222002 and BK20231145)the Clinical Capacity Enhancement Project of Jiangsu Province Hospital(the First Affiliated Hospital of Nanjing Medical University)(Grant No.J SPH-MA-2022-3)。
文摘It is often challenging to diagnose acute myocardial infarction(AMI)in patients with elevated high-sensitivity cardiac troponin T(hs-cTnT)before observing a significant rise and/or fall in hs-cTnT.The current study aimed to identify an optimal cut-off to rule in AMI.A total of 76411 patients with elevated hs-cTnT were included.The predictive cut-off values for diagnosing ST-segment elevation myocardial infarction(STEMI)and non-STsegment elevation myocardial infarction(NSTEMI)were assessed using the area under the receiver operating characteristic curve(AUC).Among the patients,50466(66.0%)had non-cardiac diseases,25945(34.0%)had cardiac diseases,and 15502(20.3%)had AMI,including 816(1.1%)with STEMI and 14686(19.2%)with NSTEMI.The median hs-cTnT level was 3788.0 ng/L in STEMI patients and 67.2 ng/L in NSTEMI patients.The optimal cut-off for diagnosing STEMI was 251.9 ng/L,with a sensitivity of 90.7%,specificity of 86.5%,and an AUC of 0.942;the optimal cut-off for diagnosing NSTEMI was 130.5 ng/L,with a sensitivity of 40.9%,specificity of 83.8%,and an AUC of 0.638.Collectively,optimizing the cut-off values for diagnosing STEMI and NSTEMI to 251.9 ng/L and 130.5 ng/L,respectively,demonstrated high accuracy in a large cohort of Chinese patients with elevated hs-cTnT.
文摘Ambient air pollution is increasingly being recognized as a risk factor for heart failure;however,its effects on cardiac biomarkers remain unclear.This scoping review assessed the existing evidence on the association between air pollution and cardiac biomarkers in heart failure,described the key concepts,synthesized data,and identified research gaps.Following the PRISMA-ScR guidelines,PubMed,Embase,Web of Science,and CNKI databases were searched for studies on air pollution,heart failure,and biomarkers.A total of 765 records were screened,and 81 full texts were assessed for eligibility,resulting in 15 studies.The results showed that the exposure to particulate matter was associated with elevated N-terminal pro-B-type natriuretic peptide and troponin levels.Several studies have linked particulate matter exposure to a higher cardiovascular risk and heart failure biomarkers.Inflammatory and oxidative stress markers were consistently elevated across studies,supporting the biological relevance of these associations.However,few studies have focused specifically on populations with heart failure or clinically relevant biomarkers,and the evidence for gaseous pollutants remains inconclusive.These findings highlight the need to integrate environmental risk assessment into heart failure care and inform policy efforts to reduce the pollutionrelated cardiovascular burden.Further research should address these gaps through improved exposure assessments and the integration of mechanistic evidence.
文摘Supraventricular tachycardia(SVT)is a frequent cause of emergency presentations.Troponin elevation is common,but its clinical significance remains uncertain and may trigger unnecessary downstream testing.In this mini-review,we aimed to review the prevalence,mechanisms,prognostic relevance,and management of troponin elevation in adult paroxysmal SVT.A narrative review was conducted using PubMed and EMBASE(2000-2025)with MeSH terms related to SVT and troponin.Eligible studies included original research or registry analyses in adults with paroxysmal SVT.Pediatric and atrial fibrillation/flutter cohorts were excluded.Additional data were obtained from reference lists and expert commentaries.Troponin elevation occurs in approximately 30%-50%of adult SVT cases,primarily reflecting a tachycardia-induced supply-demand imbalance or myocardial stretch,rather than plaque rupture.Short-term registry data suggest potential prognostic associations,but long-term outcomes remain inconsistent and are largely determined by comorbidities and underlying coronary artery disease.Troponin-driven management often leads to increased admissions,consultations,and additional testing without a demonstrable benefit.Troponin elevation in SVT is frequent but usually benign.Routine measurement in all patients is not justified.A selective,risk-based approach–focused on ischemic symptoms,electrocardiogram changes,or high-risk clinical features–offers more appropriate,efficient,and patient-centered care.
文摘Background Patients with acute ischemic stroke(AIS)frequently present with subclinical cardiac injury.Current clinical assessments predominantly focus on neurological deficits,while the systematic identification and risk stratification of early cardiac complications remain inadequate.Myocardial injury markers and electrocardiographic abnormalities reflect biochemical myocardial damage and electrophysiological disturbances,respectively.Their combined use may provide a more comprehensive evaluation of cardiac involvement following AIS,thereby compensating for the limitations of neurological assessment alone.However,their synergistic value in predicting the prognosis of AIS patients requires further clarification.Methods A retrospective analysis was conducted on the medical records of 204 AIS patients admitted to our hospital from July 2023 to July 2025.Based on cardiac troponin I(cTnI)and creatine kinase-MB(CK-MB)levels,as well as electrocardiographic findings within 72 hours of onset,patients were categorized into a myocardial injury group(n=87)and a non-myocardial injury group(n=117).Both groups received standardized treatment.The modified Rankin Scale(mRS)scores at 90 days post-onset and the incidence of in-hospital major adverse cardiovascular events(MACE)were compared between the groups.Independent prognostic factors were analyzed,and the predictive performance of these factors was evaluated.Results Among the 204 patients,myocardial injury markers were elevated in 42.65%(87/204)of them.The incidence of electrocardiographic abnormalities,such as ST T changes(38.24%,78/204)and arrhythmias(24.02%,49/204),was significantly higher in the injury group than in the non injury group(all P<0.05).Elevated cTnI level(OR=1.052),prolonged QTc interval(OR=1.049),and a high National Institutes of Health Stroke Scale(NIHSS)score(OR=1.458)were identified as independent risk factors for poor prognosis at 90 days(all P<0.05),whereas CK-MB level was not an independent risk factor(P>0.05).The combination of NIHSS score,cTnI,and QTc interval demonstrated an area under the curve(AUC)of 0.920,with a specificity of 96.80%and a sensitivity of 70.89%,in predicting poor prognosis.Conclusions Patients with AIS frequently exhibit concomitant myocardial injury and electrocardiographic abnormalities.Elevated cTnI levels and prolonged QTc intervals are independently associated with poor 90-day prognosis,serving as significant predictive biomarkers.Early monitoring of these indicators contributes to risk stratification and personalized management.
文摘Background Kawasaki disease(KD)is a common acute systemic vasculitis in children,with coronary artery injury being its most serious complication.Currently,intravenous immunoglobulin(IVIG)serves as the standard first line treatment.However,approximately 10%-20%of patients do not respond to initial IVIG therapy,leading to difficulties in inflammation control,increased risk of coronary artery lesions,and a lack of reliable early predictive indicators.Existing scoring systems(such as the Kobayashi and Egami scores)for predicting IVIG nonresponse are predominantly based on clinical features and conventional inflammatory markers,and thus have limited ability to specifically reflect the extent of myocardial involvement and cardiac functional impairment.Therefore,identifying biomarkers capable of predicting IVIG responsiveness is of significant importance for clinical decision making and improving patients'outcomes.Brain natriuretic peptide(BNP)and cardiac troponin I(cTnI),which reflect cardiac function and myocardial injury respectively,may serve as potential indicators for evaluating IVIG treatment response.Combining these two cardiac specific biomarkers with traditional scoring systems could provide a more comprehensive and accurate tool for early identification of IVIG nonresponsive patients.Methods A retrospective analysis was conducted on the clinical data of 80 children with KD who were admitted to Longyan First Hospital from January 2024 to October 2025.All patients received IVIG therapy.Based on treatment response,they were divided into an IVIG-responsive group and an IVIG-nonresponsive group.General information and laboratory parameters were collected from both groups.Univariate and multivariate logistic regression analyses were employed to screen for independent risk factors affecting the efficacy of IVIG in KD patients.Additionally,receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of BNP and cTnI for IVIG treatment response.Results After standard IVIG treatment,all KD children were categorized based on treatment response into an IVIG-responsive group(n=68,85.00%)and an IVIG-nonresponsive group(n=12,15.00%).The Kobayashi score,ESR,BNP,and cTnI levels were significantly higher in the IVIG-nonresponsive group compared to the IVIGresponsive group(P<0.05).Multivariate logistic regression analysis identified Kobayashi score,BNP,and cTnI as independent risk factors affecting IVIG treatment efficacy.Furthermore,ROC curve analysis demonstrated that both BNP and cTnI exhibited predictive value for IVIG treatment outcomes.Conclusions The Kobayashi score,serum BNP level,and serum cTnI level were all independent risk factors influencing the efficacy of IVIG therapy in children with KD.Both serum BNP and cTnI levels demonstrated certain predictive value for IVIG treatment outcomes.
基金the National Natural Science Foundation of China(GrantNos.:82373841,82003710)Basic and Applied Basic Research Foundationof Guangdong Province(Grant No.:2024A1515011385)+1 种基金Guangzhou Basic and Applied Basic Research Foundation(Grant No.:2025A04J7083)Grant from the GuangdongPharmaceutical University(Grant No.:2024QZ01).
文摘Cardiac troponin I(cTnI),a widely used biomarker for assessing cardiovascular risk,can provide a window for the evaluation of drug-induced myocardial injury.Label-free biosensors are promising candidates for detecting cell secretomes,since they do not require labor-intensive processes.In this work,a label-free electrochemical aptasensor is developed for in situ monitoring of cardiac cell secre-tomes in cell culture media based on target-induced strand displacement.The aptasensing system contains an aptamer-functionalized signal nanoprobe facing trimetallic metal-organic framework nanosheets and a gold nanoparticle-based detection working electrode modified with DNA nanotetrahedron-based complementary DNA for indirect target detection.The signal nanoprobes(termed CAHA)consisted of copper-based metal-organic frameworks,AuPt nanoparticles,horseradish peroxidase,and an aptamer.When the aptasensor is exposed to cardiac cell secretomes,cTnI competi-tively binds to the aptamer,resulting in the release of signal nanoprobes from the biorecognition interface and electrochemical signal changes.The aptasensor exhibited rapid response times,a low detection limit of 0.31 pg/mL,and a wide linear range of 0.001-100 ng/mL.We successfully used this aptasensor to measure cTnI concentrations among secreted cardiac markers during antitumor drug treatment.In general,aptasensors can be used to monitor a variety of cardiac biomarkers in the eval-uation of cardiotoxicity.
基金Supported by the Capital’s Funds for Health Improvement and Research:Clinical Study on Yiqi Liangxue Shengji Prescription for Improving Cardiac Function after Myocardial Ischemia Reperfusion Injury in Patients with Acute Myocardial Infarction(CFH 2020-4-4204)Beijing University of Traditional Chinese Medicine Qihuang Yingcai·Excellent Young Science and Technology Talent Cultivation Program(K2023A03)Beijing University of Traditional Chinese Medicine Dongfang Hospital High-level Capacity Building Project"Zhuoyuan"Project National Talent Precision Cultivation Program(DFRCZY-2024GJRC012)。
文摘OBJECTIVE:To evaluate the effect of Yiqi Liangxue Shengji prescription(益气凉血生肌方,YQLXSJ)on cardiac function and outcomes in acute myocardial infarction(AMI)patients with myocardial ischemiareperfusion injury(MIRI)and to determine its clinical efficacy.METHODS:This prospective,randomized,double-blind,placebo-controlled trial enrolled hospitalized patients with AMI who underwent percutaneous coronary intervention and experienced MIRI either intraoperatively or postoperatively.Participants were randomly allocated to the treatment group,which received YQLXSJ,or the control group,which received a placebo,concurrent with standard Western Medicine therapy.The intervention period lasted 8 weeks.The primary outcome measure was left ventricular ejection fraction(LVEF),determined by echocardiography.Secondary outcomes included Nterminal pro brain natriuretic peptide(NT-pro BNP)and cardiac troponin I(cTnI)levels,left ventricular internal diameter,major adverse cardiovascular events(MACE),angina pectoris scores,and Chinese medicine evidence scores.RESULTS:Following 8 weeks of intervention,the treatment group demonstrated a significant increase in LVEF and a marked reduction in NT-pro BNP when compared to the control group.There was also a significant decrease in peak cTnI levels,Chinese medicine evidence scores,and angina pectoris scores.The control group's left ventricular end-systolic diameter(LVESD)significantly increased compared to baseline after 8 weeks(P<0.05),whereas the treatment group's LVESD showed no significant change from baseline(P>0.05).Although the treatment group showed a downward trend in MACE incidence compared to the control group,this difference was not statistically significant(P>0.05).CONCLUSIONS:This study demonstrated that the addition of YQLXSJ to standard therapy can improve cardiac function and alleviate clinical symptoms in AMI patients with MIRI,and also showed a potential to mitigate the incidence of MACE.Furthermore,YQLXSJ displayed a favorable safety profile in clinical application.
基金This study was approved by the Medical Ethics Committee of the Second Affiliated Hospital of Gannan Medical University(approval No.EFYJ20240113007).
文摘BACKGROUND Identification of myocardial injury has traditionally relied on high-sensitivity troponin T(hs-TnT)levels exceeding the 99th percentile threshold.However,patients with detectable hs-TnT levels below this threshold represent a heterogeneous group with an inadequately characterized risk profile.AIM To investigate the association between hs-TnT levels below the 99th percentile and the presence of diabetic kidney disease(DKD)in patients with diabetes mellitus.METHODS This study analyzed data from the National Health and Nutrition Examination Survey obtained between 1999 and 2004,focusing on adults with type 2 diabetes mellitus.Serum hs-TnT concentrations were evaluated.DKD was defined as impaired glomerular filtration rate(<60 mL/minute/1.73 m^(2)),proteinuria(urinary albumin-to-creatinine ratio of≥30 mg/g),or both conditions in patients with diabetes mellitus.Weighted multivariable logistic regression analysis and restricted cubic spline analyses were employed to examine the independent association between hs-TnT and DKD,with the likelihood ratio test being used to evaluate nonlinearity.RESULTS The study included 2505 patients with a mean age of 55.02(standard error:0.72)years,of whom 44.87%were females.Among the participants,909(32.34%)were diagnosed with DKD.Multivariable logistic regression analysis indicated that,compared to the lowest tertile of hs-TnT(<5.93 ng/L),tertile 2(5.94-9.79 ng/L)had an odds ratio of 1.25(95%confidence interval:0.77-2.02,P=0.350),while tertile 3(9.80-21.88 ng/L)had an odds ratio of 2.07(95%confidence interval:1.13-3.80,P=0.022),with a significant trend(P for trend=0.022).Smoothed curve fitting demonstrated a linear association between hs-TnT levels and DKD in the overall population(P=0.061 for nonlinearity)and in male(P=0.136 for nonlinearity)and female(P=0.067 for nonlinearity)subgroups.Further stratification and sensitivity analyses yielded consistent conclusions.CONCLUSION Our study findings suggest that in individuals with type 2 diabetes,detectable hs-TnT levels below the 99th percentile are associated with DKD.
基金supported by the Health Bureau of Jiangsu Province(No.K201104)the Scientific Support Plan of Jiangsu Province(No.BE2011803)+2 种基金the National Natural Science Foundation of China(No.81170102/H0203)the Priority Academic Program Development of Jiangsu Higher Education Institutions(No.BL2012011)the Fourth Period Project"333"of Jiangsu Province(No.BRA2012207),China
文摘Cardiac troponin-I （cTnI） and -T （cTnT） are sensitive and specific markers of myocardial injury. However, the role of increased cTnI and cTnT in percutaneous coronary intervention （PCI）-related myocardial injury remains controversial. In this prospective, single-center and double-blind study, we aimed to determine the diagnostic and prognostic value of cTnI as well as cTnT （cTns） in PCI-related myocardial injury in a Chinese population. A total of 1,008 patients with stable angina pectoris and non-ST-segment elevation acute coronary syndrome were recruited. The levels of cTnI and cTnT were examined before and after PCI. All patients were followed up for 26± 9 months to observe the incidence of major adverse cardiac events （MACEs）. Our results showed that post- PCI cTnI and/or cTnT levels were increased to more than the 99^th percentile upper reference limit （URL） in 133 （13.2%） patients, among which 22 （2.2%） were more than 5 × 99^th percentile URL. By univariate analysis, an elevation in cTns after PCI was not an independent predictor of increased MACEs, HR 1.35 （P = 0.33, 95% CI： 0.74-2.46）. In conclusion, our data demonstrate that the incidence of PCI-related myocardial injury is not common in a Chinese population and minor elevated cTns levels may not be a sensitive prognostic marker for MACEs.
