Tag Archives: Biomarkers

The bibliography has been updated over at the ECG blog…

The Emergency Cardiology Group

… was to get the bibliography up to date!

The links go to the full article where possible, but some of these remain behind paywalls.

For individual reprint requests for academic/educational use please leave a message and we will provide these wherever possible according to copyright restrictions.

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Cross blogged from our Emergency Cardiology Site…

The Emergency Cardiology Group

There has been lots of media interest in our paper ‘Validation of high-sensitivity troponin I in a 2-h diagnostic strategy to assess 30-day outcomes in emergency-department patients with possible acute coronary syndrome‘ that went online in in the Journal of the American College of Cardiology in the last few days.

Those in Queensland may have heard reference to the study on the ABC Radio news this morning and Louise Cullen has been interviewed today by ABC Radio National and Channel Nine.

We may have lost out to Black Caviar on the Channel Nine News though…

A copy of the press release from the Queensland Government is available here: RBWH media release – improved testing for potential heart attack patient.

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The Emergency Cardiology Group

A/Prof Louise Cullen writes…

The minefield of differences in troponin assays confuses clinicians, in an area of medicine that is already complex. Determining which patients presenting to Emergency Departments (EDs) with symptoms of possible Acute Coronary Syndromes actually have this underlying diagnosis is challenging. Current guidelines recommend lengthy assessment processes generally not achievable in acceptable time frames for patients to remain in the ED, and thus encourage Emergency Physicians to admit ‘all’ who present with possible symptoms of ACS.

Add to this mix the variability in analytical characteristics between troponin assays and information on change values (deltas) and it seems to many clinicians that this is simply getting too tough.

Our latest paper Delta troponin for the early diagnosis of AMI in emergency patients with chest pain’ in the International Journal of Cardiology highlights how early (0 and 2hr post ED presentation) troponin values may be used to…

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Nothing to help recover from an overseas better than a brisk ride on my bike at 5 am and a couple of favourable replies from journal editors – Our Emergency Cardiology Group has a few ‘In Press…’ now and you can check this out here.

The Emergency Cardiology Group

All that writing is beginning to pay off.

I’ve had to update the ‘In Press…’ page again…

and Jaimi’s Bio is on line!

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Day 3 began with the excellent Session 696: Battles in the Emergency Room over Management of Possible ACS. Pollack, Mueller, Hollander, Than et al covered most of the big questions in this area with all the strengths and weaknesses of clinical assessment, risk stratification, biomarkers and non-invasive testing, especially CT coronary angiography (CTCA) of course. Whilst there are many answers it’s also clear that many questions remain.

Christian Mueller, as you’d expect, provided a great overview of the benefits of the increasingly sensitive troponin assays in this context. What many people don’t realise is that none of the high sensitivity troponin assays available elsewhere have yet been approved for clinical use in the US. But it is very likely that they will be over the next 18 months and so there is quite intense interest in this now. Martin Than had sent the scene for all of this with much of our own data including the ASPECT and ADAPT studies along with what I think was the first look at the results of Louise Cullen’s highly sensitive troponin I data (which is now in press in the Journal of the American College of Cardiology).

The debate over CTCA has, I think, some time to run. Judd Hollander makes a compelling case for this as the ‘best test’ for ruling out coronary disease in patients with chest pain but then he works in a hospital where the test is available until 10pm each night and for four hours on Saturdays and Sundays!!!

And from there it was on to have our poster moderated…

I’ll be presenting a moderated poster in session 1302M: High sensitivity troponins: New insights at the #ACC13 meeting this morning. The paper compares the diagnostic accuracy of two high sensitivity assays for clinical end points in a large cohort of ED chest pain patients. If you want a copy of the poster then I should be able to direct you haw to get a reprint if you contact me either through the blog or twitter (@LastCardiology)

There are important presentations from a number of other prominent research groups working in the area including Christian Mueller’s group and the ROMICAT team.

The posters are going to be moderated by Harvey White and Kristin Newby so there should be some lively discussion… me? nervous? nahhhh!