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Towards an improved definition of periprocedural myocardial infarction: The role of high-sensitivity cardiac troponins.

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In the past few years, many have disputed the optimal biomarker for confirming or ruling out a diagnosis of periprocedural myocardial infarction (PMI) and the optimal cut-off concentrations to apply.… Click to show full abstract

In the past few years, many have disputed the optimal biomarker for confirming or ruling out a diagnosis of periprocedural myocardial infarction (PMI) and the optimal cut-off concentrations to apply. In this issue of the Journal of Cardiac Surgery, Niclauss et al. performed a retrospective analysis of CK-MB and high-sensitivity cardiac troponin T (hs-cTnT) dynamics and peak concentrations following different cardiac surgical interventions in 400 patients during a 2-year period in a single center. The authors found that CK-MB and hs-cTnT predict PMI with a comparable diagnostic accuracy and discriminatory power >95%. They also attempted to propose an improved, more sensitive threshold of hs-cTnT for PMI. Their findings could have implications for clinical practice, but more research is warranted to identify more appropriate cut-offs. This could include hs-cTnT release pattern, slope steepness, and changes. Ultimately, this could results in patient-specific model, able to predict expected and abnormal ranges of hs-cTnT release, enabling an improved and timely diagnosis of PMI.

Keywords: pmi; periprocedural myocardial; high sensitivity; myocardial infarction; sensitivity cardiac

Journal Title: Journal of cardiac surgery
Year Published: 2021

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