Clinical chemistry
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Multicenter Study
Growth differentiation factor-15 in the early diagnosis and risk stratification of patients with acute chest pain.
Growth differentiation factor-15 (GDF-15) is a stress-responsive marker that might aid in the early diagnosis and risk stratification of patients with suspected acute myocardial infarction (AMI). ⋯ GDF-15 predicts all-cause mortality in unselected patients with acute chest pain independently of and more accurately than hs-cTnT and BNP. However, GDF-15 does not seem to help in the early diagnosis of AMI.
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Glial fibrillary acidic protein (GFAP) is a biomarker candidate indicative of intracerebral hemorrhage (ICH) in patients with symptoms of acute stroke. GFAP is released rapidly in the presence of expanding intracerebral bleeding, whereas a more gradual release occurs in ischemic stroke. In this study the diagnostic accuracy of plasma GFAP was determined in a prospective multicenter approach. ⋯ Plasma GFAP analysis performed within 4.5 h of symptom onset can differentiate ICH and ischemic stroke. Studies are needed to evaluate a GFAP point-of-care system that may help optimize the prehospital triage and management of patients with symptoms of acute stroke.
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Multicenter Study
Markers of plaque instability in the early diagnosis and risk stratification of acute myocardial infarction.
Plaque erosion and plaque rupture occur early in the pathophysiology of acute myocardial infarction (AMI). We hypothesized that markers of plaque instability might be useful in the early diagnosis and risk stratification of AMI. ⋯ Biomarkers of plaque instability do not seem helpful in the early diagnosis of AMI but may provide some incremental value in the risk stratification of patients with acute chest pain.
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Multicenter Study Clinical Trial
Incremental value of high-sensitivity cardiac troponin T for risk prediction in patients with suspected acute myocardial infarction.
High-sensitivity cardiac troponin assays have better analytical precision and sensitivity than earlier-generation assays when measuring cardiac troponin at low concentrations. We evaluated whether use of a high-sensitivity assay could further improve risk stratification compared with a standard cardiac troponin assay. ⋯ Concentrations of hs-cTnT >0.014 μg/L improve the prediction of death but not subsequent AMI in unselected patients presenting with acute chest pain.
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Multicenter Study
Prognostic utility of ST2 in patients with acute dyspnea and preserved left ventricular ejection fraction.
Soluble ST2 (sST2), an interleukin-1 receptor family member, is an emerging risk indicator for patients with cardiovascular disease. We evaluated the prognostic role of sST2 for patients presenting to the emergency department with acute dyspnea, with a focus on those with preserved left ventricular ejection fraction (LVEF ≥50%), as risk stratification is often most complex in this subgroup. ⋯ sST2 is a strong predictor of mortality in patients presenting with acute dyspnea, particularly those with preserved LVEF, and may be useful for triage and risk stratification of this challenging group.