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Troponin Elevation Beyond Coronary Arteries

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Biomarkers in Cardiovascular Disease

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Abstract

Cardiac troponins are protein complexes that have become the gold standard biomarkers in the detection of myocardial injury. The use of new-generation high-sensitivity assays, which can detect even small increases in troponin levels, resulted in an increase in the number of patients with elevated troponin concentrations. However, in this case there are more false-positive results. This makes it of paramount importance to set differential diagnosis among several noncoronary entities such as stroke, pulmonary embolism (PE), sepsis, acute perimyocarditis, Takotsubo, acute heart failure (HF), and tachycardia. Technological progress of high-sensitivity troponin assays may be helpful in detecting even slight elevations of troponin in individuals, a condition that is met in several different clinical pathologies. However, despite the fact that troponin elevation is indicative of myocardial necrosis, it does not elucidate the pathophysiologic mechanism that causes myocardial damage. The purpose of this chapter is to report clinical pathologies where elevated troponin concentrations are found and to cite studies that have used troponin in the prediction and evaluation of future events.

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Abbreviations

ACC:

American College of Cardiology

ACS:

Acute coronary syndromes

AMI:

Acute myocardial infraction

AV:

Atrioventricular

CAD:

Coronary artery disease

CKD:

Chronic kidney disease

cTn:

Cardiac troponin

ESC:

European Society of Cardiology

ESRD:

End-stage renal disease

HF:

Heart failure

IL:

Interleukin

MI:

Myocardial infraction

MRI:

Magnetic resonance imaging

PE:

Pulmonary embolism

PSVT:

Paroxysmal supraventricular tachycardia

SAH:

Subarachnoid hemorrhage

SIRS:

Systemic inflammatory response

SRCs:

Stress-related cardiomyopathies

TAVI:

Transcatheter aortic valve implantation

Tn:

Troponin

TNF-α:

Tumor necrosis factor-α

VARC:

Valve Academic Research Consortium

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Authors and Affiliations

  1. 1st Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, 114 Vas. Sofias Ave, 115 27, Athens, Greece

    Manolis Vavuranakis, Maria Kariori, Theodore G. Papaioannou & Dimitrios Tousoulis

Authors
  1. Manolis Vavuranakis
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  2. Maria Kariori
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  3. Theodore G. Papaioannou
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  4. Dimitrios Tousoulis
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Correspondence to Manolis Vavuranakis .

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Editors and Affiliations

  1. Department of Biomedical Science, Faculty of Science & Technology , University of Westminster, London, United Kingdom

    Vinood B. Patel

  2. Department of Nutrition and Dietetics, Division of Diabetes and Nutritional Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom

    Victor R. Preedy

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Vavuranakis, M., Kariori, M., Papaioannou, T.G., Tousoulis, D. (2016). Troponin Elevation Beyond Coronary Arteries. In: Patel, V., Preedy, V. (eds) Biomarkers in Cardiovascular Disease. Biomarkers in Disease: Methods, Discoveries and Applications. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7678-4_41

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