Cut off evidence in AMI

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Aug 6th, 2022
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How to cut off evidence in AMI

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[Applause] everyone happier here and welcome Martin Ana thank you I just like to say that that Americans always impressed me by how they do actually come and see things in England as I once wrote if your favorite living writer who also happened to be your long-lost twin brother was giving a reading in the next house along it wouldnamp;#39;t even occur to you to go and stick your head round the door not as true now as it was then but thatamp;#39;s the difference between them I thought we would begin with the title of your new novel itamp;#39;s such a powerful evocative phrase I wonder if you could talk about that um well it has sort of three labels the zone of interest with what the Nazis called the greater Ashe wits area and as will no doubt weamp;#39;ll have more to say about this that interest is there not because itamp;#39;s interesting but because it makes money the cupidity in rapacity of the Nazis in this project the Holocaust is beyond belief and compounds the the crime it

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We have proposed a cut-off value of 100 ng/L as diagnostic for acute myocardial injury in the absence of end-stage renal disease and AMI in ischemic patients. If one extrapolates this cut-off to chest-pain patients, it accurately predicts AMI with a positive predictive value of 90% and the specificity 99%.
The manufacturers upper reference level for troponin T is 14 ng/L. Based on the meta-analyses, cut-off values for troponin in patients with renal impairment with myocardial infarction was 42 ng/L for troponin I and 48 ng/L for troponin T. For patients on dialysis the troponin T cut-off is even higher at 239 ng/L.
Reference values The 99th percentile cutoff for cardiac troponin T (cTnT) is 0.01 ng/mL. The reference range for the high sensitivity troponin T is a normal 14 ng/L, borderline of 14-52 ng/L, and elevated of 52 ng/L.
Access High Sensitivity Troponin I (Beckman Coulter) The Access High Sensitivity Troponin I assay has a recommended 99th centile cut-off point of 17.5 ng/l for the whole population, 11.6 ng/l for females and 19.8 ng/l for males, with a CoV of 10%. The assay can detect troponin I in 50% of the reference population.
Troponin T, High Sensitivity (hs-TnT) is an independent prognostic marker that aids in the diagnosis of myocardial infarction (MI) in an acute setting (22 ng/L for males and 14 ng/L for females), and there is literature supporting its use to assess relative risk for cardiovascular disease (CVD) and adverse
Patients with cardiac troponin concentrations 5 ng/L at presentation are retested at 3 hours. Myocardial infarction is ruled out at 3 hours if cardiac troponin concentrations are unchanged (
Generally speaking, a normal troponin level ranges from 00.04 ng/ml. However, this can vary among laboratories. Levels that are higher than 0.04 ng/ml can indicate a recent heart attack or other injuries and conditions that affect the heart.
The reference ranges for the troponin test, ing to the American Board of Internal Medicine, are measured in nanograms per milliliter (ng/mL). They are: Troponin I: 0 - 0.04 ng/mL. Troponin T: 0 - 0.01 ng/mL.
Currently, 14 ng/L is considered as the cutoff value for a positive Hs-troponin result when evaluating patients with NSTEMI. This value is highly sensitive but lack specificity. When conducting a ROC curve on our data a Hs-troponin value of 14 ng/L had a sensitivity of 99.9% with an only 4% specificity.
For hs-cTnT, abundant data suggest that the LOD (5 ng/L) is appropriate. For hs-cTnI (Abbott ARCHITECT), recommendations from the available data are mixed. A cutoff set at the LOD (2 ng/L) appears safer, although the data of Neumann et al. (9) suggest that the more liberal cutoff of 3 ng/L may suffice.

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