Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Showing posts with label elevated troponin. Show all posts
Showing posts with label elevated troponin. Show all posts

Thursday, July 4, 2019

Blood test may predict cardiovascular disease

You can tell the competency of your doctor and hospital if they do nothing to ensure further research is done. Hope you are ok with such incompetency. I bet they did nothing with these earlier posts and of course our fucking failures of stroke associations did nothing either.

 

 

Blood test may predict cardiovascular disease

Healthline/Medical News Today | May 01, 2019
Advertisement
New research suggests that a simple blood test, which doctors currently use to diagnose heart attacks, may be useful in predicting the risk of cardiovascular disease.
According to the latest statistics from the American Heart Association (AHA), almost half of the people living in the United States have some form of cardiovascular disease. In fact, according to 2016 figures, 121.5 million US adults, or 48% of the entire population, have cardiovascular disease (CVD), which is a cluster of conditions that includes hypertension. Doctors often call hypertension the "silent killer" because it does not show any visible symptoms until it is too late.
The same AHA report predicts that by 2035, over 130 million adults will have a form of CVD that could bring costs in the United States to 1.1 trillion dollars. Currently, heart disease is the leading cause of death in the United States, while stroke is the fifth.
But what if there was a blood test that could accurately predict whether a person will have heart disease or a stroke? New research suggests that such a test may already exist. By detecting the blood levels of specific proteins that heart muscles release when they are injured, scientists may be able to predict a person's risk of eventually developing CVD.
Dr. Christie Ballantyne, who is the cardiology chief at Baylor College of Medicine in Houston, TX, and his team, detail this idea in a new study that appears in the AHA journal Circulation.

Troponin levels can predict CVD risk

Troponins are proteins that signal heart muscle damage, and in the new research, Dr. Ballantyne and his colleagues wanted to see if detecting troponin in the blood of healthy middle-aged adults or seniors could predict CVD risk.
Dr. Ballantyne and colleagues analyzed a group of 8,121 people aged 54–74 who participated in the "Atherosclerosis Risk in Communities" study. None of the participants had a history of cardiovascular disease. The scientists identified troponin levels in 85% of the participants and applied Cox proportional hazards models to examine the links between these levels and cardiovascular disease. Namely, they studied correlations with coronary heart disease, myocardial infarction, ischemic stroke, atherosclerotic cardiovascular disease, heart failure hospitalization, global cardiovascular disease, and all-cause mortality.
The research found that high levels of troponin correlated strongly with "increased global CVD incidence in the general population independent of traditional risk factors." High-sensitivity troponin tests, therefore, proved to be an accurate way of predicting CVD risk, especially when combined with a standard method of calculating a person's 10-year cardiovascular risk.
"What we're finding out is that these tests can be used in the general population to give us information as to who is most likely to have a future problem, whether it be a heart attack, stroke, or heart failure," says Dr. Ballantyne. "If you can treat someone much earlier, before [they] have symptoms, you will be far more effective in preventing events," continues the researcher, who adds, "Our major problem is that we do too little, too late."
"If the first time you find out that you're at risk for heart failure is when you actually start getting short of breath and you end up in the hospital, you probably have advanced heart disease already, and it is going to be harder to treat than if that person took steps years earlier."
—Dr. Ballantyne
Instead, knowing the risk in advance can prompt people to take preventive measures, such as exercising more and watching their blood pressure. However, the scientists explain that although doctors currently use troponin tests to diagnose a heart attack, they do not yet accept them as a tool for predicting risk. Scientists need to do more research before using these tests to evaluate risk.
"Research in this area is leading us toward individualized care more and more, so we can better predict who's at risk for developing adverse cardiovascular outcomes," comments Dr. Rebecca Vigen, an assistant professor of internal medicine at the University of Texas Southwestern Medical Center in Dallas, who did not participate in the research. "This study is a step in the direction of personalizing care," Dr. Vigen says.
Read the full article on Healthline/Medical News Today

Thursday, May 2, 2019

Blood test may predict cardiovascular disease

You can tell the competency of your doctor and hospital if they do nothing to ensure further research is done. Hope you are ok with such incompetency. I bet they did nothing with these earlier posts and of course our fucking failures of stroke associations did nothing either.

 

Blood test may predict cardiovascular disease

Healthline/Medical News Today | May 01, 2019
New research suggests that a simple blood test, which doctors currently use to diagnose heart attacks, may be useful in predicting the risk of cardiovascular disease.
Advertisement
According to the latest statistics from the American Heart Association (AHA), almost half of the people living in the United States have some form of cardiovascular disease. In fact, according to 2016 figures, 121.5 million
US adults, or 48% of the entire population, have cardiovascular disease (CVD), which is a cluster of conditions that includes hypertension. Doctors often call hypertension the "silent killer" because it does not show any visible symptoms until it is too late. The same AHA report predicts that by 2035, over 130 million adults will have a form of CVD that could bring costs in the United States to 1.1 trillion dollars. Currently, heart disease is the leading cause of death in the United States, while stroke is the fifth.
But what if there was a blood test that could accurately predict whether a person will have heart disease or a stroke? New research suggests that such a test may already exist. By detecting the blood levels of specific proteins that heart muscles release when they are injured, scientists may be able to predict a person's risk of eventually developing CVD.
Dr. Christie Ballantyne, who is the cardiology chief at Baylor College of Medicine in Houston, TX, and his team, detail this idea in a new study that appears in the AHA journal Circulation.

Troponin levels can predict CVD risk

Troponins are proteins that signal heart muscle damage, and in the new research, Dr. Ballantyne and his colleagues wanted to see if detecting troponin in the blood of healthy middle-aged adults or seniors could predict CVD risk.
Dr. Ballantyne and colleagues analyzed a group of 8,121 people aged 54–74 who participated in the "Atherosclerosis Risk in Communities" study. None of the participants had a history of cardiovascular disease. The scientists identified troponin levels in 85% of the participants and applied Cox proportional hazards models to examine the links between these levels and cardiovascular disease. Namely, they studied correlations with coronary heart disease, myocardial infarction, ischemic stroke, atherosclerotic cardiovascular disease, heart failure hospitalization, global cardiovascular disease, and all-cause mortality.
The research found that high levels of troponin correlated strongly with "increased global CVD incidence in the general population independent of traditional risk factors." High-sensitivity troponin tests, therefore, proved to be an accurate way of predicting CVD risk, especially when combined with a standard method of calculating a person's 10-year cardiovascular risk.
"What we're finding out is that these tests can be used in the general population to give us information as to who is most likely to have a future problem, whether it be a heart attack, stroke, or heart failure," says Dr. Ballantyne. "If you can treat someone much earlier, before [they] have symptoms, you will be far more effective in preventing events," continues the researcher, who adds, "Our major problem is that we do too little, too late."
"If the first time you find out that you're at risk for heart failure is when you actually start getting short of breath and you end up in the hospital, you probably have advanced heart disease already, and it is going to be harder to treat than if that person took steps years earlier."
—Dr. Ballantyne
Instead, knowing the risk in advance can prompt people to take preventive measures, such as exercising more and watching their blood pressure. However, the scientists explain that although doctors currently use troponin tests to diagnose a heart attack, they do not yet accept them as a tool for predicting risk. Scientists need to do more research before using these tests to evaluate risk.
"Research in this area is leading us toward individualized care more and more, so we can better predict who's at risk for developing adverse cardiovascular outcomes," comments Dr. Rebecca Vigen, an assistant professor of internal medicine at the University of Texas Southwestern Medical Center in Dallas, who did not participate in the research. "This study is a step in the direction of personalizing care," Dr. Vigen says.
To read more, click here.

Sunday, November 25, 2018

Elevated troponin in acute ischemic stroke – a matter of debate?

So no clue yet what needs to be done for these stroke patients. I have not heard of this problem before. Have your doctor report back to you on the results of the PRAISE study.  You really don't want a heart attack right after your stroke. 

Elevated troponin in acute ischemic stroke – a matter of debate?


Author: Dr. med. Antje Schmidt-Pogoda, Universitätsklinikum Münster
With respect to high prognostic relevance,1 international guidelines recommend the measurement of troponin in all patients presenting with acute ischemic stroke.2 However, high-sensitivity troponin is elevated in 20-55% of acute stroke patients,3 many of whom without thrombotic acute coronary syndrome (ACS). Therefore, the management of stroke patients with elevated troponin is a common matter of debate between neurologists and cardiologists in emergency rooms. This blog post discusses three frequent questions from the neurologist’s perspective.

Why is troponin elevated in so many acute stroke patients?

At first, acute ischemic stroke is a stressful condition, which may cause coronary demand ischemia, especially in patients with preexisting chronic heart failure, atrial fibrillation or coronary artery disease.4 Large strokes in particular may also induce a neurogenic heart syndrome through bursts of neurogenic sympathetic activity and catecholamine release, leading to coronary demand ischemia and myocardial necrosis.4 Beyond, elevated troponin in stroke patients might be attributable to nonischemic myocyte injury due to catecholamine-mediated myocardial toxicity, cytokine-mediated myocardial injury, endothelial dysfunction and microvascular spasms.4 Further conditions frequently associated with elevated troponin include atrial fibrillation, heart failure, pulmonary embolism, sepsis, and renal insufficiency.

Is troponin suitable to predict ACS in stroke patients?

This question was addressed by the Troponin Elevation in Acute Ischemic Stroke (TRELAS) study, which included 2123 consecutive patients presenting with acute ischemic stroke, who did not have ST-segment-elevation myocardial infarction (STEMI).5 Of all included patients, a subset of 29 of 291 patients with elevated troponin underwent diagnostic coronary angiography. The prevalence of coronary culprit lesions on angiography was 24%, and 21% of patients underwent revascularization.5 Compared to a control cohort of age- and sex-matched non-ST-segment-elevation myocardial infarction (NSTEMI) patients without stroke, the prevalence of coronary culprit lesions was lower in stroke patients.5 Nonetheless, coronary culprit lesions were identified in 24% of stroke patients with elevated troponin, thus demonstrating that elevated troponin should not be ignored in acute stroke patients.

What’s the ideal management of stroke patients with elevated troponin?

The recently launched Prediction of Acute Coronary Syndrome in Acute Ischemic Stroke (PRAISE) study aims to develop a diagnostic algorithm that allows the prediction of acute coronary syndrome in stroke patients with elevated troponin. For the time being, a clear recommendation for acute stroke patients with elevated troponin is lacking. The total level and the dynamic of the troponin increase may help to predict myocardial infarction,6 but eventually, the diagnostic work up and treatment of individual patients remains a matter of debate between neurologists and cardiologists. Most importantly, stroke severity and bleeding risk through dual platelet inhibition and anticoagulation will largely influence treatment options.
So, elevated troponin in acute ischemic stroke remains a matter of debate!
  1. Batal O, Jentzer J, Balaney B, Kolia N, Hickey G, Dardari Z, Reddy V, Jovin T, Hammer M, Gorcsan J, Schmidhofer M. The prognostic significance of troponin I elevation in acute ischemic stroke. J Crit Care. 2016;31:41–47.
  2. Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, Biller J, Brown M, Demaerschalk BM, Hoh B, Jauch EC, Kidwell CS, Leslie-Mazwi TM, Ovbiagele B, Scott PA, Sheth KN, Southerland AM, Summers DV, Tirschwell DL, American Heart Association Stroke Council. 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2018;49:e46–e110.
  3. Scheitz JF, Nolte CH, Laufs U, Endres M. Application and interpretation of high-sensitivity cardiac troponin assays in patients with acute ischemic stroke. Stroke. 2015;46:1132–1140.
  4. Jensen JK, Atar D, Mickley H. Mechanism of troponin elevations in patients with acute ischemic stroke. Am. J. Cardiol. 2007;99:867–870.
  5. Mochmann H-C, Scheitz JF, Petzold GC, Haeusler KG, Audebert HJ, Laufs U, Schneider C, Landmesser U, Werner N, Endres M, Witzenbichler B, Nolte CH, TRELAS Study Group. Coronary Angiographic Findings in Acute Ischemic Stroke Patients With Elevated Cardiac Troponin: The Troponin Elevation in Acute Ischemic Stroke (TRELAS) Study. Circulation. 2016;133:1264–1271.
  6. Agewall S, Giannitsis E, Jernberg T, Katus H. Troponin elevation in coronary vs. non-coronary disease. Eur. Heart J. 2011;32:404–411.