High-Sensitivity Troponin is not a Myth, and “Myth-busting” is often another Myth to be Busted

Conclusion: Early rule out protocol is effective and safe.We refer interested readers to the following excellent reviews of high-sensitivity troponin implementation:Twerenbold, R. et al.JACC70 (8): 996 –1012.https://doi.org/10.1016/j.jacc.2017.07.718.Yader S. et al. 2016. Am J Med 129 (4): 354 –65.https://doi.org/10.1016/j.amjmed.2015.12.005.Response to the 2nd “Myth-busting” articleInterestingly, on Nov 5, Dr. Spiegel publishedanother “Myths in EM” piece in EM News: “Is hs-cTnT Worth the Downstream Testing?. The piece assesses a new randomized trial of the Roche hs -cTnT (not the Abbott Troponin I, which is what was studied in the above Lancet study). [Here is the full text of this randomized trial:A Randomized Trial of a 1-Hour Troponin T Protocol in Suspected Acute Coronary Syndromes.]   Spiegel ’s piece starts by conceding that “hs assays....will soon replace the 4th generation assays currently being used.” This hs-cTnT study randomized potential ACS workups to a 0/1 hour hs-cTnT protocol vs. standard care. In the standard care arm, 0/3 hour troponins were used and the providers were blinded to any value less than 29 ng/L (the rationale for hs-cTn is to be able to precisely measure such small quantities, so this study was testing thevalue of knowing, vs. not knowing, the precise value of all such low troponin measurements). The study showed that more patients are disch...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs

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This study clearly goes against what has been the common wisdom for the last 30, 40 years” and may lead to less testing and invasive treatment for such patients in the future, said Dr. Glenn Levine, a Baylor College of Medicine cardiologist with no role in the research. Some doctors still may quibble with the study, but it was very well done “and I think the results are extremely believable,” he said. About 17 million Americans have clogged arteries that crimp the heart’s blood supply, which can cause periodic chest pain. Cheap and generic aspirin, cholesterol-lowering drugs and blood pressure medic...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized onetime Research Source Type: news
Cardiac rehabilitation (CR), or “cardiac rehab,” is a multifaceted, medically supervised program proven to improve heart health and outcomes in people with certain types of cardiovascular disease. CR revolves around three major components: an individualized exercise and training program, education on topics related to heart health, and stress reduction. CR is currently recommended for the following diagnoses: angina (chest pain); heart attack with or without angioplasty or bypass surgery; heart failure with reduced ejection fraction (HFrEF); and heart surgery including heart valve procedures or heart or heart/l...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Exercise and Fitness Health Heart Health Source Type: blogs
Walking is often touted as a perfect exercise to improve multiple aspects of health. But what if walking causes leg pain? Many people shrug off leg pain when they walk as a normal part of aging. In some cases, though, it’s the sign of peripheral artery disease (PAD), which can put heart and brain health at risk. While PAD doesn’t usually run in families, it’s more likely to occur as people age, or among people who smoke or have high blood pressure, high cholesterol, or diabetes. What causes leg pain if you have PAD? People with PAD have fatty deposits in arteries outside the heart — most often in th...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Exercise and Fitness Healthy Aging Heart Health Hypertension and Stroke Pain Management Source Type: blogs
A 67-year-old woman with a high-stress job had a vigorous disagreement with her neighbors last week. She developed severe substernal chest pain and called 911 fearing a heart attack. She is thin, has never smoked, has normal blood pressure and normal cholesterol. She is not a diabetic and runs on a treadmill for two hours […]Find jobs at  Careers by KevinMD.com.  Search thousands of physician, PA, NP, and CRNA jobs now.  Learn more.
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Physician Cardiology Primary Care Source Type: blogs
In conclusion, in the absence of obesity, visceral adipose tissue possesses a pronounced anti-inflammatory phenotype during aging which is further enhanced by exercise. Methods of Inducing Cellular Damage are Rarely Relevant to Aging, and the Details Matter https://www.fightaging.org/archives/2019/08/methods-of-inducing-cellular-damage-are-rarely-relevant-to-aging-and-the-details-matter/ One of the major challenges in aging research is determining whether or not models of cellular or organismal damage and its consequences are in any way relevant to the natural processes of aging. One can hit a brick with...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
We examined 9293 individuals from the Copenhagen General Population Study using nuclear magnetic resonance spectroscopy measurements of total cholesterol, free- and esterified cholesterol, triglycerides, phospholipids, and particle concentration. Fourteen subclasses of decreasing size and their lipid constituents were analysed: six subclasses were very low-density lipoprotein (VLDL), one intermediate-density lipoprotein (IDL), three low-density lipoprotein (LDL), and four subclasses were high-density lipoprotein (HDL). Remnant lipoproteins were VLDL and IDL combined. Mean nonfasting cholesterol concentration was 72...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
(Natural News) Heart disease is caused by problems related to the arteries. The narrowing or blockage of these blood vessels, which deliver blood to and from the heart, can cause significant damage and result in heart attack, chest pain, or stroke. Because the cholesterol that builds up along the walls of the arteries comes mostly from...
Source: NaturalNews.com - Category: Consumer Health News Source Type: news
ConclusionHigh blood pressure is a public health problem most often associated with other cardiovascular risk factors. An evaluation of cardiovascular risk is necessary in postmenopausal hypertensive diabetic women and effective management of risk factors is recommended.
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
This study elucidates the potential to use mitochondria from different donors (PAMM) to treat UVR stress and possibly other types of damage or metabolic malfunctions in cells, resulting in not only in-vitro but also ex-vivo applications. Gene Therapy in Mice Alters the Balance of Macrophage Phenotypes to Slow Atherosclerosis Progression https://www.fightaging.org/archives/2019/07/gene-therapy-in-mice-alters-the-balance-of-macrophage-phenotypes-to-slow-atherosclerosis-progression/ Atherosclerosis causes a sizable fraction of all deaths in our species. It is the generation of fatty deposits in blood vessel...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
This study sought to investigate what could be learned from how these men have fared. The men were born in 1925-1928 and similar health-related data from questionnaires, physical examination, and blood samples are available for all surveys. Survival curves over various variable strata were applied to evaluate the impact of individual risk factors and combinations of risk factors on all-cause deaths. At the end of 2018, 118 (16.0%) of the men had reached 90 years of age. Smoking in 1974 was the strongest single risk factor associated with survival, with observed percentages of men reaching 90 years being 26.3, 25.7, ...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
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