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10.1097/JIM.0000000000000239 http://scihub22266oqcxt.onion/10.1097/JIM.0000000000000239 C4648186!4648186!26425879     free     free     free Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       J+Investig+Med 2015 ; 63 (8): 905-15 Nephropedia Template TP {{tp|p=26425879|t=2015. Cardiac Troponin Measurement in the Critically Ill: Potential for Guiding Clinical Management |pdf=|usr=}}{{26425879}} gab.com Text Cardiac Troponin Measurement in the Critically Ill: Potential for Guiding Clinical Management JO: J Investig Med http://www.kidney.de/pget.php?&tw=1&pmid=26425879 #FOAvip Elevated cardiac troponin (cTn) in the absence of acute coronary syndromes (ACS) is associated with increased mortality in critically ill patients. There are no evidence-based interventions that reduce mortality in this group.Objectives: We performed a retrospective investigation of the Veterans Administration Inpatient Evaluation Center database to determine whether drugs used in ACS (?-blockers, aspirin, and statins) are associated with reduced mortality in critically ill patients. Methods: Thirty-day mortality was determined for non-ACS patients admitted to any Veterans Administration Intensive Care Unit between October 1, 2007, and September 30, 2008, adjusted for severity of illness. Troponin assay values were normalized across institutions. Results: Multivariate analyses for 30-day mortality showed an odds ratio (OR) of 1.82 for patients with high cTn (P < 0.0001, cTn > 10% coefficient of variation) and 1.18 for intermediate cTn (P = 0.0021, cTn between lowest limit detectable and 10% coefficient of variation) compared with patients with no elevation, adjusting for severity of illness (n = 19,979). Logistic regression models showed that patients with no or intermediate elevations of cTn taking statins within 24 hours of cTn measurement had a lower mortality than patients not taking statins (OR, 0.66; 95% confidence interval [95% CI], 0.53?0.82; P = 0.0003), whereas patients with high cTn had a lower mortality if they were taking ?-blockers or aspirin within 24 hours of cTn measurement compared to patients not taking ?-blockers or aspirin (?-blockers: OR, 0.80; 95% CI, 0.68?0.94; P = 0.0077; aspirin: OR, 0.81;95% CI, 0.69?0.96; P = 0.0134). Conclusions: This retrospective study confirms an association between elevated troponin and outcomes in critically ill patients without ACS and identifies statins, ?-blockers, and aspirin as potential outcome modifiers in a cTn-dependent manner. Twit Text FOAVip Cardiac Troponin Measurement in the Critically Ill: Potential for Guiding Clinical Management ????J Investig Med http://www.kidney.de/pget.php?&tw=1&pmid=26425879 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=26425879 #FOAvip English Wikipedia <ref>{{Cite pmid|26425879}}</ref> Cardiac Troponin Measurement in the Critically Ill: Potential for Guiding Clinical Management #MMPMID26425879 Poe S; Vandivier-Pletsch RH; Clay M; Wong HR; Haynes E; Rothenberg FG J Investig Med 2015[Dec]; 63 (8): 905-15 PMID26425879show ga Elevated cardiac troponin (cTn) in the absence of acute coronary syndromes (ACS) is associated with increased mortality in critically ill patients. There are no evidence-based interventions that reduce mortality in this group.Objectives: We performed a retrospective investigation of the Veterans Administration Inpatient Evaluation Center database to determine whether drugs used in ACS (?-blockers, aspirin, and statins) are associated with reduced mortality in critically ill patients. Methods: Thirty-day mortality was determined for non-ACS patients admitted to any Veterans Administration Intensive Care Unit between October 1, 2007, and September 30, 2008, adjusted for severity of illness. Troponin assay values were normalized across institutions. Results: Multivariate analyses for 30-day mortality showed an odds ratio (OR) of 1.82 for patients with high cTn (P < 0.0001, cTn > 10% coefficient of variation) and 1.18 for intermediate cTn (P = 0.0021, cTn between lowest limit detectable and 10% coefficient of variation) compared with patients with no elevation, adjusting for severity of illness (n = 19,979). Logistic regression models showed that patients with no or intermediate elevations of cTn taking statins within 24 hours of cTn measurement had a lower mortality than patients not taking statins (OR, 0.66; 95% confidence interval [95% CI], 0.53?0.82; P = 0.0003), whereas patients with high cTn had a lower mortality if they were taking ?-blockers or aspirin within 24 hours of cTn measurement compared to patients not taking ?-blockers or aspirin (?-blockers: OR, 0.80; 95% CI, 0.68?0.94; P = 0.0077; aspirin: OR, 0.81;95% CI, 0.69?0.96; P = 0.0134). Conclusions: This retrospective study confirms an association between elevated troponin and outcomes in critically ill patients without ACS and identifies statins, ?-blockers, and aspirin as potential outcome modifiers in a cTn-dependent manner. äCardiac Troponin Measurement in the Critically Ill: Potential for Guid(epmc).pdf DeepDyve Pubget Overpricing