Measurement of cardiac troponin in serum is an essential part of diagnosing myocardial infarction in the emergency department. The guidelines suggest that high-sensitivity techniques should be used for measuring cardiac troponin I (cTnI) or cardiac troponin T (cTnT). The aim of our study was to correlate the values of both troponins, and to ascertain which type of troponin is more in agreement with the diagnosis. The patients were classified into four groups: 43 patients in non-ST-elevation myocardial infarction (NSTEMI), 7 in ST-elevation myocardial infarction (STEMI), 48 in Type 2 myocardial infarction, and 21 in the control group. A significant correlation between cTnI and cTnT was found in the NSTEMI (r = 0.70) and Type 2 (r = 0.75) groups while in the control group there was no association (r = −0.06). The ratios of cTnI and cTnT relative to their cut-off values were lower in Type 2 myocardial infarction compared to NSTEMI. This difference can be attributed to the pathophysiology of these two types of heart conditions. The ratio in the NSTEMI group was higher in female than in male patients (53.3 vs. 24.6 ng/L); the same difference was found for the ratio of cTnT (20.8 vs. 13.1 ng/L). In the same manner, the ratios in the Type 2 group were higher in female than in male patients for cTnI (25.6 vs. 12.7 ng/L) as well as for cTnT (19.0 vs. 6.73 ng/L). These differences could be due to biological differences, but they could also be influenced by other factors contributing to different damage responses.

Aim: Although the levels of cardiac troponin I (cTnI) have proved to be a useful diagnostic biomarker of acute myocardial infarction, there are a wide variety of point-of-care (POC) analysers, which provide measurements of cTnI. The aim of this study was to compare the results obtained by the ADVIA Centaur ultra-assay cTnI assay (us-cTnI), ADVIA Centaur high-sensitive cTnI assay (hs-cTnI) and a POC high-sensitivity assay using PATHFAST. We also aimed to explore total turnaround time (TAT) for laboratory results using the POC PATHFAST analyser. Methods: Samples from 161 patients were taken. Of these samples, 129 were tested with all three assays (us-cTnI, hs-cTnI and PATHFAST), and 32 samples were tested on PATHFAST for the comparison of whole blood, serum and plasma. Results: Comparison of the POC testing methods in this study demonstrated that there are strong linear relationships between all three cTnI assays (us-cTnI, hs-cTnI and POC on PATHFAST). Furthermore, we also show there are strong linear relationships between the two high-sensitive cTnI assays (hs-cTnI and PATHFAST) for blood serum samples, as determined by Passing–Bablok regression analyses. In our comparison of our new data with our older study, the TAT went down. Conclusion: The timeliness of laboratory results is, in addition to accuracy and precision, one of the key indicators of laboratory performance, and at the same time has a significant impact on the course of the patient’s condition. It is therefore important that the laboratory strives to meet the expectations of clinicians regarding the time from the order to the result of the analysis.

Background: Several studies on pediatric and adult population proposed measurment of optic nerve sheath diameter (ONSD) as a noninvasive

Cardiac troponin I (cTnI) is a standard biomarker for the diagnosis of acute myocardial infarction (AMI). While older, ultra-sensitive cTnI (us-cTnI) assays use the 99th percentile as the reference threshold, newer high-sensitive cTnI (hs-cTnI) assays use the limit of detection or functional sensitivity instead. However, little has been done to systematically compare these two methods. The present study also served as a validation of hs-cTnI in our laboratory. Here, we compared the results obtained from the blood serum obtained from 8810 patients using the us-cTnI and the hs-cTnI assays run in tandem on the ADVIA Centaur XP analyser. We found that in 2279 samples the concentration of cTnI measured with the ultra-sensitive method was below the detection limit, while with the high-sensitive method, only 540 were below the detection limit. We also compared results from these assays with the ultimate diagnosis of a subset of individuals. The analysis of the results below cut-off with the ultra-sensitive method showed that this method would not detect 96 cases related to heart disorder. Overall, the main finding of our research is that hs-cTnI is the preferable option and is able to be deployed effectively in the laboratory setting.

Background: Biliverdin reductase (BVR) plays a central role in bile pigment metabolism by reducing biliverdin (BV) to bilirubin (BR), a potent antioxidant that scavenges reactive oxygen species (ROS) under normal and pathological conditions. Elevated oxidative stress activates extracellular signal-regulated protein kinases 1/2 (ERK1/2) signaling, which strongly interacts with BVR’s C and D motifs, forming the BVR/ERK1/2 axis. In pathological states, increased ERK1/2 activity inhibits BVR’s ability to convert BV to BR, exacerbating oxidative damage and contributing to cardiovascular disease. Therefore, the interaction between BVR and ERK1/2 is critical in modulating oxidative stress. Objectives: This study aimed to evaluate the effects of BR and the ERK1/2 inhibitor PD-98059, both individually and in combination, on ROS levels, ERK1/2 activity, and vascular responses under normoxic and hypoxia-reoxygenation (H-R) injury conditions. Methods: Aortic rings from rats were subjected to equal distending pressure after oxidative stress induction using 22'-Azobis (2-amidinopropane) dihydrochloride (ABAP) in an organ bath. Different doses of BR were administered in combination with the ERK1/2 inhibitor PD-98059 to assess their impact on ROS depletion, vascular relaxation, and maximal effect (Emax). Results: The combination of BR and PD-98059 significantly enhanced aortic relaxation and Emax under both normoxic and H/R conditions compared to either treatment alone. Inhibiting ERK1/2 with PD-98059 appeared to upregulate BVR activity, increasing BR synthesis and reducing oxidative damage in aortic rings. Conclusions: Biliverdin reductase plays a vital role in defending against oxidative stress and endothelial dysfunction through its dual-specificity kinase activity and interaction with ERK1/2. ERK1/2 inhibition further enhances BR’s ROS-scavenging ability and vascular protective effects. Targeting the interaction between BVR and ERK1/2 holds potential as an effective therapeutic strategy for conditions characterized by excessive ROS levels, such as cardiovascular diseases.

Background/Objectives: Point-of-care ultrasound (POCUS) is increasingly used in emergency care, but data on its use in acute aortic syndrome (AAS) remains limited. This single-center retrospective cohort described POCUS use among patients with confirmed AAS and explored factors associated with POCUS use and time to completion of diagnostic workup. Methods: Records coded ICD10 I71.0–I71.8 from the Emergency Medical Unit, University Medical Centre Ljubljana (2019–2023) were reviewed. Clinical, imaging, and outcome data were extracted, and diagnoses were confirmed by two investigators through manual chart review of ED documentation, radiology reports, and specialist consultation notes. Fisher’s exact and Wilcoxon rank sum tests were used for comparisons. Associations with POCUS use and time to completion of diagnostic workup (defined from arrival at triage to completion of the emergency department workup) were assessed with univariable logistic regression and linear regression models, respectively. Survival was explored using univariable Cox proportional-hazards models. Statistical significance was set at p < 0.05. Results: Among 120,109 emergency department visits, 73 patients had confirmed AAS (type A: 48; type B: 17; intramural hematoma: 8). POCUS was performed in 62% of patients, more often in those who were hemodynamically unstable (87.5% vs. 54.4%; p = 0.020) or had unclear presentations (40% vs. 7%; p = 0.003). Median time to completion of diagnostic workup was shorter with POCUS (110 vs. 213 min), though not statistically significant (p = 0.069). Hemodynamic instability was associated with higher odds of POCUS use (OR 5.87, 95% CI 1.22–28.2; p = 0.028), whereas a clear clinical presentation was associated with lower odds of POCUS use (OR 0.12, 95% CI 0.02–0.55; p = 0.007). Lower triage level was associated with longer time to completion of diagnostic workup (time ratio 5.43, 95% CI 2.21–13.4; p < 0.001 for urgent vs. immediate triage), whereas very high D-dimer levels were associated with shorter time to completion of diagnostic workup (time ratio 0.44, 95% CI 0.21–0.93; p = 0.031 for highest vs. lowest quartile). In-hospital mortality was 14%, with only age associated with mortality (HR 1.06 per year, 95% CI 1.02–1.11; p = 0.007). Conclusions: In this single-center retrospective AAS cohort, POCUS was used more frequently in unstable and diagnostically unclear patients but was not associated with time to completion of diagnostic workup. Findings are descriptive and exploratory; they do not establish that POCUS accelerates diagnosis or improves outcomes.