Circadian rhythm of cardiac troponin I and its clinical impact
on the diagnostic accuracy for acute myocardial infarction

WILDI, K., H. SINGEISEN, R. TWERENBOLD, P. BADERTSCHER, D. WUSSLER, L.J.J. KLINKENBERG, S.J.R. MEEX, T. NESTELBERGER, J. BOEDDINGHAUS, O. MIRO, F.J. MARTIN-SANCHEZ, B. MORAWIEC, P. MUZYK, Jiří PAŘENICA, D.I. KELLER, N. GEIGY, E. POTLUKOVA, Z. SABTI, N. KOZHUHAROV, C. PUELACHER, J.D. de LAVALLAZ, M.R. GIMENEZ, S. SHRESTHA, G. MARZANO, K. RENTSCH, S. OSSWALD, T. REICHLIN and C. MUELLER. Circadian rhythm of cardiac troponin I and its clinical impact on the diagnostic accuracy for acute myocardial infarction. International Journal of Cardiology. Clare: Elsevier Ireland Ltd., 2018, vol. 270, NOV 1 2018, p. 14-20. ISSN 0167-5273. Available from: https://dx.doi.org/10.1016/j.ijcard.2018.05.136.

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TY  - JOUR
ID  - 1456237
AU  - Wildi, K. - Singeisen, H. - Twerenbold, R. - Badertscher, P. - Wussler, D. - Klinkenberg, L.J.J. - Meex, S.J.R. - Nestelberger, T. - Boeddinghaus, J. - Miro, O. - Martin-Sanchez, F.J. - Morawiec, B. - Muzyk, P. - Pařenica, Jiří - Keller, D.I. - Geigy, N. - Potlukova, E. - Sabti, Z. - Kozhuharov, N. - Puelacher, C. - Lavallaz, J.D. de - Gimenez, M.R. - Shrestha, S. - Marzano, G. - Rentsch, K. - Osswald, S. - Reichlin, T. - Mueller, C.
PY  - 2018
TI  - Circadian rhythm of cardiac troponin I and its clinical impact on the diagnostic accuracy for acute myocardial infarction
JF  - International Journal of Cardiology
VL  - 270
IS  - NOV 1 2018
SP  - 14-20
EP  - 14-20
PB  - Elsevier Ireland Ltd.
SN  - 01675273
KW  - Acute myocardial infarction
KW  - Diagnosis
KW  - High-sensitivity cardiac troponin I
KW  - Circadian rhythm
N2  - Background: High-sensitivity cardiac troponin T (hs-cTnT) blood concentrationswere shown to exhibit a diurnal rhythm, characterized by gradually decreasing concentrations throughout daytime, rising concentrations during nighttime and peak concentrations in the morning. We aimed to investigate whether this also applies to (h)s-cTnI assays and whether it would affect diagnostic accuracy for acute myocardial infarction (AMI). Methods: Blood concentrations of cTnI were measured at presentation and after 1 h using four different cTnI assays: three commonly used sensitive (s-cTnI Architect, Ultra and Accu) and one experimental high-sensitivity assay (hs-cTnI Accu) in a prospective multicenter diagnostic study of patients presenting to the emergency department with suspected AMI. These concentrations and their diagnostic accuracy for AMI (quantified by the area under the curve (AUC)) were compared between morning (11 p.m. to 2 p.m.) and evening (2 p.m. to 11 p. m.) presenters. Results: Among 2601 patients, AMI was the final diagnosis in 17.6% of patients. Concentrations of (h) s-cTnI as measured using all four assayswere comparable in patients presenting in themorning versus patients presenting in the evening. Diagnostic accuracy for AMI of all four (h) s-cTnI assays were high and comparable between patients presenting in the morning versus presenting in the evening (AUC at presentation: 0.90 vs 0.93 for s-cTnI Architect; 0.91 vs 0.94 for s-cTnI Ultra; 0.89 vs 0.94 for s-cTnI Accu; 0.91 vs 0.94 for hs-cTnI Accu). Conclusions: Cardiac TnI does not seemto express a diurnal rhythm. Diagnostic accuracy for AMI is very high and does not differ with time of presentation. Clinical trial registration: NCT00470587, http://clinicaltrials.gov/show/NCT00470587 (c) 2018 Elsevier B.V. All rights reserved.
ER  -

Basic information
Original name	Circadian rhythm of cardiac troponin I and its clinical impact on the diagnostic accuracy for acute myocardial infarction
Authors	WILDI, K. (756 Switzerland), H. SINGEISEN (756 Switzerland), R. TWERENBOLD (756 Switzerland), P. BADERTSCHER (756 Switzerland), D. WUSSLER (756 Switzerland), L.J.J. KLINKENBERG (528 Netherlands), S.J.R. MEEX (528 Netherlands), T. NESTELBERGER (756 Switzerland), J. BOEDDINGHAUS (756 Switzerland), O. MIRO (724 Spain), F.J. MARTIN-SANCHEZ (724 Spain), B. MORAWIEC (616 Poland), P. MUZYK (616 Poland), Jiří PAŘENICA (203 Czech Republic, belonging to the institution), D.I. KELLER (756 Switzerland), N. GEIGY (756 Switzerland), E. POTLUKOVA (756 Switzerland), Z. SABTI (756 Switzerland), N. KOZHUHAROV (756 Switzerland), C. PUELACHER (756 Switzerland), J.D. de LAVALLAZ (756 Switzerland), M.R. GIMENEZ (756 Switzerland), S. SHRESTHA (756 Switzerland), G. MARZANO (756 Switzerland), K. RENTSCH (756 Switzerland), S. OSSWALD (756 Switzerland), T. REICHLIN (756 Switzerland) and C. MUELLER (756 Switzerland, guarantor).
Edition	International Journal of Cardiology, Clare, Elsevier Ireland Ltd. 2018, 0167-5273.

Other information
Original language	English
Type of outcome	Article in a journal
Field of Study	30201 Cardiac and Cardiovascular systems
Country of publisher	Ireland
Confidentiality degree	is not subject to a state or trade secret
Impact factor	Impact factor: 3.471
RIV identification code	RIV/00216224:14110/18:00104226
Organization unit	Faculty of Medicine
Doi	http://dx.doi.org/10.1016/j.ijcard.2018.05.136
UT WoS	000444609000003
Keywords in English	Acute myocardial infarction; Diagnosis; High-sensitivity cardiac troponin I; Circadian rhythm
Tags	14110211, rivok
Tags	International impact, Reviewed
Changed by	Changed by: Soňa Böhmová, učo 232884. Changed: 9/2/2019 21:23.

Abstract

Background: High-sensitivity cardiac troponin T (hs-cTnT) blood concentrationswere shown to exhibit a diurnal rhythm, characterized by gradually decreasing concentrations throughout daytime, rising concentrations during nighttime and peak concentrations in the morning. We aimed to investigate whether this also applies to (h)s-cTnI assays and whether it would affect diagnostic accuracy for acute myocardial infarction (AMI). Methods: Blood concentrations of cTnI were measured at presentation and after 1 h using four different cTnI assays: three commonly used sensitive (s-cTnI Architect, Ultra and Accu) and one experimental high-sensitivity assay (hs-cTnI Accu) in a prospective multicenter diagnostic study of patients presenting to the emergency department with suspected AMI. These concentrations and their diagnostic accuracy for AMI (quantified by the area under the curve (AUC)) were compared between morning (11 p.m. to 2 p.m.) and evening (2 p.m. to 11 p. m.) presenters. Results: Among 2601 patients, AMI was the final diagnosis in 17.6% of patients. Concentrations of (h) s-cTnI as measured using all four assayswere comparable in patients presenting in themorning versus patients presenting in the evening. Diagnostic accuracy for AMI of all four (h) s-cTnI assays were high and comparable between patients presenting in the morning versus presenting in the evening (AUC at presentation: 0.90 vs 0.93 for s-cTnI Architect; 0.91 vs 0.94 for s-cTnI Ultra; 0.89 vs 0.94 for s-cTnI Accu; 0.91 vs 0.94 for hs-cTnI Accu). Conclusions: Cardiac TnI does not seemto express a diurnal rhythm. Diagnostic accuracy for AMI is very high and does not differ with time of presentation. Clinical trial registration: NCT00470587, http://clinicaltrials.gov/show/NCT00470587 (c) 2018 Elsevier B.V. All rights reserved.

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Circadian rhythm of cardiac troponin I and its clinical impact on the diagnostic accuracy for acute ...

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