Predicting Acute Myocardial Infarction with a Single Blood Draw

J 2019

Predicting Acute Myocardial Infarction with a Single Blood Draw

BOEDDINGHAUS, Jasper, Thomas NESTELBERGER, Patrick BADERTSCHER, Raphael TWERENBOLD, Brigitte FITZE et. al.

Základní údaje

Originální název

Predicting Acute Myocardial Infarction with a Single Blood Draw

Autoři

BOEDDINGHAUS, Jasper (756 Švýcarsko), Thomas NESTELBERGER (756 Švýcarsko), Patrick BADERTSCHER (756 Švýcarsko), Raphael TWERENBOLD (756 Švýcarsko), Brigitte FITZE (756 Švýcarsko), Desiree WUSSLER (756 Švýcarsko), Ivo STREBEL (756 Švýcarsko), Maria Rubini GIMENEZ (756 Švýcarsko), Karin WILDI (756 Švýcarsko), Christian PUELACHER (756 Švýcarsko), Jeanne du Fay DE LAVALLAZ, Loris OEHEN (756 Švýcarsko), Joan WALTER (756 Švýcarsko), Oscar MIRO (724 Španělsko), Javier F. MARTIN-SANCHEZ (724 Španělsko), Beata MORAWIEC (616 Polsko), Eliska POTLUKOVA (756 Švýcarsko), Dagmar I. KELLER (756 Švýcarsko), Tobias REICHLIN (756 Švýcarsko), Christian MUELLER (garant), Zaid SABTI (756 Švýcarsko), Michael FREESE (756 Švýcarsko), Claudia STELZIG (756 Švýcarsko), Samyut SHRESTHA (756 Švýcarsko), Nicolas SCHAERLI (756 Švýcarsko), Nikola KOZHUHAROV (756 Švýcarsko), Dayana FLORES (756 Švýcarsko), Jens LOHRMANN (756 Švýcarsko), Ewalina BISKUP (756 Švýcarsko), Wanda KLOOS (756 Švýcarsko), Stefan OSSWALD (756 Švýcarsko), Deborah MUELLER (756 Švýcarsko), Lorraine SAZGARY (756 Švýcarsko), Beatriz LOPEZ (724 Španělsko), Esther Rodriguez ADRADA (724 Španělsko), Damian KAWECKI (616 Polsko), Piotr MUZYK (616 Polsko), Ewa NOWALANY-KOZIELSKA (616 Polsko), Jiří PAŘENICA (203 Česká republika, domácí), Eva GANOVSKÁ (703 Slovensko, domácí), Kathrin MEISSNER (756 Švýcarsko), Caroline KULANGARA (756 Švýcarsko), Riham MAHFOUZ (756 Švýcarsko), Beate HARTMANN (756 Švýcarsko), Ina FEREL (756 Švýcarsko), Isabel CAMPODARVE (724 Španělsko), Katharina RENTSCH (756 Švýcarsko), Arnold VON ECKARDSTEIN (756 Švýcarsko), Andreas BUSER (756 Švýcarsko) a Nicolas GEIGY (756 Švýcarsko)

Vydání

Clinical Chemistry, Washington, USA, Amer. Assoc. Clinical Chemistry, 2019, 0009-9147

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 7.292

Kód RIV

RIV/00216224:14110/19:00111299

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1373/clinchem.2018.294124

UT WoS

000459957500013

Klíčová slova anglicky

SENSITIVITY CARDIAC TROPONIN; CHEST-PAIN SYMPTOMS; HOUR RULE-IN; EARLY-DIAGNOSIS; 2-HOUR ALGORITHM; RELATIVE CHANGES; RAPID RULE; VALIDATION; ABSOLUTE; BIOMARKER

Štítky

14110211, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 24. 1. 2020 14:47, Mgr. Tereza Miškechová

Anotace

V originále

BACKGROUND: We desired to determine cardiac troponin (cTn) concentrations necessary to achieve a positive predictive value (PPV) of >75% for acute myocardial infarction (AMI) to justify immediate admission of patients to a monitored unit and, in general, early coronary angiography. METHODS: In a prospective multicenter diagnostic study enrolling patients presenting to the emergency department with symptoms suggestive of AMI, final diagnoses were adjudicated by 2 independent cardiologists based on clinical information including cardiac imaging. cTn concentrations were measured using 5 different sensitive and high-sensitivity cTn (hs-cTn) assays in a blinded fashion at presentation and serially thereafter. The diagnostic end point was PPV for rule-in of AMI of initial cTn concentrations alone and in combination with early changes. RESULTS: Among 3828 patients, 616 (16%) had an AMI. At presentation, 7% to 14% of patients had cTnT/I concentrations associated with a PPV of >= 75%. Adding absolute or relative changes did not significantly further increase the PPV. PPVs increased from 46.5% (95% CI, 43.6-49.4) for hs-cTnT at presentation >14 ng/L to 78.9% (95% CI, 74.7-82.5) for >52 ng/L (P < 0.001), whereas PPVs in higher hs-cTnT strata remained largely unchanged [e.g., 82.4% (95% CI, 77.5-86.7) for >80 ng/L vs 83.9% (95% CI, 76.0-90.1) for >200 ng/L (P = 0.72)]. The addition of early changes in hs-cTnT further increased the PPV up to 60 ng/L, but not for higher concentrations. CONCLUSIONS: Serial sampling does not seem necessary for predicting AMI and concurrent decision-making in about 10% of patients, as it only marginally increases the PPV for AMI and not in a statistically or clinically significant way. (c) 2018 American Association for Clinical Chemistry

Citovat

BOEDDINGHAUS, Jasper, Thomas NESTELBERGER, Patrick BADERTSCHER, Raphael TWERENBOLD, Brigitte FITZE, Desiree WUSSLER, Ivo STREBEL, Maria Rubini GIMENEZ, Karin WILDI, Christian PUELACHER, Jeanne du Fay DE LAVALLAZ, Loris OEHEN, Joan WALTER, Oscar MIRO, Javier F. MARTIN-SANCHEZ, Beata MORAWIEC, Eliska POTLUKOVA, Dagmar I. KELLER, Tobias REICHLIN, Christian MUELLER, Zaid SABTI, Michael FREESE, Claudia STELZIG, Samyut SHRESTHA, Nicolas SCHAERLI, Nikola KOZHUHAROV, Dayana FLORES, Jens LOHRMANN, Ewalina BISKUP, Wanda KLOOS, Stefan OSSWALD, Deborah MUELLER, Lorraine SAZGARY, Beatriz LOPEZ, Esther Rodriguez ADRADA, Damian KAWECKI, Piotr MUZYK, Ewa NOWALANY-KOZIELSKA, Jiří PAŘENICA, Eva GANOVSKÁ, Kathrin MEISSNER, Caroline KULANGARA, Riham MAHFOUZ, Beate HARTMANN, Ina FEREL, Isabel CAMPODARVE, Katharina RENTSCH, Arnold VON ECKARDSTEIN, Andreas BUSER a Nicolas GEIGY. Predicting Acute Myocardial Infarction with a Single Blood Draw. Clinical Chemistry. Washington, USA: Amer. Assoc. Clinical Chemistry, 2019, roč. 65, č. 3, s. 437-450. ISSN 0009-9147. Dostupné z: https://dx.doi.org/10.1373/clinchem.2018.294124.

@article{1579477,
   author = {Boeddinghaus, Jasper and Nestelberger, Thomas and Badertscher, Patrick and Twerenbold, Raphael and Fitze, Brigitte and Wussler, Desiree and Strebel, Ivo and Gimenez, Maria Rubini and Wildi, Karin and Puelacher, Christian and de Lavallaz, Jeanne du Fay and Oehen, Loris and Walter, Joan and Miro, Oscar and MartinandSanchez, Javier F. and Morawiec, Beata and Potlukova, Eliska and Keller, Dagmar I. and Reichlin, Tobias and Mueller, Christian and Sabti, Zaid and Freese, Michael and Stelzig, Claudia and Shrestha, Samyut and Schaerli, Nicolas and Kozhuharov, Nikola and Flores, Dayana and Lohrmann, Jens and Biskup, Ewalina and Kloos, Wanda and Osswald, Stefan and Mueller, Deborah and Sazgary, Lorraine and Lopez, Beatriz and Adrada, Esther Rodriguez and Kawecki, Damian and Muzyk, Piotr and NowalanyandKozielska, Ewa and Pařenica, Jiří and Ganovská, Eva and Meissner, Kathrin and Kulangara, Caroline and Mahfouz, Riham and Hartmann, Beate and Ferel, Ina and Campodarve, Isabel and Rentsch, Katharina and von Eckardstein, Arnold and Buser, Andreas and Geigy, Nicolas},
   article_location = {Washington, USA},
   article_number = {3},
   doi = {http://dx.doi.org/10.1373/clinchem.2018.294124},
   keywords = {SENSITIVITY CARDIAC TROPONIN; CHEST-PAIN SYMPTOMS; HOUR RULE-IN; EARLY-DIAGNOSIS; 2-HOUR ALGORITHM; RELATIVE CHANGES; RAPID RULE; VALIDATION; ABSOLUTE; BIOMARKER},
   language = {eng},
   issn = {0009-9147},
   journal = {Clinical Chemistry},
   title = {Predicting Acute Myocardial Infarction with a Single Blood Draw},
   url = {http://dx.doi.org/10.1373/clinchem.2018.294124},
   volume = {65},
   year = {2019}
}

TY  - JOUR
ID  - 1579477
AU  - Boeddinghaus, Jasper - Nestelberger, Thomas - Badertscher, Patrick - Twerenbold, Raphael - Fitze, Brigitte - Wussler, Desiree - Strebel, Ivo - Gimenez, Maria Rubini - Wildi, Karin - Puelacher, Christian - de Lavallaz, Jeanne du Fay - Oehen, Loris - Walter, Joan - Miro, Oscar - Martin-Sanchez, Javier F. - Morawiec, Beata - Potlukova, Eliska - Keller, Dagmar I. - Reichlin, Tobias - Mueller, Christian - Sabti, Zaid - Freese, Michael - Stelzig, Claudia - Shrestha, Samyut - Schaerli, Nicolas - Kozhuharov, Nikola - Flores, Dayana - Lohrmann, Jens - Biskup, Ewalina - Kloos, Wanda - Osswald, Stefan - Mueller, Deborah - Sazgary, Lorraine - Lopez, Beatriz - Adrada, Esther Rodriguez - Kawecki, Damian - Muzyk, Piotr - Nowalany-Kozielska, Ewa - Pařenica, Jiří - Ganovská, Eva - Meissner, Kathrin - Kulangara, Caroline - Mahfouz, Riham - Hartmann, Beate - Ferel, Ina - Campodarve, Isabel - Rentsch, Katharina - von Eckardstein, Arnold - Buser, Andreas - Geigy, Nicolas
PY  - 2019
TI  - Predicting Acute Myocardial Infarction with a Single Blood Draw
JF  - Clinical Chemistry
VL  - 65
IS  - 3
SP  - 437-450
EP  - 437-450
PB  - Amer. Assoc. Clinical Chemistry
SN  - 00099147
KW  - SENSITIVITY CARDIAC TROPONIN
KW  - CHEST-PAIN SYMPTOMS
KW  - HOUR RULE-IN
KW  - EARLY-DIAGNOSIS
KW  - 2-HOUR ALGORITHM
KW  - RELATIVE CHANGES
KW  - RAPID RULE
KW  - VALIDATION
KW  - ABSOLUTE
KW  - BIOMARKER
UR  - http://dx.doi.org/10.1373/clinchem.2018.294124
L2  - http://dx.doi.org/10.1373/clinchem.2018.294124
N2  - BACKGROUND: We desired to determine cardiac troponin (cTn) concentrations necessary to achieve a positive predictive value (PPV) of >75% for acute myocardial infarction (AMI) to justify immediate admission of patients to a monitored unit and, in general, early coronary angiography. METHODS: In a prospective multicenter diagnostic study enrolling patients presenting to the emergency department with symptoms suggestive of AMI, final diagnoses were adjudicated by 2 independent cardiologists based on clinical information including cardiac imaging. cTn concentrations were measured using 5 different sensitive and high-sensitivity cTn (hs-cTn) assays in a blinded fashion at presentation and serially thereafter. The diagnostic end point was PPV for rule-in of AMI of initial cTn concentrations alone and in combination with early changes. RESULTS: Among 3828 patients, 616 (16%) had an AMI. At presentation, 7% to 14% of patients had cTnT/I concentrations associated with a PPV of >= 75%. Adding absolute or relative changes did not significantly further increase the PPV. PPVs increased from 46.5% (95% CI, 43.6-49.4) for hs-cTnT at presentation >14 ng/L to 78.9% (95% CI, 74.7-82.5) for >52 ng/L (P < 0.001), whereas PPVs in higher hs-cTnT strata remained largely unchanged [e.g., 82.4% (95% CI, 77.5-86.7) for >80 ng/L vs 83.9% (95% CI, 76.0-90.1) for >200 ng/L (P = 0.72)]. The addition of early changes in hs-cTnT further increased the PPV up to 60 ng/L, but not for higher concentrations. CONCLUSIONS: Serial sampling does not seem necessary for predicting AMI and concurrent decision-making in about 10% of patients, as it only marginally increases the PPV for AMI and not in a statistically or clinically significant way. (c) 2018 American Association for Clinical Chemistry
ER  -

BOEDDINGHAUS, Jasper, Thomas NESTELBERGER, Patrick BADERTSCHER, Raphael TWERENBOLD, Brigitte FITZE, Desiree WUSSLER, Ivo STREBEL, Maria Rubini GIMENEZ, Karin WILDI, Christian PUELACHER, Jeanne du Fay DE LAVALLAZ, Loris OEHEN, Joan WALTER, Oscar MIRO, Javier F. MARTIN-SANCHEZ, Beata MORAWIEC, Eliska POTLUKOVA, Dagmar I. KELLER, Tobias REICHLIN, Christian MUELLER, Zaid SABTI, Michael FREESE, Claudia STELZIG, Samyut SHRESTHA, Nicolas SCHAERLI, Nikola KOZHUHAROV, Dayana FLORES, Jens LOHRMANN, Ewalina BISKUP, Wanda KLOOS, Stefan OSSWALD, Deborah MUELLER, Lorraine SAZGARY, Beatriz LOPEZ, Esther Rodriguez ADRADA, Damian KAWECKI, Piotr MUZYK, Ewa NOWALANY-KOZIELSKA, Jiří PAŘENICA, Eva GANOVSKÁ, Kathrin MEISSNER, Caroline KULANGARA, Riham MAHFOUZ, Beate HARTMANN, Ina FEREL, Isabel CAMPODARVE, Katharina RENTSCH, Arnold VON ECKARDSTEIN, Andreas BUSER a Nicolas GEIGY. Predicting Acute Myocardial Infarction with a Single Blood Draw. \textit{Clinical Chemistry}. Washington, USA: Amer. Assoc. Clinical Chemistry, 2019, roč.~65, č.~3, s.~437-450. ISSN~0009-9147. Dostupné z: https://dx.doi.org/10.1373/clinchem.2018.294124.

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