• Je něco špatně v tomto záznamu ?

Clinical Effect of Sex-Specific Cutoff Values of High-Sensitivity Cardiac Troponin T in Suspected Myocardial Infarction

M. Rubini Giménez, R. Twerenbold, J. Boeddinghaus, T. Nestelberger, C. Puelacher, P. Hillinger, K. Wildi, C. Jaeger, K. Grimm, KF. Heitzelmann, Z. Sabti, P. Badertscher, J. Cupa, U. Honegger, N. Schaerli, N. Kozhuharov, J. du Fay de Lavallaz, B....

. 2016 ; 1 (8) : 912-920.

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/bmc18034082

Importance: It is currently unknown whether the uniform (universal clinical practice for more than 2 decades) or 2 sex-specific cutoff levels are preferable when using high-sensitivity cardiac troponin T (hs-cTnT) levels in the diagnosis of acute myocardial infarction (AMI). Objective: To improve the management of suspected AMI in women by exploring sex-specific vs uniform cutoff levels for hs-cTnT. Design, Setting, and Participants: In an ongoing prospective, diagnostic, multicenter study conducted at 9 emergency departments, the present study evaluated patients enrolled from April 21, 2006, through June 5, 2013. The participants included 2734 adults presenting with suspected AMI. Duration of follow-up was 2 years, and data analysis occurred from June 5 to December 21, 2015. Interventions: The final diagnosis was centrally adjudicated by 2 independent cardiologists using all available information, including measurements of serial hs-cTnT blood concentrations twice: once using the uniform 99th percentile cutoff value level of 14 ng/L and once using sex-specific 99th percentile levels of hs-cTnT (women, 9 ng/L; men, 15.5 ng/L). Main Outcomes and Measures: Diagnostic reclassification in women and men using sex-specific vs the uniform cutoff level in the diagnosis of AMI. Results: Of the 2734 participants, 876 women (32%) and 1858 men (68%) were included. Median (interquartile range) age was 68 (55-77) and 59 (48-71) years, respectively. With the use of the uniform cutoff value, 127 women (14.5%) and 345 men (18.6%) received a final diagnosis of AMI. Among these, at emergency department presentation, levels of hs-cTnT were already above the uniform cutoff value in 427 patients (sensitivity, 91.3% [95% CI, 85%-95.6%] in women vs 90.7% [95% CI, 87.1%-93.5% in men]; specificity, 79.2% [95% CI, 76.1%-82.1%] in women vs 78.5% [95% CI, 76.4%-80.6%] in men). After readjudication using sex-specific 99th percentile levels, diagnostic reclassification regarding AMI occurred in only 3 patients: 0.11% (95% CI, 0.02-0.32) of all patients and 0.6% (95% CI, 0.13-1.85) of patients with AMI. The diagnosis in 2 women was upgraded from unstable angina to AMI, and the diagnosis in 1 man was downgraded from AMI to unstable angina. These diagnostic results were confirmed when using 2 alternative pairs of uniform and sex-specific cutoff values. Conclusions and Relevance: The uniform 99th percentile should remain the standard of care when using hs-cTnT levels for the diagnosis of AMI.

Citace poskytuje Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc18034082
003      
CZ-PrNML
005      
20181017150859.0
007      
ta
008      
181008s2016 xxu f 000 0|eng||
009      
AR
024    7_
$a 10.1001/jamacardio.2016.2882 $2 doi
035    __
$a (PubMed)27653005
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a xxu
100    1_
$a Rubini Giménez, Maria $u Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland2Global Research in Acute Conditions Network3Emergency Department, Centro de Investigación Biomédica en Red Enfermedades Respiratorias Instituto de Salud Carlos III, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.
245    10
$a Clinical Effect of Sex-Specific Cutoff Values of High-Sensitivity Cardiac Troponin T in Suspected Myocardial Infarction / $c M. Rubini Giménez, R. Twerenbold, J. Boeddinghaus, T. Nestelberger, C. Puelacher, P. Hillinger, K. Wildi, C. Jaeger, K. Grimm, KF. Heitzelmann, Z. Sabti, P. Badertscher, J. Cupa, U. Honegger, N. Schaerli, N. Kozhuharov, J. du Fay de Lavallaz, B. Lopez, E. Salgado, Ò. Miró, FJ. Martín-Sánchez, ER. Adrada, B. Morawiec, J. Parenica, E. Ganovska, C. Neugebauer, K. Rentsch, J. Lohrmann, S. Osswald, T. Reichlin, C. Mueller,
520    9_
$a Importance: It is currently unknown whether the uniform (universal clinical practice for more than 2 decades) or 2 sex-specific cutoff levels are preferable when using high-sensitivity cardiac troponin T (hs-cTnT) levels in the diagnosis of acute myocardial infarction (AMI). Objective: To improve the management of suspected AMI in women by exploring sex-specific vs uniform cutoff levels for hs-cTnT. Design, Setting, and Participants: In an ongoing prospective, diagnostic, multicenter study conducted at 9 emergency departments, the present study evaluated patients enrolled from April 21, 2006, through June 5, 2013. The participants included 2734 adults presenting with suspected AMI. Duration of follow-up was 2 years, and data analysis occurred from June 5 to December 21, 2015. Interventions: The final diagnosis was centrally adjudicated by 2 independent cardiologists using all available information, including measurements of serial hs-cTnT blood concentrations twice: once using the uniform 99th percentile cutoff value level of 14 ng/L and once using sex-specific 99th percentile levels of hs-cTnT (women, 9 ng/L; men, 15.5 ng/L). Main Outcomes and Measures: Diagnostic reclassification in women and men using sex-specific vs the uniform cutoff level in the diagnosis of AMI. Results: Of the 2734 participants, 876 women (32%) and 1858 men (68%) were included. Median (interquartile range) age was 68 (55-77) and 59 (48-71) years, respectively. With the use of the uniform cutoff value, 127 women (14.5%) and 345 men (18.6%) received a final diagnosis of AMI. Among these, at emergency department presentation, levels of hs-cTnT were already above the uniform cutoff value in 427 patients (sensitivity, 91.3% [95% CI, 85%-95.6%] in women vs 90.7% [95% CI, 87.1%-93.5% in men]; specificity, 79.2% [95% CI, 76.1%-82.1%] in women vs 78.5% [95% CI, 76.4%-80.6%] in men). After readjudication using sex-specific 99th percentile levels, diagnostic reclassification regarding AMI occurred in only 3 patients: 0.11% (95% CI, 0.02-0.32) of all patients and 0.6% (95% CI, 0.13-1.85) of patients with AMI. The diagnosis in 2 women was upgraded from unstable angina to AMI, and the diagnosis in 1 man was downgraded from AMI to unstable angina. These diagnostic results were confirmed when using 2 alternative pairs of uniform and sex-specific cutoff values. Conclusions and Relevance: The uniform 99th percentile should remain the standard of care when using hs-cTnT levels for the diagnosis of AMI.
650    _2
$a senioři $7 D000368
650    _2
$a biologické markery $x analýza $7 D015415
650    _2
$a ženské pohlaví $7 D005260
650    _2
$a lidé $7 D006801
650    _2
$a mužské pohlaví $7 D008297
650    _2
$a lidé středního věku $7 D008875
650    _2
$a infarkt myokardu $x diagnóza $7 D009203
650    _2
$a prospektivní studie $7 D011446
650    _2
$a senzitivita a specificita $7 D012680
650    _2
$a troponin T $x analýza $7 D020107
655    _2
$a časopisecké články $7 D016428
655    _2
$a práce podpořená grantem $7 D013485
700    1_
$a Twerenbold, Raphael $u Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland2Global Research in Acute Conditions Network.
700    1_
$a Boeddinghaus, Jasper $u Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland2Global Research in Acute Conditions Network.
700    1_
$a Nestelberger, Thomas $u Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland2Global Research in Acute Conditions Network.
700    1_
$a Puelacher, Christian $u Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland2Global Research in Acute Conditions Network.
700    1_
$a Hillinger, Petra $u Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.
700    1_
$a Wildi, Karin $u Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland2Global Research in Acute Conditions Network.
700    1_
$a Jaeger, Cedric $u Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland2Global Research in Acute Conditions Network.
700    1_
$a Grimm, Karin $u Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland2Global Research in Acute Conditions Network.
700    1_
$a Heitzelmann, Karl-Frieder $u Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.
700    1_
$a Sabti, Zaid $u Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.
700    1_
$a Badertscher, Patrick $u Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.
700    1_
$a Cupa, Janosch $u Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.
700    1_
$a Honegger, Ursina $u Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.
700    1_
$a Schaerli, Nicolas $u Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.
700    1_
$a Kozhuharov, Nikola $u Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.
700    1_
$a du Fay de Lavallaz, Jeanne $u Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.
700    1_
$a Lopez, Beatriz $u Global Research in Acute Conditions Network4Emergency Department, Hospital Clinic, Barcelona, Spain.
700    1_
$a Salgado, Emilio $u Global Research in Acute Conditions Network4Emergency Department, Hospital Clinic, Barcelona, Spain.
700    1_
$a Miró, Òscar $u Global Research in Acute Conditions Network4Emergency Department, Hospital Clinic, Barcelona, Spain.
700    1_
$a Martín-Sánchez, F Javier $u Emergency Department, Hospital Clinic San Carlos, Madrid, Spain.
700    1_
$a Adrada, Esther Rodríguez $u Emergency Department, Hospital Clinic San Carlos, Madrid, Spain.
700    1_
$a Morawiec, Beata $u Second Cardiology Department, Zabrze, University of Silesia, Katowice, Poland.
700    1_
$a Parenica, Jiri $u Department of Cardiology, University Hospital, Brno, Czech Republic.
700    1_
$a Ganovska, Eva $u Department of Cardiology, University Hospital, Brno, Czech Republic.
700    1_
$a Neugebauer, Claire $u Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.
700    1_
$a Rentsch, Katharina $u Laboratory Medicine, University Hospital Basel, Basel, Switzerland.
700    1_
$a Lohrmann, Jens $u Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.
700    1_
$a Osswald, Stefan $u Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.
700    1_
$a Reichlin, Tobias $u Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland2Global Research in Acute Conditions Network.
700    1_
$a Mueller, Christian $u Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland2Global Research in Acute Conditions Network.
773    0_
$w MED00191356 $t JAMA cardiology $x 2380-6591 $g Roč. 1, č. 8 (2016), s. 912-920
856    41
$u https://pubmed.ncbi.nlm.nih.gov/27653005 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y a $z 0
990    __
$a 20181008 $b ABA008
991    __
$a 20181017151358 $b ABA008
999    __
$a ok $b bmc $g 1339710 $s 1031076
BAS    __
$a 3
BAS    __
$a PreBMC
BMC    __
$a 2016 $b 1 $c 8 $d 912-920 $i 2380-6591 $m JAMA cardiology $n JAMA Cardiol $x MED00191356
LZP    __
$a Pubmed-20181008

Najít záznam

Citační ukazatele

Pouze přihlášení uživatelé

Možnosti archivace