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Záznam pochází z PubMed

Early diagnosis of acute myocardial infarction in patients with mild elevations of cardiac troponin

Boeddinghaus, Jasper
Autor Boeddinghaus, Jasper Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland Department of Internal Medicine, University Hospital Basel, University of Basel, Basel, Switzerland GREAT Network, Basel, Switzerland
Reichlin, Tobias
Autor Reichlin, Tobias Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland GREAT Network, Basel, Switzerland
Nestelberger, Thomas
Autor Nestelberger, Thomas Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland Department of Internal Medicine, University Hospital Basel, University of Basel, Basel, Switzerland GREAT Network, Basel, Switzerland
Twerenbold, Raphael
Autor Twerenbold, Raphael Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland GREAT Network, Basel, Switzerland
Meili, Yvette
Autor Meili, Yvette Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland GREAT Network, Basel, Switzerland
Wildi, Karin
Autor Wildi, Karin Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland GREAT Network, Basel, Switzerland
Hillinger, Petra
Autor Hillinger, Petra Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland Department of Internal Medicine, University Hospital Basel, University of Basel, Basel, Switzerland GREAT Network, Basel, Switzerland
Giménez, Maria Rubini
Autor Giménez, Maria Rubini Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland Department of Internal Medicine, University Hospital Basel, University of Basel, Basel, Switzerland GREAT Network, Basel, Switzerland
Cupa, Janosch
Autor Cupa, Janosch Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland GREAT Network, Basel, Switzerland
Schumacher, Lukas
Autor Schumacher, Lukas Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland GREAT Network, Basel, Switzerland
Schubera, Marie
Autor Schubera, Marie Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland GREAT Network, Basel, Switzerland
Badertscher, Patrick
Autor Badertscher, Patrick Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland GREAT Network, Basel, Switzerland
Corbière, Sydney
Autor Corbière, Sydney Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland GREAT Network, Basel, Switzerland
Grimm, Karin
Autor Grimm, Karin Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland Department of Internal Medicine, University Hospital Basel, University of Basel, Basel, Switzerland GREAT Network, Basel, Switzerland
Puelacher, Christian
Autor Puelacher, Christian Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland GREAT Network, Basel, Switzerland
Sabti, Zaid
Autor Sabti, Zaid Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland GREAT Network, Basel, Switzerland
Widmer, Dayana Flores
Autor Widmer, Dayana Flores Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland GREAT Network, Basel, Switzerland
Schaerli, Nicolas
Autor Schaerli, Nicolas Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland Department of Internal Medicine, University Hospital Basel, University of Basel, Basel, Switzerland GREAT Network, Basel, Switzerland
Kozhuharov, Nikola
Autor Kozhuharov, Nikola Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland GREAT Network, Basel, Switzerland
Shrestha, Samyut
Autor Shrestha, Samyut Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland GREAT Network, Basel, Switzerland
Bürge, Tobias
Autor Bürge, Tobias Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland
Mächler, Patrick
Autor Mächler, Patrick Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland
Büchi, Michael
Autor Büchi, Michael Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland
Rentsch, Katharina
Autor Rentsch, Katharina Laboratory Medicine, University Hospital Basel, Basel, Switzerland
Miró, Òscar
Autor Miró, Òscar GREAT Network, Basel, Switzerland Emergency Department, Hospital Clinic, Barcelona, Catalonia, Spain
López, Beatriz
Autor López, Beatriz GREAT Network, Basel, Switzerland Emergency Department, Hospital Clinic, Barcelona, Catalonia, Spain
Martin-Sanchez, F Javier
Autor Martin-Sanchez, F Javier Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, Spain
Rodriguez-Adrada, Esther
Autor Rodriguez-Adrada, Esther Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, Spain
Morawiec, Beata
Autor Morawiec, Beata 2nd Department of Cardiology, Medical University of Silesia, Zabrze, Poland
Kawecki, Damian
Autor Kawecki, Damian 2nd Department of Cardiology, Medical University of Silesia, Zabrze, Poland
Ganovská, Eva
Autor Ganovská, Eva GREAT Network, Basel, Switzerland Department of Cardiology, University Hospital Brno, Brno, Czech Republic Medical Faculty, Masaryk University, Brno, Czech Republic
Parenica, Jiri
Autor Parenica, Jiri GREAT Network, Basel, Switzerland Department of Cardiology, University Hospital Brno, Brno, Czech Republic Medical Faculty, Masaryk University, Brno, Czech Republic
Lohrmann, Jens
Autor Lohrmann, Jens Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland
Buser, Andreas
Autor Buser, Andreas Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland Department of Hematology, University Hospital Basel, Basel, Switzerland
Keller, Dagmar I
Autor Keller, Dagmar I Emergency Department, University Hospital Zurich, Zurich, Switzerland
Osswald, Stefan
Autor Osswald, Stefan Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland
Mueller, Christian
Autor Mueller, Christian Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland. christian.mueller@usb.ch GREAT Network, Basel, Switzerland. christian.mueller@usb.ch

Clinical research in cardiology. 2017 Jun ; 106 (6) : 457-467. [epub] 20170201

Clin Res Cardiol
ISSN 1861-0692 | 1861-0684
Zdroj

Jazyk angličtina Země Německo Médium print-electronic

Typ dokumentu časopisecké články

Perzistentní odkaz https://www.medvik.cz/link/pmid28150185

PubMed 28150185
DOI 10.1007/s00392-016-1075-9
PII: 10.1007/s00392-016-1075-9
Knihovny.cz E-zdroje

Klíčová slova
Acute myocardial infarction, Copeptin, Diagnosis of AMI,
MeSH
biologické markery krev MeSH
časná diagnóza MeSH
glykopeptidy krev MeSH
infarkt myokardu krev diagnóza MeSH
lidé středního věku MeSH
lidé MeSH
následné studie MeSH
prospektivní studie MeSH
ROC křivka MeSH
senioři nad 80 let MeSH
senioři MeSH
troponin I krev MeSH
troponin T krev MeSH
urgentní služby nemocnice MeSH
Check Tag
lidé středního věku MeSH
lidé MeSH
mužské pohlaví MeSH
senioři nad 80 let MeSH
senioři MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH
Názvy látek
biologické markery MeSH
copeptins MeSH Prohlížeč
glykopeptidy MeSH
troponin I MeSH
troponin T MeSH

BACKGROUND: The early diagnosis of acute myocardial infarction (AMI) in patients with mild elevations of high-sensitivity cardiac troponin (hs-cTn) is a challenge. It is unclear whether copeptin, a marker of endogenous stress, or 1h-hs-cTn changes are better suited to address this important unmet clinical need. METHODS: We prospectively enrolled patients presenting with symptoms suggestive of AMI to the emergency department (ED). Two independent cardiologists adjudicated the final diagnosis. Mild hs-cTn elevations were defined as 26.2 ng/L (99th percentile) to 75 ng/L for hs-cTnI, and 14 ng/L (99th percentile) to 50 ng/L (biological-equivalent to 75 ng/L for hs-cTnI) for hs-cTnT. RESULTS: Among 1356 patients, 80 (6%) had mild hs-cTnI elevations at presentation. Within this group, AMI was the final diagnosis in 39 patients (49%). The diagnostic accuracy for the diagnosis of AMI as quantified by the area under the receiver operating characteristic curve (AUC) was 0.51 (95% CI 0.39-0.64) for hs-cTnI at presentation, 0.58 (95% CI 0.45-0.71) for copeptin at presentation, and 0.78 (95% CI 0.68-0.88) for 1h-hs-cTnI changes, which was significantly higher as compared to copeptin (p = 0.02) or hs-cTnI alone (p < 0.001). The additional use of 1h-hs-cTnI changes, but not of copeptin, improved diagnostic accuracy of hs-cTnI at presentation (AUC 0.80, 95% CI 0.70-0.90; p = 0.002 for comparison). Similar findings regarding copeptin and 1h-hs-cTnT/I changes were obtained for mild hs-cTnT elevations. CONCLUSIONS: About 6-22% of patients presenting with suggestive AMI to the ED have mild hs-cTnT/I elevations at presentation. In contrast to copeptin, the addition of 1h-hs-cTn changes substantially improves the early diagnosis of AMI.

2nd Department of Cardiology Medical University of Silesia Zabrze Poland

Blood Transfusion Centre Swiss Red Cross Basel Switzerland

Department of Cardiology Cardiovascular Research Institute Basel University Hospital Basel University of Basel Petersgraben 4 4031 Basel Switzerland

Department of Cardiology University Hospital Brno Brno Czech Republic

Department of Hematology University Hospital Basel Basel Switzerland

Department of Internal Medicine University Hospital Basel University of Basel Basel Switzerland

Emergency Department Hospital Clinic Barcelona Catalonia Spain

Emergency Department University Hospital Zurich Zurich Switzerland

GREAT Network Basel Switzerland

Laboratory Medicine University Hospital Basel Basel Switzerland

Medical Faculty Masaryk University Brno Czech Republic

Servicio de Urgencias Hospital Clínico San Carlos Madrid Spain