JavaScript NENÍ povolen !

* Zobrazit nápovědu

Pracoviště: Department of Cardiology University Hospital Br...

1 záznamů v Medvik Filtry

Článek

Direct Comparison of 4 Very Early Rule-Out Strategies for Acute Myocardial Infarction Using High-Sensitivity Cardiac Troponin I

Boeddinghaus, Jasper
Autor Boeddinghaus, Jasper From Cardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (J.B., T.N., R.T., K.W., P.B., J.C., T.B., P.M., S.C., K.G., M.R.G., C.P., S.S., D.F.W., J.F., P.H., Z.S., U.H., N.S., N.K., J.L. W.K., S.O., T.R., C.M.) Department of Internal Medicine, University Hospital Basel, University of Basel, Switzerland (J.B., T.N., K.G., P.H., N.S.) GREAT Network (J.B., T.N., R.T., K.W., P.B., J.C., S.C., K.G., M.R.G., C.P., S.S., D.F.W., P.H., Z.S., U.H., N.S., N.K., O.M., B.L., E.G., J.P., T.R., C.M.) Emergency Department, University Hospital Zurich, Switzerland (T.B., P.M., D.I.K.) Laboratory Medicine, University Hospital Basel, Switzerland (K.R.) Emergency Department, Hospital Clinic, Barcelona, Catalonia, Spain (O.M., B.L.) Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, Spain (F.J.M.-S., E.R.-A.) 2nd Department of Cardiology, Medical University of Silesia, Zabrze, Poland (B.M., D.K.) Department of Cardiology, University Hospital Brno, Czech Republic and Medical Faculty, Masaryk University (E.G., J.P.) Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland and Department of Hematology, University Hospital Basel (A.B.) and Emergency Department, Kantonsspital Liestal, Switzerland (N.G.)
Nestelberger, Thomas
Autor Nestelberger, Thomas From Cardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (J.B., T.N., R.T., K.W., P.B., J.C., T.B., P.M., S.C., K.G., M.R.G., C.P., S.S., D.F.W., J.F., P.H., Z.S., U.H., N.S., N.K., J.L. W.K., S.O., T.R., C.M.) Department of Internal Medicine, University Hospital Basel, University of Basel, Switzerland (J.B., T.N., K.G., P.H., N.S.) GREAT Network (J.B., T.N., R.T., K.W., P.B., J.C., S.C., K.G., M.R.G., C.P., S.S., D.F.W., P.H., Z.S., U.H., N.S., N.K., O.M., B.L., E.G., J.P., T.R., C.M.) Emergency Department, University Hospital Zurich, Switzerland (T.B., P.M., D.I.K.) Laboratory Medicine, University Hospital Basel, Switzerland (K.R.) Emergency Department, Hospital Clinic, Barcelona, Catalonia, Spain (O.M., B.L.) Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, Spain (F.J.M.-S., E.R.-A.) 2nd Department of Cardiology, Medical University of Silesia, Zabrze, Poland (B.M., D.K.) Department of Cardiology, University Hospital Brno, Czech Republic and Medical Faculty, Masaryk University (E.G., J.P.) Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland and Department of Hematology, University Hospital Basel (A.B.) and Emergency Department, Kantonsspital Liestal, Switzerland (N.G.)
Twerenbold, Raphael
Autor Twerenbold, Raphael From Cardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (J.B., T.N., R.T., K.W., P.B., J.C., T.B., P.M., S.C., K.G., M.R.G., C.P., S.S., D.F.W., J.F., P.H., Z.S., U.H., N.S., N.K., J.L. W.K., S.O., T.R., C.M.) Department of Internal Medicine, University Hospital Basel, University of Basel, Switzerland (J.B., T.N., K.G., P.H., N.S.) GREAT Network (J.B., T.N., R.T., K.W., P.B., J.C., S.C., K.G., M.R.G., C.P., S.S., D.F.W., P.H., Z.S., U.H., N.S., N.K., O.M., B.L., E.G., J.P., T.R., C.M.) Emergency Department, University Hospital Zurich, Switzerland (T.B., P.M., D.I.K.) Laboratory Medicine, University Hospital Basel, Switzerland (K.R.) Emergency Department, Hospital Clinic, Barcelona, Catalonia, Spain (O.M., B.L.) Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, Spain (F.J.M.-S., E.R.-A.) 2nd Department of Cardiology, Medical University of Silesia, Zabrze, Poland (B.M., D.K.) Department of Cardiology, University Hospital Brno, Czech Republic and Medical Faculty, Masaryk University (E.G., J.P.) Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland and Department of Hematology, University Hospital Basel (A.B.) and Emergency Department, Kantonsspital Liestal, Switzerland (N.G.)
Wildi, Karin
Autor Wildi, Karin From Cardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (J.B., T.N., R.T., K.W., P.B., J.C., T.B., P.M., S.C., K.G., M.R.G., C.P., S.S., D.F.W., J.F., P.H., Z.S., U.H., N.S., N.K., J.L. W.K., S.O., T.R., C.M.) Department of Internal Medicine, University Hospital Basel, University of Basel, Switzerland (J.B., T.N., K.G., P.H., N.S.) GREAT Network (J.B., T.N., R.T., K.W., P.B., J.C., S.C., K.G., M.R.G., C.P., S.S., D.F.W., P.H., Z.S., U.H., N.S., N.K., O.M., B.L., E.G., J.P., T.R., C.M.) Emergency Department, University Hospital Zurich, Switzerland (T.B., P.M., D.I.K.) Laboratory Medicine, University Hospital Basel, Switzerland (K.R.) Emergency Department, Hospital Clinic, Barcelona, Catalonia, Spain (O.M., B.L.) Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, Spain (F.J.M.-S., E.R.-A.) 2nd Department of Cardiology, Medical University of Silesia, Zabrze, Poland (B.M., D.K.) Department of Cardiology, University Hospital Brno, Czech Republic and Medical Faculty, Masaryk University (E.G., J.P.) Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland and Department of Hematology, University Hospital Basel (A.B.) and Emergency Department, Kantonsspital Liestal, Switzerland (N.G.)
Badertscher, Patrick
Autor Badertscher, Patrick From Cardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (J.B., T.N., R.T., K.W., P.B., J.C., T.B., P.M., S.C., K.G., M.R.G., C.P., S.S., D.F.W., J.F., P.H., Z.S., U.H., N.S., N.K., J.L. W.K., S.O., T.R., C.M.) Department of Internal Medicine, University Hospital Basel, University of Basel, Switzerland (J.B., T.N., K.G., P.H., N.S.) GREAT Network (J.B., T.N., R.T., K.W., P.B., J.C., S.C., K.G., M.R.G., C.P., S.S., D.F.W., P.H., Z.S., U.H., N.S., N.K., O.M., B.L., E.G., J.P., T.R., C.M.) Emergency Department, University Hospital Zurich, Switzerland (T.B., P.M., D.I.K.) Laboratory Medicine, University Hospital Basel, Switzerland (K.R.) Emergency Department, Hospital Clinic, Barcelona, Catalonia, Spain (O.M., B.L.) Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, Spain (F.J.M.-S., E.R.-A.) 2nd Department of Cardiology, Medical University of Silesia, Zabrze, Poland (B.M., D.K.) Department of Cardiology, University Hospital Brno, Czech Republic and Medical Faculty, Masaryk University (E.G., J.P.) Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland and Department of Hematology, University Hospital Basel (A.B.) and Emergency Department, Kantonsspital Liestal, Switzerland (N.G.)
Cupa, Janosch
Autor Cupa, Janosch From Cardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (J.B., T.N., R.T., K.W., P.B., J.C., T.B., P.M., S.C., K.G., M.R.G., C.P., S.S., D.F.W., J.F., P.H., Z.S., U.H., N.S., N.K., J.L. W.K., S.O., T.R., C.M.) Department of Internal Medicine, University Hospital Basel, University of Basel, Switzerland (J.B., T.N., K.G., P.H., N.S.) GREAT Network (J.B., T.N., R.T., K.W., P.B., J.C., S.C., K.G., M.R.G., C.P., S.S., D.F.W., P.H., Z.S., U.H., N.S., N.K., O.M., B.L., E.G., J.P., T.R., C.M.) Emergency Department, University Hospital Zurich, Switzerland (T.B., P.M., D.I.K.) Laboratory Medicine, University Hospital Basel, Switzerland (K.R.) Emergency Department, Hospital Clinic, Barcelona, Catalonia, Spain (O.M., B.L.) Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, Spain (F.J.M.-S., E.R.-A.) 2nd Department of Cardiology, Medical University of Silesia, Zabrze, Poland (B.M., D.K.) Department of Cardiology, University Hospital Brno, Czech Republic and Medical Faculty, Masaryk University (E.G., J.P.) Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland and Department of Hematology, University Hospital Basel (A.B.) and Emergency Department, Kantonsspital Liestal, Switzerland (N.G.)
Bürge, Tobias
Autor Bürge, Tobias From Cardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (J.B., T.N., R.T., K.W., P.B., J.C., T.B., P.M., S.C., K.G., M.R.G., C.P., S.S., D.F.W., J.F., P.H., Z.S., U.H., N.S., N.K., J.L. W.K., S.O., T.R., C.M.) Department of Internal Medicine, University Hospital Basel, University of Basel, Switzerland (J.B., T.N., K.G., P.H., N.S.) GREAT Network (J.B., T.N., R.T., K.W., P.B., J.C., S.C., K.G., M.R.G., C.P., S.S., D.F.W., P.H., Z.S., U.H., N.S., N.K., O.M., B.L., E.G., J.P., T.R., C.M.) Emergency Department, University Hospital Zurich, Switzerland (T.B., P.M., D.I.K.) Laboratory Medicine, University Hospital Basel, Switzerland (K.R.) Emergency Department, Hospital Clinic, Barcelona, Catalonia, Spain (O.M., B.L.) Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, Spain (F.J.M.-S., E.R.-A.) 2nd Department of Cardiology, Medical University of Silesia, Zabrze, Poland (B.M., D.K.) Department of Cardiology, University Hospital Brno, Czech Republic and Medical Faculty, Masaryk University (E.G., J.P.) Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland and Department of Hematology, University Hospital Basel (A.B.) and Emergency Department, Kantonsspital Liestal, Switzerland (N.G.)
Mächler, Patrick
Autor Mächler, Patrick From Cardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (J.B., T.N., R.T., K.W., P.B., J.C., T.B., P.M., S.C., K.G., M.R.G., C.P., S.S., D.F.W., J.F., P.H., Z.S., U.H., N.S., N.K., J.L. W.K., S.O., T.R., C.M.) Department of Internal Medicine, University Hospital Basel, University of Basel, Switzerland (J.B., T.N., K.G., P.H., N.S.) GREAT Network (J.B., T.N., R.T., K.W., P.B., J.C., S.C., K.G., M.R.G., C.P., S.S., D.F.W., P.H., Z.S., U.H., N.S., N.K., O.M., B.L., E.G., J.P., T.R., C.M.) Emergency Department, University Hospital Zurich, Switzerland (T.B., P.M., D.I.K.) Laboratory Medicine, University Hospital Basel, Switzerland (K.R.) Emergency Department, Hospital Clinic, Barcelona, Catalonia, Spain (O.M., B.L.) Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, Spain (F.J.M.-S., E.R.-A.) 2nd Department of Cardiology, Medical University of Silesia, Zabrze, Poland (B.M., D.K.) Department of Cardiology, University Hospital Brno, Czech Republic and Medical Faculty, Masaryk University (E.G., J.P.) Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland and Department of Hematology, University Hospital Basel (A.B.) and Emergency Department, Kantonsspital Liestal, Switzerland (N.G.)
Corbière, Sydney
Autor Corbière, Sydney From Cardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (J.B., T.N., R.T., K.W., P.B., J.C., T.B., P.M., S.C., K.G., M.R.G., C.P., S.S., D.F.W., J.F., P.H., Z.S., U.H., N.S., N.K., J.L. W.K., S.O., T.R., C.M.) Department of Internal Medicine, University Hospital Basel, University of Basel, Switzerland (J.B., T.N., K.G., P.H., N.S.) GREAT Network (J.B., T.N., R.T., K.W., P.B., J.C., S.C., K.G., M.R.G., C.P., S.S., D.F.W., P.H., Z.S., U.H., N.S., N.K., O.M., B.L., E.G., J.P., T.R., C.M.) Emergency Department, University Hospital Zurich, Switzerland (T.B., P.M., D.I.K.) Laboratory Medicine, University Hospital Basel, Switzerland (K.R.) Emergency Department, Hospital Clinic, Barcelona, Catalonia, Spain (O.M., B.L.) Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, Spain (F.J.M.-S., E.R.-A.) 2nd Department of Cardiology, Medical University of Silesia, Zabrze, Poland (B.M., D.K.) Department of Cardiology, University Hospital Brno, Czech Republic and Medical Faculty, Masaryk University (E.G., J.P.) Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland and Department of Hematology, University Hospital Basel (A.B.) and Emergency Department, Kantonsspital Liestal, Switzerland (N.G.)
Grimm, Karin
Autor Grimm, Karin From Cardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (J.B., T.N., R.T., K.W., P.B., J.C., T.B., P.M., S.C., K.G., M.R.G., C.P., S.S., D.F.W., J.F., P.H., Z.S., U.H., N.S., N.K., J.L. W.K., S.O., T.R., C.M.) Department of Internal Medicine, University Hospital Basel, University of Basel, Switzerland (J.B., T.N., K.G., P.H., N.S.) GREAT Network (J.B., T.N., R.T., K.W., P.B., J.C., S.C., K.G., M.R.G., C.P., S.S., D.F.W., P.H., Z.S., U.H., N.S., N.K., O.M., B.L., E.G., J.P., T.R., C.M.) Emergency Department, University Hospital Zurich, Switzerland (T.B., P.M., D.I.K.) Laboratory Medicine, University Hospital Basel, Switzerland (K.R.) Emergency Department, Hospital Clinic, Barcelona, Catalonia, Spain (O.M., B.L.) Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, Spain (F.J.M.-S., E.R.-A.) 2nd Department of Cardiology, Medical University of Silesia, Zabrze, Poland (B.M., D.K.) Department of Cardiology, University Hospital Brno, Czech Republic and Medical Faculty, Masaryk University (E.G., J.P.) Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland and Department of Hematology, University Hospital Basel (A.B.) and Emergency Department, Kantonsspital Liestal, Switzerland (N.G.)

Circulation (New York, N.Y.). 2017 ; 135 (17) : 1597-1611. [pub] 20170310

Circulation (New York)
ISSN 1524-4539
Medvik
Zdroj

BACKGROUND: Four strategies for very early rule-out of acute myocardial infarction using high-sensitivity cardiac troponin I (hs-cTnI) have been identified. It remains unclear which strategy is most attractive for clinical application. METHODS: We prospectively enrolled unselected patients presenting to the emergency department with symptoms suggestive of acute myocardial infarction. The final diagnosis was adjudicated by 2 independent cardiologists. Hs-cTnI levels were measured at presentation and after 1 hour in a blinded fashion. We directly compared all 4 hs-cTnI-based rule-out strategies: limit of detection (LOD, hs-cTnI<2 ng/L), single cutoff (hs-cTnI<5 ng/L), 1-hour algorithm (hs-cTnI<5 ng/L and 1-hour change<2 ng/L), and the 0/1-hour algorithm recommended in the European Society of Cardiology guideline combining LOD and 1-hour algorithm. RESULTS: Among 2828 enrolled patients, acute myocardial infarction was the final diagnosis in 451 (16%) patients. The LOD approach ruled out 453 patients (16%) with a sensitivity of 100% (95% confidence interval [CI], 99.2%-100%), the single cutoff 1516 patients (54%) with a sensitivity of 97.1% (95% CI, 95.1%-98.3%), the 1-hour algorithm 1459 patients (52%) with a sensitivity of 98.4% (95% CI, 96.8%-99.2%), and the 0/1-hour algorithm 1463 patients (52%) with a sensitivity of 98.4% (95% CI, 96.8%-99.2%). Predefined subgroup analysis in early presenters (≤2 hours) revealed significantly lower sensitivity (94.2%, interaction P=0.03) of the single cutoff, but not the other strategies. Two-year survival was 100% with LOD and 98.1% with the other strategies (P<0.01 for LOD versus each of the other strategies). CONCLUSIONS: All 4 rule-out strategies balance effectiveness and safety equally well. The single cutoff should not be applied in early presenters, whereas the 3 other strategies seem to perform well in this challenging subgroup. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00470587.

MeSH
akutní koronární syndrom krev diagnóza mortalita MeSH
algoritmy MeSH
biologické markery krev MeSH
časové faktory MeSH
dospělí MeSH
elektrokardiografie MeSH
hodnocení rizik MeSH
infarkt myokardu krev diagnóza mortalita MeSH
Kaplanův-Meierův odhad MeSH
lidé středního věku MeSH
lidé MeSH
metody pro podporu rozhodování * MeSH
prediktivní hodnota testů MeSH
prognóza MeSH
prospektivní studie MeSH
rizikové faktory MeSH
senioři nad 80 let MeSH
senioři MeSH
sexuální faktory MeSH
troponin I krev MeSH
upregulace MeSH
věkové faktory MeSH
zdravotní stav MeSH
Check Tag
dospělí MeSH
lidé středního věku MeSH
lidé MeSH
mužské pohlaví MeSH
senioři nad 80 let MeSH
senioři MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH
multicentrická studie MeSH
srovnávací studie MeSH
Geografické názvy
Evropa MeSH

Kolekce

Publikováno

Filtry

Filtry

* Zobrazit nápovědu

* Zobrazit nápovědu

Upřesnit dle MeSH