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Performance of the ...
Performance of the European Society of Cardiology 0/1-Hour, 0/2-Hour, and 0/3-Hour Algorithms for Rapid Triage of Acute Myocardial Infarction : An International Collaborative Meta-analysis
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- Chiang, Cho-Han (författare)
- National Taiwan University College of Medicine
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- Chiang, Cho-Hung (författare)
- Taipei Tzu Chi Hospital
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- Pickering, John W (författare)
- Christchurch Hospital New Zealand
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- Stoyanov, Kiril M (författare)
- University Hospital Heidelberg
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- Chew, Derek P (författare)
- Flinders University
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- Neumann, Johannes T (författare)
- Monash University
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- Ojeda, Francisco (författare)
- University Heart & Vascular Center Hamburg
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- Sörensen, Nils A (författare)
- University Heart & Vascular Center Hamburg
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- Su, Ke-Ying (författare)
- National Taiwan University Hospital
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- Kavsak, Peter (författare)
- McMaster University
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Worster, Andrew (författare)
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Inoue, Kenji (författare)
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Johannessen, Tonje R (författare)
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Atar, Dan (författare)
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Amann, Michael (författare)
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Hochholzer, Willibald (författare)
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- Mokhtari, Arash (författare)
- Lund University,Lunds universitet,Akutsjukvård,Forskargrupper vid Lunds universitet,Emergency medicine,Lund University Research Groups,Skåne University Hospital
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- Ekelund, Ulf (författare)
- Lund University,Lunds universitet,Akutsjukvård,Forskargrupper vid Lunds universitet,Emergency medicine,Lund University Research Groups,Skåne University Hospital
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Twerenbold, Raphael (författare)
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Mueller, Christian (författare)
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Bahrmann, Philipp (författare)
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Buttinger, Nicolas (författare)
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Dooley, Maureen (författare)
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Ruangsomboon, Onlak (författare)
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Nowak, Richard M (författare)
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DeFilippi, Christopher R (författare)
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Peacock, William F (författare)
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Neilan, Tomas G (författare)
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Liu, Michael A (författare)
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Hsu, Wan-Ting (författare)
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Lee, Gin Hoong (författare)
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Tang, Pui-Un (författare)
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Ma, Kevin Sheng-Kai (författare)
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Westermann, Dirk (författare)
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Blankenberg, Stefan (författare)
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Giannitsis, Evangelos (författare)
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Than, Martin P (författare)
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Lee, Chien-Chang (författare)
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(creator_code:org_t)
- 2022
- 2022
- Engelska.
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Ingår i: Annals of Internal Medicine. - 0003-4819. ; 175:1, s. 101-113
- Relaterad länk:
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.7...
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Abstract
Ämnesord
Stäng
- BACKGROUND: The 2020 European Society of Cardiology (ESC) guidelines recommend using the 0/1-hour and 0/2-hour algorithms over the 0/3-hour algorithm as the first and second choices of high-sensitivity cardiac troponin (hs-cTn)-based strategies for triage of patients with suspected acute myocardial infarction (AMI).PURPOSE: To evaluate the diagnostic accuracies of the ESC 0/1-hour, 0/2-hour, and 0/3-hour algorithms.DATA SOURCES: PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus from 1 January 2011 to 31 December 2020. (PROSPERO: CRD42020216479).STUDY SELECTION: Prospective studies that evaluated the ESC 0/1-hour, 0/2-hour, or 0/3-hour algorithms in adult patients presenting with suspected AMI.DATA EXTRACTION: The primary outcome was index AMI. Twenty unique cohorts were identified. Primary data were obtained from investigators of 16 cohorts and aggregate data were extracted from 4 cohorts. Two independent authors assessed each study for methodological quality.DATA SYNTHESIS: A total of 32 studies (20 cohorts) with 30 066 patients were analyzed. The 0/1-hour algorithm had a pooled sensitivity of 99.1% (95% CI, 98.5% to 99.5%) and negative predictive value (NPV) of 99.8% (CI, 99.6% to 99.9%) for ruling out AMI. The 0/2-hour algorithm had a pooled sensitivity of 98.6% (CI, 97.2% to 99.3%) and NPV of 99.6% (CI, 99.4% to 99.8%). The 0/3-hour algorithm had a pooled sensitivity of 93.7% (CI, 87.4% to 97.0%) and NPV of 98.7% (CI, 97.7% to 99.3%). Sensitivity of the 0/3-hour algorithm was attenuated in studies that did not use clinical criteria (GRACE score <140 and pain-free) compared with studies that used clinical criteria (90.2% [CI, 82.9 to 94.6] vs. 98.4% [CI, 88.6 to 99.8]). All 3 algorithms had similar specificities and positive predictive values for ruling in AMI, but heterogeneity across studies was substantial. Diagnostic performance was similar across the hs-cTnT (Elecsys; Roche), hs-cTnI (Architect; Abbott), and hs-cTnI (Centaur/Atellica; Siemens) assays.LIMITATION: Diagnostic accuracy, inclusion and exclusion criteria, and cardiac troponin sampling time varied among studies.CONCLUSION: The ESC 0/1-hour and 0/2-hour algorithms have higher sensitivities and NPVs than the 0/3-hour algorithm for index AMI.PRIMARY FUNDING SOURCE: National Taiwan University Hospital.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- Algorithms
- Biomarkers/blood
- Diagnosis, Differential
- Europe
- Humans
- Myocardial Infarction/diagnosis
- Practice Guidelines as Topic
- Predictive Value of Tests
- Reproducibility of Results
- Risk Factors
- Societies, Medical
- Time Factors
- Triage/methods
- Troponin/blood
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Chiang, Cho-Han
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Chiang, Cho-Hung
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Pickering, John ...
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Stoyanov, Kiril ...
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Chew, Derek P
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Neumann, Johanne ...
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Ojeda, Francisco
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Sörensen, Nils A
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Su, Ke-Ying
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Kavsak, Peter
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Worster, Andrew
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Inoue, Kenji
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Johannessen, Ton ...
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Atar, Dan
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Amann, Michael
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Hochholzer, Will ...
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Mokhtari, Arash
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Ekelund, Ulf
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Twerenbold, Raph ...
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Mueller, Christi ...
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Bahrmann, Philip ...
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Buttinger, Nicol ...
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Dooley, Maureen
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Ruangsomboon, On ...
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Nowak, Richard M
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DeFilippi, Chris ...
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Peacock, William ...
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Neilan, Tomas G
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Liu, Michael A
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Hsu, Wan-Ting
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Lee, Gin Hoong
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Tang, Pui-Un
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Ma, Kevin Sheng- ...
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Westermann, Dirk
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Blankenberg, Ste ...
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Giannitsis, Evan ...
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Than, Martin P
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Lee, Chien-Chang
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kardiologi
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Annals of Intern ...
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