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Combined testing of...
Combined testing of copeptin and high-sensitivity cardiac troponin T at presentation in comparison to other algorithms for rapid rule-out of acute myocardial infarction
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Mueller-Hennessen, Matthias (författare)
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- Lindahl, Bertil, 1957- (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Uppsala kliniska forskningscentrum (UCR),UCR
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Giannitsis, Evangelos (författare)
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Vafaie, Mehrshad (författare)
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Biener, Moritz (författare)
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Haushofer, Alexander C (författare)
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Seier, Josef (författare)
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Christ, Michael (författare)
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Alquézar-Arbé, Aitor (författare)
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deFilippi, Christopher R (författare)
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McCord, James (författare)
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Body, Richard (författare)
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Panteghini, Mauro (författare)
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- Jernberg, Tomas (författare)
- Karolinska Institutet
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Plebani, Mario (författare)
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Verschuren, Franck (författare)
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French, John K (författare)
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Christenson, Robert H (författare)
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Dinkel, Carina (författare)
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Katus, Hugo A (författare)
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Mueller, Christian (författare)
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(creator_code:org_t)
- Elsevier BV, 2019
- 2019
- Engelska.
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 276, s. 261-267
- Relaterad länk:
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https://www.research...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- BACKGROUND: We aimed to directly compare the diagnostic and prognostic performance of a dual maker strategy (DMS) with combined testing of copeptin and high-sensitivity (hs) cardiac troponin T (cTnT) at time of presentation with other algorithms for rapid rule-out of acute myocardial infarction (AMI).METHODS: 922 patients presenting to the emergency department with suspected AMI and available baseline copeptin measurements qualified for the present TRAPID-AMI substudy. Diagnostic measures using the DMS (copeptin <10, <14 or < 20 pmol/L and hs-cTnT≤14 ng/L), the 1 h-algorithm (hs-cTnT<12 ng/L and change <3 ng/L at 1 h), as well as the hs-cTnT limit-of-blank (LoB, <3 ng/L) and -detection (LoD, <5 ng/L) were compared. Outcomes were assessed as combined end-points of death and myocardial re-infarction.RESULTS: True-negative rule-out using the DMS could be achieved in 50.9%-62.3% of all patients compared to 35.0%, 45.3% and 64.5% using LoB, LoD or the 1 h-algorithm, respectively. The DMS showed NPVs of 98.1%-98.3% compared to 99.2% for the 1 h-algorithm, 99.4% for the LoB and 99.3% for the LoD. Sensitivities were 93.5%-94.8%, as well as 96.8%, 98.7% and 98.1%, respectively. Addition of clinical low-risk criteria such as a HEART-score ≤ 3 to the DMS resulted in NPVs and sensitivities of 100% with a true-negative rule-out to 33.8%-41.6%. Rates of the combined end-point of death/MI within 30 days ranged between 0.2% and 0.3% for all fast-rule-out protocols.CONCLUSION: Depending on the applied copeptin cut-off and addition of clinical low-risk criteria, the DMS might be an alternative to the hs-cTn-only-based algorithms for rapid AMI rule-out with comparable diagnostic measures and outcomes.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- Copeptin
- Dual-marker strategy
- High-sensitivity cardiac troponin T
- Rapid AMI rule-out
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Mueller-Hennesse ...
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Lindahl, Bertil, ...
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Giannitsis, Evan ...
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Vafaie, Mehrshad
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Biener, Moritz
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Haushofer, Alexa ...
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Seier, Josef
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Christ, Michael
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Alquézar-Arbé, A ...
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deFilippi, Chris ...
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McCord, James
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Body, Richard
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Panteghini, Maur ...
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Jernberg, Tomas
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Plebani, Mario
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Verschuren, Fran ...
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French, John K
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Christenson, Rob ...
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Dinkel, Carina
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Katus, Hugo A
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Mueller, Christi ...
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