Sökning: WFRF:(Badertscher Patrick)
> (2019) >
Diagnosis of acute ...
-
Nestelberger, ThomasUniv Hosp Basel, CRIB, Basel, Switzerland
(författare)
Diagnosis of acute myocardial infarction in the presence of left bundle branch block
- Artikel/kapitelEngelska2019
Förlag, utgivningsår, omfång ...
-
2019-05-29
-
BMJ PUBLISHING GROUP,2019
-
printrdacarrier
Nummerbeteckningar
-
LIBRIS-ID:oai:DiVA.org:uu-397782
-
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-397782URI
-
https://doi.org/10.1136/heartjnl-2018-314673DOI
Kompletterande språkuppgifter
-
Språk:engelska
-
Sammanfattning på:engelska
Ingår i deldatabas
Klassifikation
-
Ämneskategori:ref swepub-contenttype
-
Ämneskategori:art swepub-publicationtype
Anmärkningar
-
Objective: Patients with suspected acute myocardial infarction (AMI) in the setting of left bundle branch block (LBBB) present an important diagnostic and therapeutic challenge to the clinician.Methods: We prospectively evaluated the incidence of AMI and diagnostic performance of specific ECG and high-sensitivity cardiac troponin (hs-cTn) criteria in patients presenting with chest discomfort to 26 emergency departments in three international, prospective, diagnostic studies. The final diagnosis of AMI was centrally adjudicated by two independent cardiologists according to the universal definition of myocardial infarction.Results: Among 8830 patients, LBBB was present in 247 (2.8%). AMI was the final diagnosis in 30% of patients with LBBB, with similar incidence in those with known LBBB versus those with presumably new LBBB (29% vs 35%, p=0.42). ECG criteria had low sensitivity (1%-12%) but high specificity (95%-100%) for AMI. The diagnostic accuracy as quantified by the receiver operating characteristics (ROC) curve of hs-cTnT and hs-cTnI concentrations at presentation (area under the ROC curve (AUC) 0.91, 95%CI 0.85 to 0.96 and AUC 0.89, 95%CI 0.83 to 0.95), as well as that of their 0/1-hour and 0/2-hour changes, was very high. A diagnostic algorithm combining ECG criteria with hs-cTnT/I concentrations and their absolute changes at 1hour or 2hours derived in cohort 1 (45 of 45(100%) patients with AMI correctly identified) showed high efficacy and accuracy when externally validated in cohorts 2 and 3 (28 of 29 patients, 97%).Conclusion: Most patients presenting with suspected AMI and LBBB will be found to have diagnoses other than AMI. Combining ECG criteria with hs-cTnT/I testing at 0/1 hour or 0/2hours allows early and accurate diagnosis of AMI in LBBB.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
-
Cullen, LouiseRoyal Brisbane & Womens Hosp, Emergency Dept, Brisbane, Qld, Australia
(författare)
-
Lindahl, Bertil,1957-Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)belin227
(författare)
-
Reichlin, TobiasUniv Hosp Bern, Dept Cardiol, Bern, Switzerland
(författare)
-
Greenslade, Jaimi H.Royal Brisbane & Womens Hosp, Emergency Dept, Brisbane, Qld, Australia
(författare)
-
Giannitsis, EvangelosUniv Klinikum Heidelberg, Dept Cardiol, Heidelberg, Germany
(författare)
-
Christ, MichaelLuzerner Kantonsspital, Dept Emergency Med, Luzern, Switzerland
(författare)
-
Morawiec, BeataUniv Hosp, Dept Cardiol, Zabrze, Poland
(författare)
-
Miro, OscarHosp Clin Barcelona, Dept Emergency Dept, Barcelona, Spain
(författare)
-
Javier Martin-Sanchez, FranciscoHosp San Carlos Madrid, Emergency Dept, Madrid, Spain
(författare)
-
Wussler, Desiree NadineUniv Hosp Basel, CRIB, Basel, Switzerland
(författare)
-
Koechlin, LucaUniv Hosp Basel, CRIB, Basel, Switzerland
(författare)
-
Twerenbold, RaphaelUniv Hosp Basel, CRIB, Basel, Switzerland
(författare)
-
Parsonage, WilliamRoyal Brisbane & Womens Hosp, Dept Cardiol, Brisbane, Qld, Australia
(författare)
-
Boeddinghaus, JasperUniv Hosp Basel, CRIB, Basel, Switzerland
(författare)
-
Gimenez, Maria RubiniUniv Hosp Basel, CRIB, Basel, Switzerland
(författare)
-
Puelacher, ChristianUniv Hosp Basel, CRIB, Basel, Switzerland
(författare)
-
Wildi, KarinUniv Hosp Basel, CRIB, Basel, Switzerland
(författare)
-
Buerge, TobiasUniv Hosp Basel, CRIB, Basel, Switzerland
(författare)
-
Badertscher, PatrickUniv Hosp Basel, CRIB, Basel, Switzerland
(författare)
-
DuFaydeLavallaz, JeanneUniv Hosp Basel, CRIB, Basel, Switzerland
(författare)
-
Strebel, IvoUniv Hosp Basel, CRIB, Basel, Switzerland
(författare)
-
Croton, LukasUniv Hosp Basel, CRIB, Basel, Switzerland
(författare)
-
Bendig, GarnetEntwicklungs & Produktionszentrum, Roche Forsch, Penzberg, Germany
(författare)
-
Osswald, StefanUniv Hosp Basel, CRIB, Basel, Switzerland
(författare)
-
Pickering, John WilliamUniv Hosp Basel, CRIB, Basel, Switzerland;Univ Otago, Dept Med, Dunedin, New Zealand
(författare)
-
Than, MartinUniv Hosp Basel, CRIB, Basel, Switzerland;Christchurch Hosp, Emergency Dept, Christchurch, New Zealand
(författare)
-
Mueller, ChristianUniv Hosp Basel, CRIB, Basel, Switzerland
(författare)
-
Univ Hosp Basel, CRIB, Basel, SwitzerlandRoyal Brisbane & Womens Hosp, Emergency Dept, Brisbane, Qld, Australia
(creator_code:org_t)
Sammanhörande titlar
-
Ingår i:Heart: BMJ PUBLISHING GROUP105:20, s. 1559-15671355-60371468-201X
Internetlänk
Hitta via bibliotek
-
Heart
(Sök värdpublikationen i LIBRIS)
Till lärosätets databas
- Av författaren/redakt...
-
Nestelberger, Th ...
-
Cullen, Louise
-
Lindahl, Bertil, ...
-
Reichlin, Tobias
-
Greenslade, Jaim ...
-
Giannitsis, Evan ...
-
visa fler...
-
Christ, Michael
-
Morawiec, Beata
-
Miro, Oscar
-
Javier Martin-Sa ...
-
Wussler, Desiree ...
-
Koechlin, Luca
-
Twerenbold, Raph ...
-
Parsonage, Willi ...
-
Boeddinghaus, Ja ...
-
Gimenez, Maria R ...
-
Puelacher, Chris ...
-
Wildi, Karin
-
Buerge, Tobias
-
Badertscher, Pat ...
-
DuFaydeLavallaz, ...
-
Strebel, Ivo
-
Croton, Lukas
-
Bendig, Garnet
-
Osswald, Stefan
-
Pickering, John ...
-
Than, Martin
-
Mueller, Christi ...
-
visa färre...
- Om ämnet
-
- MEDICIN OCH HÄLSOVETENSKAP
-
MEDICIN OCH HÄLS ...
-
och Klinisk medicin
-
och Kardiologi
- Artiklar i publikationen
-
Heart
- Av lärosätet
-
Uppsala universitet