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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00004867naa a2200517 4500
001oai:DiVA.org:uu-446850
003SwePub
008210805s2021 | |||||||||||000 ||eng|
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4468502 URI
0247 a https://doi.org/10.1093/ehjacc/zuaa0162 DOI
040 a (SwePub)uu
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Steiro, Ole-Thomasu Haukeland Hosp, Dept Heart Dis, Bergen, Norway.4 aut
2451 0a Clinical risk scores identify more patients at risk for cardiovascular events within 30 days as compared to standard ACS risk criteria :b the WESTCOR study
264 c 2020-10-02
264 1b Oxford University Press,c 2021
338 a electronic2 rdacarrier
520 a Aims Troponin-based algorithms are made to identify myocardial infarctions (MIs) but adding either standard acute coronary syndrome (ACS) risk criteria or a clinical risk score may identify more patients eligible for early discharge and patients in need of urgent revascularization. Methods and results Post-hoc analysis of the WESTCOR study including 932 patients (mean 63years, 61% male) with suspected NSTE-ACS. Serum samples were collected at 0, 3, and 8-12h and high-sensitivity cTnT (Roche Diagnostics) and cTnI (Abbott Diagnostics) were analysed. The primary endpoint was MI, all-cause mortality, and unplanned revascularizations within 30days. Secondary endpoint was non-ST-elevation myocardial infarction (NSTEMI) during index hospitalization. Two combinations were compared: troponin-based algorithms (ESC 0/3h and the High-STEACS algorithm) and either ACS risk criteria recommended in the ESC guidelines, or one of eleven clinical risk scores, HEART, mHEART, CARE, GRACE, T-MACS, sT-MACS, TIMI, EDACS, sEDACS, Goldman, and Geleijnse-Sanchis. The prevalence of primary events was 21%. Patients ruled out for NSTEMI and regarded low risk of ACS according to ESC guidelines had 3.8-4.9% risk of an event, primarily unplanned revascularizations. Using HEART score instead of ACS risk criteria reduced the number of events to 2.2-2.7%, with maintained efficacy. The secondary endpoint was met by 13%. The troponin-based algorithms without evaluation of ACS risk missed three-index NSTEMIs with a negative predictive value (NPV) of 99.5% and 99.6%. Conclusion Combining ESC 0/3h or the High-STEACS algorithm with standardized clinical risk scores instead of ACS risk criteria halved the prevalence of rule-out patients in need of revascularization, with maintained efficacy.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng
653 a Chest pain
653 a High-sensitivity troponin assay
653 a ESC 0/3h algorithm
653 a High-STEACS
653 a Risk score
653 a Revascularization
7001 a Tjora, Hilde L.u Haukeland Hosp, Emergency Care Clin, Bergen, Norway.4 aut
7001 a Langorgen, Jorundu Haukeland Hosp, Dept Heart Dis, Bergen, Norway.4 aut
7001 a Bjorneklett, Runeu Haukeland Hosp, Emergency Care Clin, Bergen, Norway.;Univ Bergen, Dept Clin Med, Bergen, Norway.4 aut
7001 a Nygård, Ottar K.u Haukeland Hosp, Dept Heart Dis, Bergen, Norway.;Univ Bergen, Dept Clin Med, Bergen, Norway.4 aut
7001 a Skadberg, Oyvindu Stavanger Univ Hosp, Lab Med Biochem, Stavanger, Norway.4 aut
7001 a Bonarjee, Vernon V. S.u Stavanger Univ Hosp, Dept Cardiol, Stavanger, Norway.4 aut
7001 a Lindahl, Bertil,d 1957-u Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi4 aut0 (Swepub:uu)belin227
7001 a Omland, Torbjornu Akershus Univ Hosp, Div Med, Oslo, Norway.;Univ Oslo, Fac Med, Ctr Heart Failure Res, Inst Clin Med, Oslo, Norway.4 aut
7001 a Vikenes, Kjellu Haukeland Hosp, Dept Heart Dis, Bergen, Norway.;Univ Bergen, Dept Clin Med, Bergen, Norway.4 aut
7001 a Aakre, Kristin M.u Univ Bergen, Dept Clin Med, Bergen, Norway.;Haukeland Hosp, Dept Med Biochem & Pharmacol, Jonas Lies Vei 65, N-5021 Bergen, Norway.4 aut
7102 a Haukeland Hosp, Dept Heart Dis, Bergen, Norway.b Haukeland Hosp, Emergency Care Clin, Bergen, Norway.4 org
7730 t European Heart Journald : Oxford University Pressg 10:3, s. 287-301q 10:3<287-301x 2048-8726x 2048-8734
8564 u https://doi.org/10.1093/ehjacc/zuaa016y Fulltext
8564 u https://uu.diva-portal.org/smash/get/diva2:1583280/FULLTEXT01.pdfx primaryx Raw objecty fulltext:print
8564 u https://doi.org/10.1093/ehjacc/zuaa016
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-446850
8564 8u https://doi.org/10.1093/ehjacc/zuaa016

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