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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00009630naa a2200757 4500
001oai:DiVA.org:uu-371504
003SwePub
008181221s2018 | |||||||||||000 ||eng|
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3715042 URI
0247 a https://doi.org/10.1093/eurheartj/ehy5142 DOI
040 a (SwePub)uu
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Boeddinghaus, Jasperu Univ Basel, CRIB, Univ Hosp Basel, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland;Univ Basel, Div Internal Med, Univ Hosp Basel, Petersgraben 4, CH-4031 Basel, Switzerland;3GREAT Network, Via Antonio Serra 54, I-00191 Rome, Italy4 aut
2451 0a Impact of age on the performance of the ESC 0/1h-algorithms for early diagnosis of myocardial infarction
264 c 2018-08-29
264 1b OXFORD UNIV PRESS,c 2018
338 a print2 rdacarrier
520 a Aims We aimed to evaluate the impact of age on the performance of the European Society of Cardiology (ESC) 0/1h-algorithms and to derive and externally validate alternative cut-offs specific to older patients. Methods and results We prospectively enrolled patients presenting to the emergency department (ED) with symptoms suggestive of and results acute myocardial infarction in three large diagnostic studies. Final diagnoses were adjudicated by two independent cardiologists. High-sensitivity cardiac troponin (hs-cTn) T and I concentrations were measured at presentation and after 1 h. Patients were stratified according to age [<55 years (young), >= 55 to <70 years (middle-age), >= 70 years (old)]. Rule-out safety of the ESC hs-cTnT 0/1h-algorithm was very high in all age-strata: sensitivity 100% [95% confidence interval (95% CI) 94.9-100] in young, 99.3% (95% CI 96.0-99.9) in middle-age, and 99.3% (95% CI 97.599.8) in old patients. Accuracy of rule-in decreased with age: specificity 97.0% (95% CI 95.8-97.9) in young, 96.1% (95% CI 94.5-97.2) in middle-age, and 92.7% (95% CI 90.7-94.3) in older patients. Triage efficacy decreased with increasing age (young 93%, middle-age 80%, old 55%, P <0.001). Similar results were found for the ESC hs-cTnT 0/1h-algorithm. Alternative, slightly higher cut-off concentrations optimized for older patients maintained very high safety of rule-out, increased specificity of rule-in (P< 0.01), reduced overall efficacy for hs-cTnT (P <0.01), while maintaining efficacy for hs-cTnl. Findings were confirmed in two validation cohorts (n = 2767). Conclusion While safety of the ESC 0/1h-algorithms remained very high, increasing age significantly reduced overall efficacy and the accuracy of rule-in. Alternative slightly higher cut-off concentrations may be considered for older patients, particularly if using hs-cTnl.
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 Age
653 a High-sensitivity cardiac troponin
653 a Guidelines
653 a 0/1h-Algorithm
653 a Diagnosis of AMI
7001 a Nestelberger, Thomasu Univ Basel, CRIB, Univ Hosp Basel, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland;3GREAT Network, Via Antonio Serra 54, I-00191 Rome, Italy4 aut
7001 a Twerenbold, Raphaelu Univ Basel, CRIB, Univ Hosp Basel, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland;3GREAT Network, Via Antonio Serra 54, I-00191 Rome, Italy;Hamburg Univ Heart Ctr, Dept Gen & Intervent Cardiol, Martinistr 52, D-20246 Hamburg, Germany4 aut
7001 a Neumann, Johannes Tobiasu Hamburg Univ Heart Ctr, Dept Gen & Intervent Cardiol, Martinistr 52, D-20246 Hamburg, Germany4 aut
7001 a Lindahl, Bertau Uppsala universitet,Institutionen för medicinska vetenskaper,Uppsala kliniska forskningscentrum (UCR)4 aut
7001 a Giannitsis, Evangelosu Heidelberg Univ, Med Klin 3, Neuenheimer Feld 410, D-69120 Heidelberg, Germany4 aut
7001 a Soerensen, Nils Arneu Hamburg Univ Heart Ctr, Dept Gen & Intervent Cardiol, Martinistr 52, D-20246 Hamburg, Germany4 aut
7001 a Badertscher, Patricku Univ Basel, CRIB, Univ Hosp Basel, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland;3GREAT Network, Via Antonio Serra 54, I-00191 Rome, Italy4 aut
7001 a Jann, Janina E.u Univ Basel, CRIB, Univ Hosp Basel, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland;3GREAT Network, Via Antonio Serra 54, I-00191 Rome, Italy4 aut
7001 a Wussler, Desireeu Univ Basel, CRIB, Univ Hosp Basel, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland;3GREAT Network, Via Antonio Serra 54, I-00191 Rome, Italy4 aut
7001 a Puelacher, Christianu Univ Basel, CRIB, Univ Hosp Basel, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland;3GREAT Network, Via Antonio Serra 54, I-00191 Rome, Italy4 aut
7001 a Gimenez, Maria Rubiniu Univ Basel, CRIB, Univ Hosp Basel, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland;3GREAT Network, Via Antonio Serra 54, I-00191 Rome, Italy4 aut
7001 a Wildi, Karinu Univ Basel, CRIB, Univ Hosp Basel, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland;3GREAT Network, Via Antonio Serra 54, I-00191 Rome, Italy4 aut
7001 a Strebel, Ivou Univ Basel, CRIB, Univ Hosp Basel, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland;3GREAT Network, Via Antonio Serra 54, I-00191 Rome, Italy4 aut
7001 a de Lavallaz, Jeanne Du Fayu Univ Basel, CRIB, Univ Hosp Basel, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland;3GREAT Network, Via Antonio Serra 54, I-00191 Rome, Italy4 aut
7001 a Selman, Farahu Univ Basel, CRIB, Univ Hosp Basel, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland4 aut
7001 a Sabti, Zaidu Univ Basel, CRIB, Univ Hosp Basel, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland;3GREAT Network, Via Antonio Serra 54, I-00191 Rome, Italy4 aut
7001 a Kozhuharov, Nikolau Univ Basel, CRIB, Univ Hosp Basel, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland;3GREAT Network, Via Antonio Serra 54, I-00191 Rome, Italy4 aut
7001 a Potlukova, Eliskau Univ Basel, CRIB, Univ Hosp Basel, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland;Univ Basel, Div Internal Med, Univ Hosp Basel, Petersgraben 4, CH-4031 Basel, Switzerland4 aut
7001 a Rentsch, Katharinau Univ Basel, Lab Med, Univ Hosp Basel, Petersgraben 4, CH-4031 Basel, Switzerland4 aut
7001 a Miro, Oscaru 3GREAT Network, Via Antonio Serra 54, I-00191 Rome, Italy;Hosp Clin Barcelona, Emergency Dept, Calle Villarroel 170, Barcelona 08036, Catalonia, Spain4 aut
7001 a Martin-Sanchez, F. Javieru 3GREAT Network, Via Antonio Serra 54, I-00191 Rome, Italy;Hosp Clin San Carlos, Serv Urgencias, Prof Martin Lagos S-N, Madrid 28040, Spain4 aut
7001 a Morawiec, Beatau 3GREAT Network, Via Antonio Serra 54, I-00191 Rome, Italy;Med Univ Katowice, Div Dent Zabrze, Dept Cardiol 2, Sch Med, Ul M Curie Sklodowskiej 9, PL-41800 Zabrze, Poland4 aut
7001 a Parenica, Jiriu 3GREAT Network, Via Antonio Serra 54, I-00191 Rome, Italy;Univ Hosp Brno, Dept Cardiol, Jihlavska 20, CZ-62500 Brno, Czech Republic;Masaryk Univ, Med Fac, Kamenice 5, Brno 62500, Czech Republic4 aut
7001 a Lohrmann, Jensu Univ Basel, CRIB, Univ Hosp Basel, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland4 aut
7001 a Kloos, Wandau Univ Basel, CRIB, Univ Hosp Basel, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland4 aut
7001 a Buser, Andreasu Swiss Red Cross, Blood Transfus Ctr, Hebelstr 10, CH-4056 Basel, Switzerland;Univ Basel, Univ Hosp Basel, Dept Hematol, Petersgraben 4, CH-4031 Basel, Switzerland4 aut
7001 a Geigy, Nicolasu Kantonsspital Liestal, Emergency Dept, Rheinstr 26, CH-4410 Liestal, Switzerland4 aut
7001 a Keller, Dagmar, Iu Univ Hosp Zurich, Emergency Dept, Ramistr 100, CH-8091 Zurich, Switzerland4 aut
7001 a Osswald, Stefanu Univ Basel, CRIB, Univ Hosp Basel, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland4 aut
7001 a Reichlin, Tobiasu Univ Basel, CRIB, Univ Hosp Basel, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland;3GREAT Network, Via Antonio Serra 54, I-00191 Rome, Italy4 aut
7001 a Westermann, Dirku Hamburg Univ Heart Ctr, Dept Gen & Intervent Cardiol, Martinistr 52, D-20246 Hamburg, Germany4 aut
7001 a Blankenberg, Stefanu Hamburg Univ Heart Ctr, Dept Gen & Intervent Cardiol, Martinistr 52, D-20246 Hamburg, Germany4 aut
7001 a Mueller, Christianu Univ Basel, CRIB, Univ Hosp Basel, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland;3GREAT Network, Via Antonio Serra 54, I-00191 Rome, Italy4 aut
7102 a Univ Basel, CRIB, Univ Hosp Basel, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland;Univ Basel, Div Internal Med, Univ Hosp Basel, Petersgraben 4, CH-4031 Basel, Switzerland;3GREAT Network, Via Antonio Serra 54, I-00191 Rome, Italyb Univ Basel, CRIB, Univ Hosp Basel, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland;3GREAT Network, Via Antonio Serra 54, I-00191 Rome, Italy4 org
7730 t European Heart Journald : OXFORD UNIV PRESSg 39:42, s. 3780-3794q 39:42<3780-3794x 0195-668Xx 1522-9645
8564 u https://academic.oup.com/eurheartj/article-pdf/39/42/3780/26367471/ehy514.pdf
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-371504
8564 8u https://doi.org/10.1093/eurheartj/ehy514

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