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Diagnostic and prog...
Diagnostic and prognostic implications using age- and gender-specific cut-offs for high-sensitivity cardiac troponin T - Sub-analysis from the TRAPID-AMI study
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- Mueller-Hennessen, Matthias (författare)
- Univ Heidelberg Hosp, Dept Internal Med Cardiol Angiol & Pulmonol 3, Heidelberg, Germany.
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- Lindahl, Bertil (författare)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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- Giannitsis, Evangelos (författare)
- Univ Heidelberg Hosp, Dept Internal Med Cardiol Angiol & Pulmonol 3, Heidelberg, Germany.
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- Biener, Moritz (författare)
- Univ Heidelberg Hosp, Dept Internal Med Cardiol Angiol & Pulmonol 3, Heidelberg, Germany.
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- Vafaie, Mehrshad (författare)
- Univ Heidelberg Hosp, Dept Internal Med Cardiol Angiol & Pulmonol 3, Heidelberg, Germany.
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- deFilippi, Christopher R. (författare)
- Univ Maryland, Sch Med, Dept Med, Baltimore, MD 21201 USA.
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- Christ, Michael (författare)
- Paracelsus Med Univ, Dept Emergency & Crit Care Med, Community Hosp, Nurnberg, Germany.
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- Santalo-Bel, Miguel (författare)
- Hosp Santa Creu & Sant Pau, Semicrit Unit, Barcelona, Spain.;Inst Invest Biomed St Pau, Barcelona, Spain.
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- Panteghini, Mauro (författare)
- Univ Milan, Sch Med, Dept Biomed & Clin Sci Luigi Sacco, Milan, Italy.
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- Plebani, Mario (författare)
- Univ Hosp Padova, Dept Lab Med, Padua, Italy.
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- Verschuren, Franck (författare)
- Catholic Univ Louvain, Dept Acute Med, Clin Univ St Luc, B-1200 Brussels, Belgium.
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- Jernberg, Tomas (författare)
- Karolinska Institutet
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- French, John K. (författare)
- Univ New S Wales, Liverpool Hosp, Sydney, NSW, Australia.
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- Christenson, Robert H. (författare)
- Univ Maryland, Sch Med, Dept Pathol, Baltimore, MD 21201 USA.
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- Body, Richard (författare)
- Cent Manchester Univ Hosp NHS Fdn Trust, Manchester, Lancs, England.
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- McCord, James (författare)
- Henry Ford Hlth Syst, Henry Ford Heart & Vasc Inst, Detroit, MI USA.
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- Dilba, Peter (författare)
- Roche Diagnost Germany, Penzberg, Germany.
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- Katus, Hugo A. (författare)
- Univ Heidelberg Hosp, Dept Internal Med Cardiol Angiol & Pulmonol 3, Heidelberg, Germany.
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- Mueller, Christian (författare)
- Univ Basel Hosp, Cardiol & Cardiovasc Res Inst Basel, Basel, Switzerland.
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Univ Heidelberg Hosp, Dept Internal Med Cardiol Angiol & Pulmonol 3, Heidelberg, Germany Kardiologi (creator_code:org_t)
- Elsevier BV, 2016
- 2016
- Engelska.
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 209, s. 26-33
- Relaterad länk:
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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
- Objectives: To evaluate the impact of age-and gender-specific cut-offs for high-sensitivity cardiac troponin T (hs-cTnT) compared to the general 99th percentile hs-cTnT cut-off on diagnosis and prognosis of acute myocardial infarction (AMI).Methods: 1282 unselected patients presenting to the emergency department with suspected AMI were enrolled as part of the TRAPID-AMI study. In the present sub-analysis, reclassification of AMI diagnosis was performed by comparing the general hs-cTnT cut-off of 14 ng/L to previously proposed age-and gender-dependent hs-cTnT 99th percentile cut-offs (28 ng/L for >= 65 years, 9 ng/L for female and 15.5 ng/L for male patients). Patients were further clinically adjudicated into acute coronary syndrome (ACS) and non-ACS.Results: For patients >= 65 years, application of age-specified cut-offs resulted in a decrease of AMI from 29.8% to 18.3% in the entire cohort (n = 557) and 54.7% to 40.9% in the ACS subcohort (n = 225). Using gender-specific cut-offs, AMI-rate increased from 16.6% to 22.6% (entire cohort, n = 477) and 62.6% to 71.7% (ACS subcohort, n = 99) in women, whereas in men, rates decreased from 23.1% to 21.1% (entire cohort, n = 805) and 48.8% to 45.9% (ACS, n = 281), respectively. Age-specified cut-offs significantly reclassified patients for outcomes of 1-month and 3-month mortality in the entire and ACS cohort (14.2% net reclassification improvement, p < 0.001, respectively). Contrary, no significant differences in outcomes could be found using gender-specific cut-offs.Conclusions: While influence of gender-specific hs-cTnT cut-offs on diagnostic and prognostic reclassification was only modest in patients with suspected AMI, age-specific cut-offs showed a significant impact and may be considered for further validation.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- Age
- Gender
- AMI
- High-sensitivity cardiac Troponin T
- 99th percentile
- Diagnosis
- Prognosis
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Mueller-Hennesse ...
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Lindahl, Bertil
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Giannitsis, Evan ...
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Biener, Moritz
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Vafaie, Mehrshad
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deFilippi, Chris ...
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Christ, Michael
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Santalo-Bel, Mig ...
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Panteghini, Maur ...
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Plebani, Mario
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Verschuren, Fran ...
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Jernberg, Tomas
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French, John K.
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Christenson, Rob ...
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Body, Richard
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McCord, James
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Dilba, Peter
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Katus, Hugo A.
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Mueller, Christi ...
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