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Sökning: onr:"swepub:oai:DiVA.org:uu-357270" > Adjusted Troponin I...

Adjusted Troponin I for Improved Evaluation of Patients with Chest Pain

Boeckel, Jes-Niels (författare)
Goethe Univ Frankfurt, Univ Hosp, Dept Internal Med 3, Cardiol, Frankfurt, Germany;German Ctr Cardiovasc Dis DZHK, Berlin, Germany;Goethe Univ Frankfurt, Ctr Mol Med, Inst Cardiovasc Regenerat, Frankfurt, Germany;Univ Hosp Leipzig, Dept Internal Med, Cardiol, Leipzig, Germany
Palapies, Lars (författare)
Goethe Univ Frankfurt, Univ Hosp, Dept Internal Med 3, Cardiol, Frankfurt, Germany
Klotsche, Jens (författare)
Tech Univ Dresden, Clin Psychol & Psychotherapy, Dresden, Germany
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Zeller, Tanja (författare)
German Ctr Cardiovasc Dis DZHK, Berlin, Germany;Univ Heart Ctr Hamburg, Clin Gen & Intervent Cardiol, Hamburg, Germany
von Jeinsen, Beatrice (författare)
Goethe Univ Frankfurt, Univ Hosp, Dept Internal Med 3, Cardiol, Frankfurt, Germany;German Ctr Cardiovasc Dis DZHK, Berlin, Germany
Perret, Maya F. (författare)
Goethe Univ Frankfurt, Univ Hosp, Dept Internal Med 3, Cardiol, Frankfurt, Germany
Kleinhaus, Soeren L. (författare)
Goethe Univ Frankfurt, Ctr Mol Med, Inst Cardiovasc Regenerat, Frankfurt, Germany
Pieper, Lars (författare)
Tech Univ Dresden, Clin Psychol & Psychotherapy, Dresden, Germany
Tzikas, Stergios (författare)
Aristotle Univ Thessaloniki, Ippokrateio Hosp, Dept Cardiol 3, Thessaloniki, Greece;Johannes Gutenberg Univ Mainz, Univ Med Ctr, Dept Med 2, Mainz, Germany
Leistner, David (författare)
Goethe Univ Frankfurt, Univ Hosp, Dept Internal Med 3, Cardiol, Frankfurt, Germany;German Ctr Cardiovasc Dis DZHK, Berlin, Germany
Bickel, Christoph (författare)
Fed Armed Forces Hosp, Dept Internal Med, Koblenz, Germany
Stalla, Guenter K. (författare)
Max Planck Inst Psychiat, Neuroendocrinol, Munich, Germany
Lehnert, Hendrik (författare)
Univ Hosp Schleswig Holstein, Dept Internal Med 1, Lubeck, Germany
Lindahl, Bertil, 1957- (författare)
Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
Wittchen, Hans-Ulrich (författare)
Tech Univ Dresden, Clin Psychol & Psychotherapy, Dresden, Germany
Silber, Sigmund (författare)
Praxisklin, Kardiol Gemeinschaftspraxis, Munich, Germany
Baldus, Stephan (författare)
Univ Heart Ctr Hamburg, Clin Gen & Intervent Cardiol, Hamburg, Germany;Univ Cologne, Heart Ctr, Cologne, Germany
Maerz, Winfried (författare)
Synlab Serv GmbH, Synlab Akad Arztl Fortbildung, Mannheim, Germany
Dimmeler, Stefanie (författare)
German Ctr Cardiovasc Dis DZHK, Berlin, Germany;Goethe Univ Frankfurt, Ctr Mol Med, Inst Cardiovasc Regenerat, Frankfurt, Germany
Blankenberg, Stefan (författare)
German Ctr Cardiovasc Dis DZHK, Berlin, Germany;Univ Heart Ctr Hamburg, Clin Gen & Intervent Cardiol, Hamburg, Germany
Muenzel, Thomas (författare)
German Ctr Cardiovasc Dis DZHK, Berlin, Germany;Johannes Gutenberg Univ Mainz, Univ Med Ctr, Dept Med 2, Mainz, Germany
Zeiher, Andreas M. (författare)
Goethe Univ Frankfurt, Univ Hosp, Dept Internal Med 3, Cardiol, Frankfurt, Germany;German Ctr Cardiovasc Dis DZHK, Berlin, Germany
Keller, Till (författare)
Goethe Univ Frankfurt, Univ Hosp, Dept Internal Med 3, Cardiol, Frankfurt, Germany;German Ctr Cardiovasc Dis DZHK, Berlin, Germany;Kerckhoff Heart & Thorax Ctr, Bad Nauheim, Germany
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 (creator_code:org_t)
NATURE PUBLISHING GROUP, 2018
2018
Engelska.
Ingår i: Scientific Reports. - : NATURE PUBLISHING GROUP. - 2045-2322. ; 8
Relaterad länk:
https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
https://urn.kb.se/re...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • The use of cardiac troponins (cTn) is the gold standard for diagnosing myocardial infarction. Independent of myocardial infarction (MI), however, sex, age and kidney function affect cTn levels. Here we developed a method to adjust cTnI levels for age, sex, and renal function, maintaining a unified cut-off value such as the 99th percentile. A total of 4587 individuals enrolled in a prospective longitudinal study were used to develop a model for adjustment of cTn. cTnI levels correlated with age and estimated glomerular filtration rate (eGFR) in males/females with r(age) = 0.436/0.518 and with (r)(eGFR) = -0.142/-0.207. For adjustment, these variables served as covariates in a linear regression model with cTnl as dependent variable. This adjustment model was then applied to a real-world cohort of 1789 patients with suspected acute MI (AMI) (N = 407). Adjusting cTnI showed no relevant loss of diagnostic information, as evidenced by comparable areas under the receiver operator characteristic curves, to identify AMI in males and females for adjusted and unadjusted cTnI. In specific patients groups such as in elderly females, adjusting cTnI improved specificity for AMI compared with unadjusted cTnI. Specificity was also improved in patients with renal dysfunction by using the adjusted cTnI values. Thus, the adjustments improved the diagnostic ability of cTnI to identify AMI in elderly patients and in patients with renal dysfunction. Interpretation of cTnI values in complex emergency cases is facilitated by our method, which maintains a single diagnostic cut-off value in all patients.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

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