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Comparison of a 3-hour versus a 6-hour sampling-protocol using high-sensitivity cardiac troponin T for rule-out and rule-in of non-STEMI in an unselected emergency department population

Standard

Comparison of a 3-hour versus a 6-hour sampling-protocol using high-sensitivity cardiac troponin T for rule-out and rule-in of non-STEMI in an unselected emergency department population. / Biener, Moritz; Mueller, Matthias; Vafaie, Mehrshad; Keller, Till; Blankenberg, Stefan; White, Harvey D; Katus, Hugo A; Giannitsis, Evangelos.

in: INT J CARDIOL, Jahrgang 167, Nr. 4, 20.08.2013, S. 1134-1140.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Biener, M, Mueller, M, Vafaie, M, Keller, T, Blankenberg, S, White, HD, Katus, HA & Giannitsis, E 2013, 'Comparison of a 3-hour versus a 6-hour sampling-protocol using high-sensitivity cardiac troponin T for rule-out and rule-in of non-STEMI in an unselected emergency department population', INT J CARDIOL, Jg. 167, Nr. 4, S. 1134-1140. https://doi.org/10.1016/j.ijcard.2012.09.122

APA

Biener, M., Mueller, M., Vafaie, M., Keller, T., Blankenberg, S., White, H. D., Katus, H. A., & Giannitsis, E. (2013). Comparison of a 3-hour versus a 6-hour sampling-protocol using high-sensitivity cardiac troponin T for rule-out and rule-in of non-STEMI in an unselected emergency department population. INT J CARDIOL, 167(4), 1134-1140. https://doi.org/10.1016/j.ijcard.2012.09.122

Vancouver

Biener M, Mueller M, Vafaie M, Keller T, Blankenberg S, White HD et al. Comparison of a 3-hour versus a 6-hour sampling-protocol using high-sensitivity cardiac troponin T for rule-out and rule-in of non-STEMI in an unselected emergency department population. INT J CARDIOL. 2013 Aug 20;167(4):1134-1140. https://doi.org/10.1016/j.ijcard.2012.09.122

Bibtex

@article{2580a65d1aa74dd89a46f3d90b083e9a,
title = "Comparison of a 3-hour versus a 6-hour sampling-protocol using high-sensitivity cardiac troponin T for rule-out and rule-in of non-STEMI in an unselected emergency department population",
abstract = "BACKGROUND: Current European guidelines recommend the use of sensitive or high-sensitivity cardiac troponin assays to reduce the minimal sampling interval from 6 to 3h.METHODS: We compared a 3-hour versus a 6-hour protocol for diagnosis of non-STEMI and used the 99th percentile for rule-out, and relative and absolute concentration changes for rule-in of non-STEMI.RESULTS: 459 patients with either an NSTE-ACS or elevated hs-cTnT not due to MI and hs-cTnT measurements at 0, 3 and 6h were enrolled. Among the 404 patients excluded due to an incomplete sampling protocol performance was comparable to the 459 patients with a complete sampling protocol (AUC 0.79 vs 0.80, p=ns). In the study group, non-STEMI was diagnosed in 111 cases (24.2%) and elevated hs-cTnT not due to MI was observed in 215 cases (46.8%). For rule-out of non-STEMI, NPVs were 94.9%, 98.7% and 100% on admission, at 3 and 6h with comparable performance at 3 and 6h (AUC 0.782 vs 0.790, p=ns). For rule-in a 3-hour protocol performed as well as a 6-hour protocol, with a significantly (p<0.0001) better performance of absolute (AUC 0.851 vs. 0.845, p=0.740) as compared to relative concentration changes (AUC 0.771 vs. 0.739, p=0.169).CONCLUSIONS: Rule-in and rule-out of non-STEMI may be accomplished comparably effective at 3 or 6h. For rule-in, absolute kinetic changes perform better than relative changes at all time points. ROC-optimal absolute δ-change was 6.95 ng/L at 3h and 8.9 ng/L at 6h.",
keywords = "Aged, Aged, 80 and over, Biomarkers/blood, Cardiovascular Diseases/blood, Cohort Studies, Emergency Medical Services/standards, Emergency Service, Hospital/standards, Female, Humans, Male, Middle Aged, Specimen Handling/standards, Time Factors, Troponin T/blood",
author = "Moritz Biener and Matthias Mueller and Mehrshad Vafaie and Till Keller and Stefan Blankenberg and White, {Harvey D} and Katus, {Hugo A} and Evangelos Giannitsis",
note = "Copyright {\textcopyright} 2012 Elsevier Ireland Ltd. All rights reserved.",
year = "2013",
month = aug,
day = "20",
doi = "10.1016/j.ijcard.2012.09.122",
language = "English",
volume = "167",
pages = "1134--1140",
journal = "INT J CARDIOL",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",
number = "4",

}

RIS

TY - JOUR

T1 - Comparison of a 3-hour versus a 6-hour sampling-protocol using high-sensitivity cardiac troponin T for rule-out and rule-in of non-STEMI in an unselected emergency department population

AU - Biener, Moritz

AU - Mueller, Matthias

AU - Vafaie, Mehrshad

AU - Keller, Till

AU - Blankenberg, Stefan

AU - White, Harvey D

AU - Katus, Hugo A

AU - Giannitsis, Evangelos

N1 - Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

PY - 2013/8/20

Y1 - 2013/8/20

N2 - BACKGROUND: Current European guidelines recommend the use of sensitive or high-sensitivity cardiac troponin assays to reduce the minimal sampling interval from 6 to 3h.METHODS: We compared a 3-hour versus a 6-hour protocol for diagnosis of non-STEMI and used the 99th percentile for rule-out, and relative and absolute concentration changes for rule-in of non-STEMI.RESULTS: 459 patients with either an NSTE-ACS or elevated hs-cTnT not due to MI and hs-cTnT measurements at 0, 3 and 6h were enrolled. Among the 404 patients excluded due to an incomplete sampling protocol performance was comparable to the 459 patients with a complete sampling protocol (AUC 0.79 vs 0.80, p=ns). In the study group, non-STEMI was diagnosed in 111 cases (24.2%) and elevated hs-cTnT not due to MI was observed in 215 cases (46.8%). For rule-out of non-STEMI, NPVs were 94.9%, 98.7% and 100% on admission, at 3 and 6h with comparable performance at 3 and 6h (AUC 0.782 vs 0.790, p=ns). For rule-in a 3-hour protocol performed as well as a 6-hour protocol, with a significantly (p<0.0001) better performance of absolute (AUC 0.851 vs. 0.845, p=0.740) as compared to relative concentration changes (AUC 0.771 vs. 0.739, p=0.169).CONCLUSIONS: Rule-in and rule-out of non-STEMI may be accomplished comparably effective at 3 or 6h. For rule-in, absolute kinetic changes perform better than relative changes at all time points. ROC-optimal absolute δ-change was 6.95 ng/L at 3h and 8.9 ng/L at 6h.

AB - BACKGROUND: Current European guidelines recommend the use of sensitive or high-sensitivity cardiac troponin assays to reduce the minimal sampling interval from 6 to 3h.METHODS: We compared a 3-hour versus a 6-hour protocol for diagnosis of non-STEMI and used the 99th percentile for rule-out, and relative and absolute concentration changes for rule-in of non-STEMI.RESULTS: 459 patients with either an NSTE-ACS or elevated hs-cTnT not due to MI and hs-cTnT measurements at 0, 3 and 6h were enrolled. Among the 404 patients excluded due to an incomplete sampling protocol performance was comparable to the 459 patients with a complete sampling protocol (AUC 0.79 vs 0.80, p=ns). In the study group, non-STEMI was diagnosed in 111 cases (24.2%) and elevated hs-cTnT not due to MI was observed in 215 cases (46.8%). For rule-out of non-STEMI, NPVs were 94.9%, 98.7% and 100% on admission, at 3 and 6h with comparable performance at 3 and 6h (AUC 0.782 vs 0.790, p=ns). For rule-in a 3-hour protocol performed as well as a 6-hour protocol, with a significantly (p<0.0001) better performance of absolute (AUC 0.851 vs. 0.845, p=0.740) as compared to relative concentration changes (AUC 0.771 vs. 0.739, p=0.169).CONCLUSIONS: Rule-in and rule-out of non-STEMI may be accomplished comparably effective at 3 or 6h. For rule-in, absolute kinetic changes perform better than relative changes at all time points. ROC-optimal absolute δ-change was 6.95 ng/L at 3h and 8.9 ng/L at 6h.

KW - Aged

KW - Aged, 80 and over

KW - Biomarkers/blood

KW - Cardiovascular Diseases/blood

KW - Cohort Studies

KW - Emergency Medical Services/standards

KW - Emergency Service, Hospital/standards

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Specimen Handling/standards

KW - Time Factors

KW - Troponin T/blood

U2 - 10.1016/j.ijcard.2012.09.122

DO - 10.1016/j.ijcard.2012.09.122

M3 - SCORING: Journal article

C2 - 23063209

VL - 167

SP - 1134

EP - 1140

JO - INT J CARDIOL

JF - INT J CARDIOL

SN - 0167-5273

IS - 4

ER -