Comparison of the performances of cardiac troponins, including sensitive assays, and copeptin in the diagnostic of acute myocardial infarction and long-term prognosis between women and men
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Comparison of the performances of cardiac troponins, including sensitive assays, and copeptin in the diagnostic of acute myocardial infarction and long-term prognosis between women and men. / Balmelli, Cathrin; Meune, Christophe; Twerenbold, Raphael; Reichlin, Tobias; Rieder, Simone; Drexler, Beatrice; Rubini, Maria Gimenez; Mosimann, Tamina; Reiter, Miriam; Haaf, Philip; Mueller, Mira; Ernst, Susanne; Ballarino, Paola; Alafify, Azza A.; Zellweger, Christa; Wildi, Karin; Moehring, Berit; Vilaplana, Carles; Bernhard, Denise; Merk, Salome; Ebmeyer, Stefan; Freidank, Heike; Osswald, Stefan; Mueller, Christian.
in: AM HEART J, Jahrgang 166, Nr. 1, 07.2013, S. 30-37.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Comparison of the performances of cardiac troponins, including sensitive assays, and copeptin in the diagnostic of acute myocardial infarction and long-term prognosis between women and men
AU - Balmelli, Cathrin
AU - Meune, Christophe
AU - Twerenbold, Raphael
AU - Reichlin, Tobias
AU - Rieder, Simone
AU - Drexler, Beatrice
AU - Rubini, Maria Gimenez
AU - Mosimann, Tamina
AU - Reiter, Miriam
AU - Haaf, Philip
AU - Mueller, Mira
AU - Ernst, Susanne
AU - Ballarino, Paola
AU - Alafify, Azza A.
AU - Zellweger, Christa
AU - Wildi, Karin
AU - Moehring, Berit
AU - Vilaplana, Carles
AU - Bernhard, Denise
AU - Merk, Salome
AU - Ebmeyer, Stefan
AU - Freidank, Heike
AU - Osswald, Stefan
AU - Mueller, Christian
N1 - Funding Information: This study was supported by grants from the Swiss National Science Foundation, the Swiss Heart Foundation, Abbott, BRAHMS, Roche, Siemens, and the Department of Internal Medicine, University Hospital Basel. The cTn assays were donated by their respective manufacturers.
PY - 2013/7
Y1 - 2013/7
N2 - Background Concerns have been raised about possible gender disparities in cardiac investigations and/or outcome. This study sought to examine and compare the diagnostic and prognostic performance of selected cardiac biomarkers in women versus men. Methods In a prospective, multicenter cohort of patients with acute chest pain cardiac troponin T (cTnT) (fourth-generation Roche assay), high-sensitivity cTnT (hs-cTnT), and copeptin were measured at presentation. Results Of 1,247 patients, 420 were women and 827 were men. Although the rate of acute myocardial infarction was similar in women (14.5%) and men (16.6%, P =.351), women more frequently had cardiac but noncoronary causes of chest pain (17.4% vs 10.8%, P =.001) and less frequently had unstable angina (8.8% vs 16.6%, P =.002) than men. Diagnostic accuracy as quantified by the area under the receiver operating characteristic curve (AUC) for acute myocardial infarction in women was 0.90 (95% CI 0.84-0.95) for cTnT, which was lower than the AUC for hs-cTnT alone (0.94, 95% CI [0.91-0.98]), the combination of cTnT with copeptin (0.96, 95% CI [0.94-0.98]) or the combination of hs-cTnT with copeptin (0.96, 95% CI [0.93-0.98]) (P =.008, P =.006, and P =.002, respectively). Prognostic accuracy as quantified by the AUCs for 1-year mortality was 0.69 (0.56-0.83), 0.86 (0.79-0.93), 0.87 (0.81-0.94), and 0.87 (0.80-0.94), respectively. No relevant gender differences in AUCs were observed. Conclusion The diagnostic and prognostic performance of cTnT, hs-cTnT, and copeptin is as good in women as in men. High-sensitivity cTnT and the combination of cTnT and copeptin outperform cTnT alone, both in women and men.
AB - Background Concerns have been raised about possible gender disparities in cardiac investigations and/or outcome. This study sought to examine and compare the diagnostic and prognostic performance of selected cardiac biomarkers in women versus men. Methods In a prospective, multicenter cohort of patients with acute chest pain cardiac troponin T (cTnT) (fourth-generation Roche assay), high-sensitivity cTnT (hs-cTnT), and copeptin were measured at presentation. Results Of 1,247 patients, 420 were women and 827 were men. Although the rate of acute myocardial infarction was similar in women (14.5%) and men (16.6%, P =.351), women more frequently had cardiac but noncoronary causes of chest pain (17.4% vs 10.8%, P =.001) and less frequently had unstable angina (8.8% vs 16.6%, P =.002) than men. Diagnostic accuracy as quantified by the area under the receiver operating characteristic curve (AUC) for acute myocardial infarction in women was 0.90 (95% CI 0.84-0.95) for cTnT, which was lower than the AUC for hs-cTnT alone (0.94, 95% CI [0.91-0.98]), the combination of cTnT with copeptin (0.96, 95% CI [0.94-0.98]) or the combination of hs-cTnT with copeptin (0.96, 95% CI [0.93-0.98]) (P =.008, P =.006, and P =.002, respectively). Prognostic accuracy as quantified by the AUCs for 1-year mortality was 0.69 (0.56-0.83), 0.86 (0.79-0.93), 0.87 (0.81-0.94), and 0.87 (0.80-0.94), respectively. No relevant gender differences in AUCs were observed. Conclusion The diagnostic and prognostic performance of cTnT, hs-cTnT, and copeptin is as good in women as in men. High-sensitivity cTnT and the combination of cTnT and copeptin outperform cTnT alone, both in women and men.
UR - http://www.scopus.com/inward/record.url?scp=84879788026&partnerID=8YFLogxK
U2 - 10.1016/j.ahj.2013.03.014
DO - 10.1016/j.ahj.2013.03.014
M3 - SCORING: Journal article
C2 - 23816018
AN - SCOPUS:84879788026
VL - 166
SP - 30
EP - 37
JO - AM HEART J
JF - AM HEART J
SN - 0002-8703
IS - 1
ER -
