Direct Comparison of Cardiac Troponin T and I Using a Uniform and a Sex-Specific Approach in the Detection of Functionally Relevant Coronary Artery Disease
Standard
Direct Comparison of Cardiac Troponin T and I Using a Uniform and a Sex-Specific Approach in the Detection of Functionally Relevant Coronary Artery Disease. / Mueller, Deborah; Puelacher, Christian; Honegger, Ursina; Walter, Joan E; Badertscher, Patrick; Schaerli, Nicolas; Strebel, Ivo; Twerenbold, Raphael; Boeddinghaus, Jasper; Nestelberger, Thomas; Hollenstein, Christina; du Fay de Lavallaz, Jeanne; Jeger, Raban; Kaiser, Christoph; Wild, Damian; Rentsch, Katharina; Buser, Andreas; Zellweger, Michael; Reichlin, Tobias; Mueller, Christian.
in: CLIN CHEM, Jahrgang 64, Nr. 11, 11.2018, S. 1596-1606.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Direct Comparison of Cardiac Troponin T and I Using a Uniform and a Sex-Specific Approach in the Detection of Functionally Relevant Coronary Artery Disease
AU - Mueller, Deborah
AU - Puelacher, Christian
AU - Honegger, Ursina
AU - Walter, Joan E
AU - Badertscher, Patrick
AU - Schaerli, Nicolas
AU - Strebel, Ivo
AU - Twerenbold, Raphael
AU - Boeddinghaus, Jasper
AU - Nestelberger, Thomas
AU - Hollenstein, Christina
AU - du Fay de Lavallaz, Jeanne
AU - Jeger, Raban
AU - Kaiser, Christoph
AU - Wild, Damian
AU - Rentsch, Katharina
AU - Buser, Andreas
AU - Zellweger, Michael
AU - Reichlin, Tobias
AU - Mueller, Christian
N1 - © 2018 American Association for Clinical Chemistry.
PY - 2018/11
Y1 - 2018/11
N2 - BACKGROUND: We aimed to directly compare high-sensitivity cardiac troponin I (hs-cTnI) and high-sensitivity cardiac troponin T (hs-cTnT) in the detection of functionally relevant coronary artery disease (fCAD).METHODS: Consecutive patients referred with clinical suspicion of fCAD and no structural heart disease other than coronary artery disease were included. The presence of fCAD was based on rest/stress myocardial perfusion single-photon emission computed tomography/computed tomography and coronary angiography. hs-cTnI and hs-cTnT concentrations were measured in a blinded fashion. Diagnostic accuracy was quantified using the area under the ROC curve (AUC) and evaluated both for uniform use in all patients and for sex-specific use in women and men separately. The prognostic end point was major adverse cardiac events (MACEs; cardiovascular death or myocardial infarction) within 2 years. For the prognostic performance, we used a multivariable model comparison with the Akaike information criterion (AIC).RESULTS: fCAD was detected in 613 of 2062 patients (29.7%) overall, 112 of 664 of women (16.9%), and 501 of 1398 of men (35.8%). hs-cTnI and hs-cTnT had comparable diagnostic accuracy when assessed for uniform use in all patients (AUC, 0.68 vs 0.66; P = 0.107) and separately in women (AUC, 0.68 vs 0.63; P = 0.068) and men (AUC, 0.65 vs 0.64; P = 0.475). However, women required lower rule-out cutoffs to achieve high sensitivity, and men needed higher rule-in cutoffs to achieve high specificity. hs-cTnI and hs-cTnT were strongly and independently associated with MACE within 2 years (P < 0.001), with comparable prognostic accuracies by the AIC.CONCLUSIONS: hs-cTnI and hs-cTnT provide moderate and comparable diagnostic accuracy. Sex-specific cutoffs may be preferred. The prognostic utility of both troponins is comparable.
AB - BACKGROUND: We aimed to directly compare high-sensitivity cardiac troponin I (hs-cTnI) and high-sensitivity cardiac troponin T (hs-cTnT) in the detection of functionally relevant coronary artery disease (fCAD).METHODS: Consecutive patients referred with clinical suspicion of fCAD and no structural heart disease other than coronary artery disease were included. The presence of fCAD was based on rest/stress myocardial perfusion single-photon emission computed tomography/computed tomography and coronary angiography. hs-cTnI and hs-cTnT concentrations were measured in a blinded fashion. Diagnostic accuracy was quantified using the area under the ROC curve (AUC) and evaluated both for uniform use in all patients and for sex-specific use in women and men separately. The prognostic end point was major adverse cardiac events (MACEs; cardiovascular death or myocardial infarction) within 2 years. For the prognostic performance, we used a multivariable model comparison with the Akaike information criterion (AIC).RESULTS: fCAD was detected in 613 of 2062 patients (29.7%) overall, 112 of 664 of women (16.9%), and 501 of 1398 of men (35.8%). hs-cTnI and hs-cTnT had comparable diagnostic accuracy when assessed for uniform use in all patients (AUC, 0.68 vs 0.66; P = 0.107) and separately in women (AUC, 0.68 vs 0.63; P = 0.068) and men (AUC, 0.65 vs 0.64; P = 0.475). However, women required lower rule-out cutoffs to achieve high sensitivity, and men needed higher rule-in cutoffs to achieve high specificity. hs-cTnI and hs-cTnT were strongly and independently associated with MACE within 2 years (P < 0.001), with comparable prognostic accuracies by the AIC.CONCLUSIONS: hs-cTnI and hs-cTnT provide moderate and comparable diagnostic accuracy. Sex-specific cutoffs may be preferred. The prognostic utility of both troponins is comparable.
KW - Area Under Curve
KW - Biomarkers/blood
KW - Coronary Angiography
KW - Coronary Artery Disease/blood
KW - Early Diagnosis
KW - Female
KW - Humans
KW - Male
KW - Prognosis
KW - Prospective Studies
KW - Sensitivity and Specificity
KW - Sex Factors
KW - Single Photon Emission Computed Tomography Computed Tomography
KW - Troponin I/blood
KW - Troponin T/blood
U2 - 10.1373/clinchem.2018.286971
DO - 10.1373/clinchem.2018.286971
M3 - SCORING: Journal article
C2 - 30097496
VL - 64
SP - 1596
EP - 1606
JO - CLIN CHEM
JF - CLIN CHEM
SN - 0009-9147
IS - 11
ER -
