Early kinetics of cardiac troponin in suspected acute myocardial infarction
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Early kinetics of cardiac troponin in suspected acute myocardial infarction. / Rubini Giménez, María; Wildi, Karin; Wussler, Desiree; Koechlin, Luca; Boeddinghaus, Jasper; Nestelberger, Thomas; Badertscher, Patrick; Sedlmayer, Raphael; Puelacher, Christian; Zimmermann, Tobias; du Fay de Lavallaz, Jeanne; Lopez-Ayala, Pedro; Leu, Kathrin; Rentsch, Katharina; Miró, Òscar; López, Beatriz; Martín-Sánchez, F Javier; Bustamante, José; Kawecki, Damian; Parenica, Jiri; Lohrmann, Jens; Kloos, Wanda; Buser, Andreas; Keller, Dagmar I; Reichlin, Tobias; Twerenbold, Raphael; Mueller, Christian.
in: REV ESP CARDIOL, Jahrgang 74, Nr. 6, 06.2021, S. 502-509.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Early kinetics of cardiac troponin in suspected acute myocardial infarction
AU - Rubini Giménez, María
AU - Wildi, Karin
AU - Wussler, Desiree
AU - Koechlin, Luca
AU - Boeddinghaus, Jasper
AU - Nestelberger, Thomas
AU - Badertscher, Patrick
AU - Sedlmayer, Raphael
AU - Puelacher, Christian
AU - Zimmermann, Tobias
AU - du Fay de Lavallaz, Jeanne
AU - Lopez-Ayala, Pedro
AU - Leu, Kathrin
AU - Rentsch, Katharina
AU - Miró, Òscar
AU - López, Beatriz
AU - Martín-Sánchez, F Javier
AU - Bustamante, José
AU - Kawecki, Damian
AU - Parenica, Jiri
AU - Lohrmann, Jens
AU - Kloos, Wanda
AU - Buser, Andreas
AU - Keller, Dagmar I
AU - Reichlin, Tobias
AU - Twerenbold, Raphael
AU - Mueller, Christian
N1 - Copyright © 2020 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.
PY - 2021/6
Y1 - 2021/6
N2 - INTRODUCTION AND OBJECTIVES: Release kinetics of high-sensitivity cardiac troponin (hs-cTn) T and I in patients with acute myocardial infarction (AMI) are incompletely understood. We aimed to assess whether hs-cTnT/I release in early AMI is near linear.METHODS: In a prospective diagnostic multicenter study the acute release of hs-cTnT and hs-cTnI within 1 and 2hours from presentation to the emergency department was quantified using 3 hs-cTnT/I assays in patients with suspected AMI. The primary endpoint was correlation between hs-cTn changes from presentation to 1 hour vs changes from presentation to 2hours, among all AMI patients and different prespecified subgroups. The final diagnosis was adjudicated by 2 independent cardiologists, based on serial hs-cTnT from the serial study blood samples and additional locally measured hs-cTn values.RESULTS: Among 2437 patients with complete hs-cTnT data, AMI was the adjudicated diagnosis in 376 patients (15%). For hs-cTnT, the correlation coefficient between 0- to 1-hour change and 0- to 2 hour change was 0.931 (95%CI, 0.916-0.944), P <.001. Similar findings were obtained with hs-cTnI (Architect) with correlation coefficients between 0- to 1-hour change and 0- to 2 hour change of 0.969 and hs-cTnI (Centaur) of 0.934 (P <.001 for both). Findings were consistent among type 1 and type 2 AMI and in the subgroup of patients presenting very early after chest pain onset.CONCLUSIONS: Patients presenting with early AMI showed a near linear release of hs-cTnT and hs-cTnI. This near linearity provides the pathophysiological basis for rapid diagnostic algorithms using 0- to 1-hour changes as surrogates for 0- to 2 hour or 0- to 3 hour changes. Registered at ClinicalTrials.gov (Identifier: NCT00470587).
AB - INTRODUCTION AND OBJECTIVES: Release kinetics of high-sensitivity cardiac troponin (hs-cTn) T and I in patients with acute myocardial infarction (AMI) are incompletely understood. We aimed to assess whether hs-cTnT/I release in early AMI is near linear.METHODS: In a prospective diagnostic multicenter study the acute release of hs-cTnT and hs-cTnI within 1 and 2hours from presentation to the emergency department was quantified using 3 hs-cTnT/I assays in patients with suspected AMI. The primary endpoint was correlation between hs-cTn changes from presentation to 1 hour vs changes from presentation to 2hours, among all AMI patients and different prespecified subgroups. The final diagnosis was adjudicated by 2 independent cardiologists, based on serial hs-cTnT from the serial study blood samples and additional locally measured hs-cTn values.RESULTS: Among 2437 patients with complete hs-cTnT data, AMI was the adjudicated diagnosis in 376 patients (15%). For hs-cTnT, the correlation coefficient between 0- to 1-hour change and 0- to 2 hour change was 0.931 (95%CI, 0.916-0.944), P <.001. Similar findings were obtained with hs-cTnI (Architect) with correlation coefficients between 0- to 1-hour change and 0- to 2 hour change of 0.969 and hs-cTnI (Centaur) of 0.934 (P <.001 for both). Findings were consistent among type 1 and type 2 AMI and in the subgroup of patients presenting very early after chest pain onset.CONCLUSIONS: Patients presenting with early AMI showed a near linear release of hs-cTnT and hs-cTnI. This near linearity provides the pathophysiological basis for rapid diagnostic algorithms using 0- to 1-hour changes as surrogates for 0- to 2 hour or 0- to 3 hour changes. Registered at ClinicalTrials.gov (Identifier: NCT00470587).
KW - Biomarkers
KW - Humans
KW - Kinetics
KW - Myocardial Infarction/diagnosis
KW - Prospective Studies
KW - Troponin I
KW - Troponin T
U2 - 10.1016/j.rec.2020.04.008
DO - 10.1016/j.rec.2020.04.008
M3 - SCORING: Journal article
C2 - 32451223
VL - 74
SP - 502
EP - 509
JO - REV ESP CARDIOL
JF - REV ESP CARDIOL
SN - 1885-5857
IS - 6
ER -
