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High-sensitivity troponin and novel biomarkers for the early diagnosis of non-ST-segment elevation myocardial infarction in patients with atrial fibrillation

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High-sensitivity troponin and novel biomarkers for the early diagnosis of non-ST-segment elevation myocardial infarction in patients with atrial fibrillation. / Sörensen, Nils A; Shah, Anoop Sv; Ojeda, Francisco M; Peitsmeyer, Philipp; Zeller, Tanja; Keller, Till; Johannsen, Silke S; Lackner, Karl J; Griffiths, Megan; Münzel, Thomas; Mills, Nicholas L; Blankenberg, Stefan; Schnabel, Renate B.

in: EUR HEART J-ACUTE CA, Jahrgang 5, Nr. 6, 10.2016, S. 419-427.

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

Harvard

Sörensen, NA, Shah, AS, Ojeda, FM, Peitsmeyer, P, Zeller, T, Keller, T, Johannsen, SS, Lackner, KJ, Griffiths, M, Münzel, T, Mills, NL, Blankenberg, S & Schnabel, RB 2016, 'High-sensitivity troponin and novel biomarkers for the early diagnosis of non-ST-segment elevation myocardial infarction in patients with atrial fibrillation', EUR HEART J-ACUTE CA, Jg. 5, Nr. 6, S. 419-427. https://doi.org/10.1177/2048872615611108

APA

Sörensen, N. A., Shah, A. S., Ojeda, F. M., Peitsmeyer, P., Zeller, T., Keller, T., Johannsen, S. S., Lackner, K. J., Griffiths, M., Münzel, T., Mills, N. L., Blankenberg, S., & Schnabel, R. B. (2016). High-sensitivity troponin and novel biomarkers for the early diagnosis of non-ST-segment elevation myocardial infarction in patients with atrial fibrillation. EUR HEART J-ACUTE CA, 5(6), 419-427. https://doi.org/10.1177/2048872615611108

Vancouver

Sörensen NA, Shah AS, Ojeda FM, Peitsmeyer P, Zeller T, Keller T et al. High-sensitivity troponin and novel biomarkers for the early diagnosis of non-ST-segment elevation myocardial infarction in patients with atrial fibrillation. EUR HEART J-ACUTE CA. 2016 Okt;5(6):419-427. https://doi.org/10.1177/2048872615611108

Bibtex

@article{6c94bb2418914f6484a4664d320df2af,
title = "High-sensitivity troponin and novel biomarkers for the early diagnosis of non-ST-segment elevation myocardial infarction in patients with atrial fibrillation",
abstract = "AIMS: To evaluate the diagnostic performance of high-sensitivity troponin I (hsTnI) and other novel biomarkers for diagnosing non-ST-segment elevation myocardial infarction (NSTEMI) in patients with atrial fibrillation.METHODS: In an acute chest pain cohort (N=1673), mean age 61.4±13.6 (34% female), we measured hsTnI and 13 established and novel biomarkers reflecting ischaemia, necrosis, inflammation, myocardial stress, angiogenesis on admission and after three hours in order to investigate their diagnostic accuracy for NSTEMI.RESULTS: In atrial fibrillation patients (N=299) hsTnI on admission had the best discriminatory ability for NSTEMI (area under the curve 0.97) with only two novel biomarkers, copeptin and heart-type fatty acid binding protein, having area under the curve >0.70. Measured biomarkers showed comparable discriminatory ability in atrial fibrillation and non-atrial fibrillation patients. The combination of hsTnI on admission with additional biomarkers did not clinically significantly improve diagnostic performance. In atrial fibrillation patients, hsTnI concentrations ⩽21.7 ng/L (99th percentile in a healthy German cohort) on admission gave a negative predictive value of ~100% (95% confidence interval 97-100%). The combination of hsTnI on admission and absolute change of hsTnI concentration after three hours of ⩾40 ng/L resulted in a positive predictive value of 81.2% and sensitivity of 88.6%. Diagnostic accuracy was validated in an independent cohort (N=1076).CONCLUSION: The diagnostic accuracy of hsTnI in patients with acute chest pain and atrial fibrillation is high and comparable to those without atrial fibrillation. Absolute change in hsTnI concentration enhanced diagnostic performance. No clinically relevant improvement was achieved by adding other biomarkers.",
keywords = "Aged, Angina Pectoris/etiology, Area Under Curve, Atrial Fibrillation/blood, Biomarkers, Pharmacological/blood, Early Diagnosis, Fatty Acid Binding Protein 3, Fatty Acid-Binding Proteins/blood, Female, Glycopeptides/blood, Humans, Male, Non-ST Elevated Myocardial Infarction/diagnosis, Prospective Studies, Sensitivity and Specificity, Troponin T/blood",
author = "S{\"o}rensen, {Nils A} and Shah, {Anoop Sv} and Ojeda, {Francisco M} and Philipp Peitsmeyer and Tanja Zeller and Till Keller and Johannsen, {Silke S} and Lackner, {Karl J} and Megan Griffiths and Thomas M{\"u}nzel and Mills, {Nicholas L} and Stefan Blankenberg and Schnabel, {Renate B}",
note = "{\textcopyright} The European Society of Cardiology 2015.",
year = "2016",
month = oct,
doi = "10.1177/2048872615611108",
language = "English",
volume = "5",
pages = "419--427",
journal = "EUR HEART J-ACUTE CA",
issn = "2048-8726",
publisher = "SAGE Publications",
number = "6",

}

RIS

TY - JOUR

T1 - High-sensitivity troponin and novel biomarkers for the early diagnosis of non-ST-segment elevation myocardial infarction in patients with atrial fibrillation

AU - Sörensen, Nils A

AU - Shah, Anoop Sv

AU - Ojeda, Francisco M

AU - Peitsmeyer, Philipp

AU - Zeller, Tanja

AU - Keller, Till

AU - Johannsen, Silke S

AU - Lackner, Karl J

AU - Griffiths, Megan

AU - Münzel, Thomas

AU - Mills, Nicholas L

AU - Blankenberg, Stefan

AU - Schnabel, Renate B

N1 - © The European Society of Cardiology 2015.

PY - 2016/10

Y1 - 2016/10

N2 - AIMS: To evaluate the diagnostic performance of high-sensitivity troponin I (hsTnI) and other novel biomarkers for diagnosing non-ST-segment elevation myocardial infarction (NSTEMI) in patients with atrial fibrillation.METHODS: In an acute chest pain cohort (N=1673), mean age 61.4±13.6 (34% female), we measured hsTnI and 13 established and novel biomarkers reflecting ischaemia, necrosis, inflammation, myocardial stress, angiogenesis on admission and after three hours in order to investigate their diagnostic accuracy for NSTEMI.RESULTS: In atrial fibrillation patients (N=299) hsTnI on admission had the best discriminatory ability for NSTEMI (area under the curve 0.97) with only two novel biomarkers, copeptin and heart-type fatty acid binding protein, having area under the curve >0.70. Measured biomarkers showed comparable discriminatory ability in atrial fibrillation and non-atrial fibrillation patients. The combination of hsTnI on admission with additional biomarkers did not clinically significantly improve diagnostic performance. In atrial fibrillation patients, hsTnI concentrations ⩽21.7 ng/L (99th percentile in a healthy German cohort) on admission gave a negative predictive value of ~100% (95% confidence interval 97-100%). The combination of hsTnI on admission and absolute change of hsTnI concentration after three hours of ⩾40 ng/L resulted in a positive predictive value of 81.2% and sensitivity of 88.6%. Diagnostic accuracy was validated in an independent cohort (N=1076).CONCLUSION: The diagnostic accuracy of hsTnI in patients with acute chest pain and atrial fibrillation is high and comparable to those without atrial fibrillation. Absolute change in hsTnI concentration enhanced diagnostic performance. No clinically relevant improvement was achieved by adding other biomarkers.

AB - AIMS: To evaluate the diagnostic performance of high-sensitivity troponin I (hsTnI) and other novel biomarkers for diagnosing non-ST-segment elevation myocardial infarction (NSTEMI) in patients with atrial fibrillation.METHODS: In an acute chest pain cohort (N=1673), mean age 61.4±13.6 (34% female), we measured hsTnI and 13 established and novel biomarkers reflecting ischaemia, necrosis, inflammation, myocardial stress, angiogenesis on admission and after three hours in order to investigate their diagnostic accuracy for NSTEMI.RESULTS: In atrial fibrillation patients (N=299) hsTnI on admission had the best discriminatory ability for NSTEMI (area under the curve 0.97) with only two novel biomarkers, copeptin and heart-type fatty acid binding protein, having area under the curve >0.70. Measured biomarkers showed comparable discriminatory ability in atrial fibrillation and non-atrial fibrillation patients. The combination of hsTnI on admission with additional biomarkers did not clinically significantly improve diagnostic performance. In atrial fibrillation patients, hsTnI concentrations ⩽21.7 ng/L (99th percentile in a healthy German cohort) on admission gave a negative predictive value of ~100% (95% confidence interval 97-100%). The combination of hsTnI on admission and absolute change of hsTnI concentration after three hours of ⩾40 ng/L resulted in a positive predictive value of 81.2% and sensitivity of 88.6%. Diagnostic accuracy was validated in an independent cohort (N=1076).CONCLUSION: The diagnostic accuracy of hsTnI in patients with acute chest pain and atrial fibrillation is high and comparable to those without atrial fibrillation. Absolute change in hsTnI concentration enhanced diagnostic performance. No clinically relevant improvement was achieved by adding other biomarkers.

KW - Aged

KW - Angina Pectoris/etiology

KW - Area Under Curve

KW - Atrial Fibrillation/blood

KW - Biomarkers, Pharmacological/blood

KW - Early Diagnosis

KW - Fatty Acid Binding Protein 3

KW - Fatty Acid-Binding Proteins/blood

KW - Female

KW - Glycopeptides/blood

KW - Humans

KW - Male

KW - Non-ST Elevated Myocardial Infarction/diagnosis

KW - Prospective Studies

KW - Sensitivity and Specificity

KW - Troponin T/blood

U2 - 10.1177/2048872615611108

DO - 10.1177/2048872615611108

M3 - SCORING: Journal article

C2 - 26460326

VL - 5

SP - 419

EP - 427

JO - EUR HEART J-ACUTE CA

JF - EUR HEART J-ACUTE CA

SN - 2048-8726

IS - 6

ER -