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Normal presenting levels of high-sensitivity troponin and myocardial infarction

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Normal presenting levels of high-sensitivity troponin and myocardial infarction. / Hoeller, Rebeca; Giménez, María Rubini; Reichlin, Tobias; Twerenbold, Raphael; Zellweger, Christa; Moehring, Berit; Wildi, Karin; Freese, Michael; Stelzig, Claudia; Hartmann, Beate; Stoll, Melanie; Mosimann, Tamina; Reiter, Miriam; Haaf, Philip; Mueller, Mira; Meller, Bernadette; Hochgruber, Thomas; Balmelli, Cathrin; Sou, Seoung Mann; Murray, Karsten; Freidank, Heike; Steuer, Stephan; Minners, Jan; Osswald, Stefan; Mueller, Christian.

in: HEART, Jahrgang 99, Nr. 21, 11.2013, S. 1567-1572.

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

Harvard

Hoeller, R, Giménez, MR, Reichlin, T, Twerenbold, R, Zellweger, C, Moehring, B, Wildi, K, Freese, M, Stelzig, C, Hartmann, B, Stoll, M, Mosimann, T, Reiter, M, Haaf, P, Mueller, M, Meller, B, Hochgruber, T, Balmelli, C, Sou, SM, Murray, K, Freidank, H, Steuer, S, Minners, J, Osswald, S & Mueller, C 2013, 'Normal presenting levels of high-sensitivity troponin and myocardial infarction', HEART, Jg. 99, Nr. 21, S. 1567-1572. https://doi.org/10.1136/heartjnl-2013-303643

APA

Hoeller, R., Giménez, M. R., Reichlin, T., Twerenbold, R., Zellweger, C., Moehring, B., Wildi, K., Freese, M., Stelzig, C., Hartmann, B., Stoll, M., Mosimann, T., Reiter, M., Haaf, P., Mueller, M., Meller, B., Hochgruber, T., Balmelli, C., Sou, S. M., ... Mueller, C. (2013). Normal presenting levels of high-sensitivity troponin and myocardial infarction. HEART, 99(21), 1567-1572. https://doi.org/10.1136/heartjnl-2013-303643

Vancouver

Hoeller R, Giménez MR, Reichlin T, Twerenbold R, Zellweger C, Moehring B et al. Normal presenting levels of high-sensitivity troponin and myocardial infarction. HEART. 2013 Nov;99(21):1567-1572. https://doi.org/10.1136/heartjnl-2013-303643

Bibtex

@article{b8d876a79e02498a8a91375262e1385a,
title = "Normal presenting levels of high-sensitivity troponin and myocardial infarction",
abstract = "Objective To analyse whether levels of high-sensitivity cardiac troponin (hs-cTn) below their respective 99th percentile can be used as a single parameter to rule out acute myocardial infarction (AMI) at presentation. Design Prospective, multicentre study. Main outcome measures We measured hs-cTn using four different methods (hs-cTnT Roche, hs-cTnI Siemens, hs-cTnI Beckman Coulter and hs-cTnI Abbott) in consecutive patients presenting to the emergency department with acute chest pain. Two independent cardiologists adjudicated the final diagnosis. Patients were followed for death or AMI during a mean period of 24 months. Results Among 2072 consecutive patients with hs-cTnT measurements available, 21.4% had an adjudicated diagnosis of AMI (sensitivity 89.6%, 95% CI 86.4% to 92.3%, negative predictive value (NPV): 96.5%, 95% CI 95.4% to 97.4%). Among 1180 consecutive patients with hs-cTnI Siemens measurements available, 20.0% had AMI (sensitivity 94.1%, 95% CI 90.3% to 96.7%, NPV: 98.0%, 95% CI: 96.6% to 98.9%). Among 1151 consecutive patients with hs-cTnI Beckman Coulter measurements available, 19.7% had AMI (sensitivity 92.1%, 95% CI 87.8% to 95.2%, NPV: 97.5%, 95% CI 96.0% to 98.5%). Among 1567 consecutive patients with hs-cTnI Abbott measurements available, 20.0% had AMI (sensitivity 77.2%, 95% CI 72.1% to 81.7%, NPV: 94.3%, 95% CI 92.8% to 95.5%). Conclusions Normal hs-cTn levels at presentation should not be used as a single parameter to rule out AMI as 6%-23% of adjudicated AMI cases had normal levels of hs-cTn levels at presentation. Our data highlight the lack of standardisation among hs-cTnI assays resulting in substantial differences in sensitivity and NPV at the 99th percentile.",
author = "Rebeca Hoeller and Gim{\'e}nez, {Mar{\'i}a Rubini} and Tobias Reichlin and Raphael Twerenbold and Christa Zellweger and Berit Moehring and Karin Wildi and Michael Freese and Claudia Stelzig and Beate Hartmann and Melanie Stoll and Tamina Mosimann and Miriam Reiter and Philip Haaf and Mira Mueller and Bernadette Meller and Thomas Hochgruber and Cathrin Balmelli and Sou, {Seoung Mann} and Karsten Murray and Heike Freidank and Stephan Steuer and Jan Minners and Stefan Osswald and Christian Mueller",
year = "2013",
month = nov,
doi = "10.1136/heartjnl-2013-303643",
language = "English",
volume = "99",
pages = "1567--1572",
journal = "HEART",
issn = "1355-6037",
publisher = "BMJ PUBLISHING GROUP",
number = "21",

}

RIS

TY - JOUR

T1 - Normal presenting levels of high-sensitivity troponin and myocardial infarction

AU - Hoeller, Rebeca

AU - Giménez, María Rubini

AU - Reichlin, Tobias

AU - Twerenbold, Raphael

AU - Zellweger, Christa

AU - Moehring, Berit

AU - Wildi, Karin

AU - Freese, Michael

AU - Stelzig, Claudia

AU - Hartmann, Beate

AU - Stoll, Melanie

AU - Mosimann, Tamina

AU - Reiter, Miriam

AU - Haaf, Philip

AU - Mueller, Mira

AU - Meller, Bernadette

AU - Hochgruber, Thomas

AU - Balmelli, Cathrin

AU - Sou, Seoung Mann

AU - Murray, Karsten

AU - Freidank, Heike

AU - Steuer, Stephan

AU - Minners, Jan

AU - Osswald, Stefan

AU - Mueller, Christian

PY - 2013/11

Y1 - 2013/11

N2 - Objective To analyse whether levels of high-sensitivity cardiac troponin (hs-cTn) below their respective 99th percentile can be used as a single parameter to rule out acute myocardial infarction (AMI) at presentation. Design Prospective, multicentre study. Main outcome measures We measured hs-cTn using four different methods (hs-cTnT Roche, hs-cTnI Siemens, hs-cTnI Beckman Coulter and hs-cTnI Abbott) in consecutive patients presenting to the emergency department with acute chest pain. Two independent cardiologists adjudicated the final diagnosis. Patients were followed for death or AMI during a mean period of 24 months. Results Among 2072 consecutive patients with hs-cTnT measurements available, 21.4% had an adjudicated diagnosis of AMI (sensitivity 89.6%, 95% CI 86.4% to 92.3%, negative predictive value (NPV): 96.5%, 95% CI 95.4% to 97.4%). Among 1180 consecutive patients with hs-cTnI Siemens measurements available, 20.0% had AMI (sensitivity 94.1%, 95% CI 90.3% to 96.7%, NPV: 98.0%, 95% CI: 96.6% to 98.9%). Among 1151 consecutive patients with hs-cTnI Beckman Coulter measurements available, 19.7% had AMI (sensitivity 92.1%, 95% CI 87.8% to 95.2%, NPV: 97.5%, 95% CI 96.0% to 98.5%). Among 1567 consecutive patients with hs-cTnI Abbott measurements available, 20.0% had AMI (sensitivity 77.2%, 95% CI 72.1% to 81.7%, NPV: 94.3%, 95% CI 92.8% to 95.5%). Conclusions Normal hs-cTn levels at presentation should not be used as a single parameter to rule out AMI as 6%-23% of adjudicated AMI cases had normal levels of hs-cTn levels at presentation. Our data highlight the lack of standardisation among hs-cTnI assays resulting in substantial differences in sensitivity and NPV at the 99th percentile.

AB - Objective To analyse whether levels of high-sensitivity cardiac troponin (hs-cTn) below their respective 99th percentile can be used as a single parameter to rule out acute myocardial infarction (AMI) at presentation. Design Prospective, multicentre study. Main outcome measures We measured hs-cTn using four different methods (hs-cTnT Roche, hs-cTnI Siemens, hs-cTnI Beckman Coulter and hs-cTnI Abbott) in consecutive patients presenting to the emergency department with acute chest pain. Two independent cardiologists adjudicated the final diagnosis. Patients were followed for death or AMI during a mean period of 24 months. Results Among 2072 consecutive patients with hs-cTnT measurements available, 21.4% had an adjudicated diagnosis of AMI (sensitivity 89.6%, 95% CI 86.4% to 92.3%, negative predictive value (NPV): 96.5%, 95% CI 95.4% to 97.4%). Among 1180 consecutive patients with hs-cTnI Siemens measurements available, 20.0% had AMI (sensitivity 94.1%, 95% CI 90.3% to 96.7%, NPV: 98.0%, 95% CI: 96.6% to 98.9%). Among 1151 consecutive patients with hs-cTnI Beckman Coulter measurements available, 19.7% had AMI (sensitivity 92.1%, 95% CI 87.8% to 95.2%, NPV: 97.5%, 95% CI 96.0% to 98.5%). Among 1567 consecutive patients with hs-cTnI Abbott measurements available, 20.0% had AMI (sensitivity 77.2%, 95% CI 72.1% to 81.7%, NPV: 94.3%, 95% CI 92.8% to 95.5%). Conclusions Normal hs-cTn levels at presentation should not be used as a single parameter to rule out AMI as 6%-23% of adjudicated AMI cases had normal levels of hs-cTn levels at presentation. Our data highlight the lack of standardisation among hs-cTnI assays resulting in substantial differences in sensitivity and NPV at the 99th percentile.

UR - http://www.scopus.com/inward/record.url?scp=84885086897&partnerID=8YFLogxK

U2 - 10.1136/heartjnl-2013-303643

DO - 10.1136/heartjnl-2013-303643

M3 - SCORING: Journal article

C2 - 23604180

AN - SCOPUS:84885086897

VL - 99

SP - 1567

EP - 1572

JO - HEART

JF - HEART

SN - 1355-6037

IS - 21

ER -