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Prognostic performance of kinetic changes of high-sensitivity troponin T in acute coronary syndrome and in patients with increased troponin without acute coronary syndrome

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Prognostic performance of kinetic changes of high-sensitivity troponin T in acute coronary syndrome and in patients with increased troponin without acute coronary syndrome. / Mueller, Matthias; Biener, Moritz; Vafaie, Mershad; Blankenberg, Stefan; White, Harvey D; Katus, Hugo A; Giannitsis, Evangelos.

in: INT J CARDIOL, Jahrgang 174, Nr. 3, 01.07.2014, S. 524-529.

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

Harvard

Mueller, M, Biener, M, Vafaie, M, Blankenberg, S, White, HD, Katus, HA & Giannitsis, E 2014, 'Prognostic performance of kinetic changes of high-sensitivity troponin T in acute coronary syndrome and in patients with increased troponin without acute coronary syndrome', INT J CARDIOL, Jg. 174, Nr. 3, S. 524-529. https://doi.org/10.1016/j.ijcard.2014.04.110

APA

Mueller, M., Biener, M., Vafaie, M., Blankenberg, S., White, H. D., Katus, H. A., & Giannitsis, E. (2014). Prognostic performance of kinetic changes of high-sensitivity troponin T in acute coronary syndrome and in patients with increased troponin without acute coronary syndrome. INT J CARDIOL, 174(3), 524-529. https://doi.org/10.1016/j.ijcard.2014.04.110

Vancouver

Mueller M, Biener M, Vafaie M, Blankenberg S, White HD, Katus HA et al. Prognostic performance of kinetic changes of high-sensitivity troponin T in acute coronary syndrome and in patients with increased troponin without acute coronary syndrome. INT J CARDIOL. 2014 Jul 1;174(3):524-529. https://doi.org/10.1016/j.ijcard.2014.04.110

Bibtex

@article{ef4dd65342054adfa682140cbd1a16c5,
title = "Prognostic performance of kinetic changes of high-sensitivity troponin T in acute coronary syndrome and in patients with increased troponin without acute coronary syndrome",
abstract = "BACKGROUND: We sought to evaluate the prognostic impact of absolute and relative kinetic changes of high-sensitivity cardiac Troponin T (hs-cTnT) in comparison to baseline hs-cTnT elevations for risk stratification in acute coronary syndrome (ACS) and non-ACS conditions with increased hs-cTnT.METHODS: hs-cTnT was measured serially in patients presenting with acute symptoms to our emergency department. We assessed the prognostic performance of baseline and serial hs-cTnT concentrations in all consecutive patients with ACS (n=406) or hs-cTnT increases not due to ACS (n=442) within 3-6h after admission.RESULTS: Mortality rates were higher, albeit not statistically, in non-ACS (53/442=12.0%) than ACS patients (36/406=8.9%). In ACS patients, receiver operating characteristics (ROC) revealed optimized cut-off values of 12.2 ng/L for absolute δ-change (AUC=0.66, p<0.001), 31.2 ng/L for baseline hs-cTnT (AUC=0.71, p<0.001) and 45.2 ng/L for maximal hs-cTnT (AUC=0.68, p<0.001). C-statistics showed superiority of absolute δ-changes (p=0.0003), baseline hs-cTnT (p=0.04) and maximal hs-cTnT (p=0.02) compared to relative δ-changes. However, the combination of baseline hs-cTnT values with either absolute or relative δ-changes did not improve risk prediction compared to baseline hs-cTnT alone (p=n.s.). In non-ACS conditions, the ROC-optimized cut-off value of 46.2 ng/L for baseline hs-cTnT (AUC=0.661, p<0.001) was superior to absolute (p=0.007) and relative δ-changes regarding prognostication (p=0.045).CONCLUSIONS: Our data suggest that the magnitude of baseline hs-cTnT, and not acute dynamic changes, convey superior long-term prognostic information in ACS and non-ACS conditions. Moreover, absolute and relative kinetic δ-changes of hs-cTnT do not add significant incremental value in risk assessment in both conditions.",
keywords = "Acute Coronary Syndrome/blood, Aged, Aged, 80 and over, Biomarkers/blood, Cohort Studies, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Male, Prognosis, Retrospective Studies, Troponin T/blood",
author = "Matthias Mueller and Moritz Biener and Mershad Vafaie and Stefan Blankenberg and White, {Harvey D} and Katus, {Hugo A} and Evangelos Giannitsis",
note = "Copyright {\textcopyright} 2014 Elsevier Ireland Ltd. All rights reserved.",
year = "2014",
month = jul,
day = "1",
doi = "10.1016/j.ijcard.2014.04.110",
language = "English",
volume = "174",
pages = "524--529",
journal = "INT J CARDIOL",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",
number = "3",

}

RIS

TY - JOUR

T1 - Prognostic performance of kinetic changes of high-sensitivity troponin T in acute coronary syndrome and in patients with increased troponin without acute coronary syndrome

AU - Mueller, Matthias

AU - Biener, Moritz

AU - Vafaie, Mershad

AU - Blankenberg, Stefan

AU - White, Harvey D

AU - Katus, Hugo A

AU - Giannitsis, Evangelos

N1 - Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

PY - 2014/7/1

Y1 - 2014/7/1

N2 - BACKGROUND: We sought to evaluate the prognostic impact of absolute and relative kinetic changes of high-sensitivity cardiac Troponin T (hs-cTnT) in comparison to baseline hs-cTnT elevations for risk stratification in acute coronary syndrome (ACS) and non-ACS conditions with increased hs-cTnT.METHODS: hs-cTnT was measured serially in patients presenting with acute symptoms to our emergency department. We assessed the prognostic performance of baseline and serial hs-cTnT concentrations in all consecutive patients with ACS (n=406) or hs-cTnT increases not due to ACS (n=442) within 3-6h after admission.RESULTS: Mortality rates were higher, albeit not statistically, in non-ACS (53/442=12.0%) than ACS patients (36/406=8.9%). In ACS patients, receiver operating characteristics (ROC) revealed optimized cut-off values of 12.2 ng/L for absolute δ-change (AUC=0.66, p<0.001), 31.2 ng/L for baseline hs-cTnT (AUC=0.71, p<0.001) and 45.2 ng/L for maximal hs-cTnT (AUC=0.68, p<0.001). C-statistics showed superiority of absolute δ-changes (p=0.0003), baseline hs-cTnT (p=0.04) and maximal hs-cTnT (p=0.02) compared to relative δ-changes. However, the combination of baseline hs-cTnT values with either absolute or relative δ-changes did not improve risk prediction compared to baseline hs-cTnT alone (p=n.s.). In non-ACS conditions, the ROC-optimized cut-off value of 46.2 ng/L for baseline hs-cTnT (AUC=0.661, p<0.001) was superior to absolute (p=0.007) and relative δ-changes regarding prognostication (p=0.045).CONCLUSIONS: Our data suggest that the magnitude of baseline hs-cTnT, and not acute dynamic changes, convey superior long-term prognostic information in ACS and non-ACS conditions. Moreover, absolute and relative kinetic δ-changes of hs-cTnT do not add significant incremental value in risk assessment in both conditions.

AB - BACKGROUND: We sought to evaluate the prognostic impact of absolute and relative kinetic changes of high-sensitivity cardiac Troponin T (hs-cTnT) in comparison to baseline hs-cTnT elevations for risk stratification in acute coronary syndrome (ACS) and non-ACS conditions with increased hs-cTnT.METHODS: hs-cTnT was measured serially in patients presenting with acute symptoms to our emergency department. We assessed the prognostic performance of baseline and serial hs-cTnT concentrations in all consecutive patients with ACS (n=406) or hs-cTnT increases not due to ACS (n=442) within 3-6h after admission.RESULTS: Mortality rates were higher, albeit not statistically, in non-ACS (53/442=12.0%) than ACS patients (36/406=8.9%). In ACS patients, receiver operating characteristics (ROC) revealed optimized cut-off values of 12.2 ng/L for absolute δ-change (AUC=0.66, p<0.001), 31.2 ng/L for baseline hs-cTnT (AUC=0.71, p<0.001) and 45.2 ng/L for maximal hs-cTnT (AUC=0.68, p<0.001). C-statistics showed superiority of absolute δ-changes (p=0.0003), baseline hs-cTnT (p=0.04) and maximal hs-cTnT (p=0.02) compared to relative δ-changes. However, the combination of baseline hs-cTnT values with either absolute or relative δ-changes did not improve risk prediction compared to baseline hs-cTnT alone (p=n.s.). In non-ACS conditions, the ROC-optimized cut-off value of 46.2 ng/L for baseline hs-cTnT (AUC=0.661, p<0.001) was superior to absolute (p=0.007) and relative δ-changes regarding prognostication (p=0.045).CONCLUSIONS: Our data suggest that the magnitude of baseline hs-cTnT, and not acute dynamic changes, convey superior long-term prognostic information in ACS and non-ACS conditions. Moreover, absolute and relative kinetic δ-changes of hs-cTnT do not add significant incremental value in risk assessment in both conditions.

KW - Acute Coronary Syndrome/blood

KW - Aged

KW - Aged, 80 and over

KW - Biomarkers/blood

KW - Cohort Studies

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Kaplan-Meier Estimate

KW - Male

KW - Prognosis

KW - Retrospective Studies

KW - Troponin T/blood

U2 - 10.1016/j.ijcard.2014.04.110

DO - 10.1016/j.ijcard.2014.04.110

M3 - SCORING: Journal article

C2 - 24814895

VL - 174

SP - 524

EP - 529

JO - INT J CARDIOL

JF - INT J CARDIOL

SN - 0167-5273

IS - 3

ER -