PortalPublikationenTwo-Hour Algorithm for Rapid Triage of Suspected Acute Myoca...

Two-Hour Algorithm for Rapid Triage of Suspected Acute Myocardial Infarction Using a High-Sensitivity Cardiac Troponin I Assay

Standard

Two-Hour Algorithm for Rapid Triage of Suspected Acute Myocardial Infarction Using a High-Sensitivity Cardiac Troponin I Assay. / Nestelberger, T; Boeddinghaus, J; Greenslade, J; Parsonage, WA; Than, M; Wussler, D; Lopez-Ayala, P; Zimmermann, T; Meier, M; Troester, V; Badertscher, P; Koechlin, Luca; Wildi, Karin; Anwar, Mahnoor; Freese, Michael; Keller, Dagmar; Reichlin, Tobias; Twerenbold, Raphael; Cullen, Louise; Mueller, Christian; APACE Investigators.

in: CLIN CHEM, Jahrgang 65, Nr. 11, 09.2019.

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

Harvard

Nestelberger, T, Boeddinghaus, J, Greenslade, J, Parsonage, WA, Than, M, Wussler, D, Lopez-Ayala, P, Zimmermann, T, Meier, M, Troester, V, Badertscher, P, Koechlin, L, Wildi, K, Anwar, M, Freese, M, Keller, D, Reichlin, T, Twerenbold, R, Cullen, L, Mueller, C & APACE Investigators 2019, 'Two-Hour Algorithm for Rapid Triage of Suspected Acute Myocardial Infarction Using a High-Sensitivity Cardiac Troponin I Assay', CLIN CHEM, Jg. 65, Nr. 11. https://doi.org/10.1373/clinchem.2019.305193

APA

Nestelberger, T., Boeddinghaus, J., Greenslade, J., Parsonage, WA., Than, M., Wussler, D., Lopez-Ayala, P., Zimmermann, T., Meier, M., Troester, V., Badertscher, P., Koechlin, L., Wildi, K., Anwar, M., Freese, M., Keller, D., Reichlin, T., Twerenbold, R., Cullen, L., ... APACE Investigators (2019). Two-Hour Algorithm for Rapid Triage of Suspected Acute Myocardial Infarction Using a High-Sensitivity Cardiac Troponin I Assay. CLIN CHEM, 65(11). https://doi.org/10.1373/clinchem.2019.305193

Vancouver

Nestelberger T, Boeddinghaus J, Greenslade J, Parsonage WA, Than M, Wussler D et al. Two-Hour Algorithm for Rapid Triage of Suspected Acute Myocardial Infarction Using a High-Sensitivity Cardiac Troponin I Assay. CLIN CHEM. 2019 Sep;65(11). https://doi.org/10.1373/clinchem.2019.305193

Bibtex

@article{f60240b1c8354975914ff43a4290631b,
title = "Two-Hour Algorithm for Rapid Triage of Suspected Acute Myocardial Infarction Using a High-Sensitivity Cardiac Troponin I Assay",
abstract = "BACKGROUNDWe aimed to derive and externally validate a 0/2-h algorithm using the high-sensitivity cardiac troponin I (hs-cTnI)-Access assay.METHODSWe enrolled patients presenting to the emergency department with symptoms suggestive of acute myocardial infarction (AMI) in 2 prospective diagnostic studies using central adjudication. Two independent cardiologists adjudicated the final diagnosis, including all available medical information including cardiac imaging. hs-cTnI-Access concentrations were measured at presentation and after 2 h in a blinded fashion.RESULTSAMI was the adjudicated final diagnosis in 164 of 1131 (14.5%) patients in the derivation cohort. Rule-out by the hs-cTnI-Access 0/2-h algorithm was defined as 0-h hs-cTnI-Access concentration <4 ng/L in patients with an onset of chest pain >3 h (direct rule-out) or a 0-h hs-cTnI-Access concentration <5 ng/L and an absolute change within 2 h <5 ng/L in all other patients. Derived thresholds for rule-in were a 0-h hs-cTnI-Access concentration ≥50 ng/L (direct rule-in) or an absolute change within 2 h ≥20 ng/L. In the derivation cohort, these cutoffs ruled out 55% of patients with a negative predictive value (NPV) of 99.8% (95% CI, 99.3–100) and sensitivity of 99.4% (95% CI, 96.5–99.9), and ruled in 30% of patients with a positive predictive value (PPV) of 73% (95% CI, 66.1–79). In the validation cohort, AMI was the adjudicated final diagnosis in 88 of 1280 (6.9%) patients. These cutoffs ruled out 77.9% of patients with an NPV of 99.8% (95% CI, 99.3–100) and sensitivity of 97.7% (95% CI, 92.0–99.7), and ruled in 5.8% of patients with a PPV of 77% (95% CI, 65.8–86) in the validation cohort.CONCLUSIONSSafety and efficacy of the l hs-cTnI-Access 0/2-h algorithm for triage toward rule-out or rule-in of AMI are very high.",
author = "T Nestelberger and J Boeddinghaus and J Greenslade and WA Parsonage and M Than and D Wussler and P Lopez-Ayala and T Zimmermann and M Meier and V Troester and P Badertscher and Luca Koechlin and Karin Wildi and Mahnoor Anwar and Michael Freese and Dagmar Keller and Tobias Reichlin and Raphael Twerenbold and Louise Cullen and Christian Mueller and {APACE Investigators}",
year = "2019",
month = sep,
doi = "10.1373/clinchem.2019.305193",
language = "English",
volume = "65",
journal = "CLIN CHEM",
issn = "0009-9147",
publisher = "American Association for Clinical Chemistry Inc.",
number = "11",

}

RIS

TY - JOUR

T1 - Two-Hour Algorithm for Rapid Triage of Suspected Acute Myocardial Infarction Using a High-Sensitivity Cardiac Troponin I Assay

AU - Nestelberger, T

AU - Boeddinghaus, J

AU - Greenslade, J

AU - Parsonage, WA

AU - Than, M

AU - Wussler, D

AU - Lopez-Ayala, P

AU - Zimmermann, T

AU - Meier, M

AU - Troester, V

AU - Badertscher, P

AU - Koechlin, Luca

AU - Wildi, Karin

AU - Anwar, Mahnoor

AU - Freese, Michael

AU - Keller, Dagmar

AU - Reichlin, Tobias

AU - Twerenbold, Raphael

AU - Cullen, Louise

AU - Mueller, Christian

AU - APACE Investigators

PY - 2019/9

Y1 - 2019/9

N2 - BACKGROUNDWe aimed to derive and externally validate a 0/2-h algorithm using the high-sensitivity cardiac troponin I (hs-cTnI)-Access assay.METHODSWe enrolled patients presenting to the emergency department with symptoms suggestive of acute myocardial infarction (AMI) in 2 prospective diagnostic studies using central adjudication. Two independent cardiologists adjudicated the final diagnosis, including all available medical information including cardiac imaging. hs-cTnI-Access concentrations were measured at presentation and after 2 h in a blinded fashion.RESULTSAMI was the adjudicated final diagnosis in 164 of 1131 (14.5%) patients in the derivation cohort. Rule-out by the hs-cTnI-Access 0/2-h algorithm was defined as 0-h hs-cTnI-Access concentration <4 ng/L in patients with an onset of chest pain >3 h (direct rule-out) or a 0-h hs-cTnI-Access concentration <5 ng/L and an absolute change within 2 h <5 ng/L in all other patients. Derived thresholds for rule-in were a 0-h hs-cTnI-Access concentration ≥50 ng/L (direct rule-in) or an absolute change within 2 h ≥20 ng/L. In the derivation cohort, these cutoffs ruled out 55% of patients with a negative predictive value (NPV) of 99.8% (95% CI, 99.3–100) and sensitivity of 99.4% (95% CI, 96.5–99.9), and ruled in 30% of patients with a positive predictive value (PPV) of 73% (95% CI, 66.1–79). In the validation cohort, AMI was the adjudicated final diagnosis in 88 of 1280 (6.9%) patients. These cutoffs ruled out 77.9% of patients with an NPV of 99.8% (95% CI, 99.3–100) and sensitivity of 97.7% (95% CI, 92.0–99.7), and ruled in 5.8% of patients with a PPV of 77% (95% CI, 65.8–86) in the validation cohort.CONCLUSIONSSafety and efficacy of the l hs-cTnI-Access 0/2-h algorithm for triage toward rule-out or rule-in of AMI are very high.

AB - BACKGROUNDWe aimed to derive and externally validate a 0/2-h algorithm using the high-sensitivity cardiac troponin I (hs-cTnI)-Access assay.METHODSWe enrolled patients presenting to the emergency department with symptoms suggestive of acute myocardial infarction (AMI) in 2 prospective diagnostic studies using central adjudication. Two independent cardiologists adjudicated the final diagnosis, including all available medical information including cardiac imaging. hs-cTnI-Access concentrations were measured at presentation and after 2 h in a blinded fashion.RESULTSAMI was the adjudicated final diagnosis in 164 of 1131 (14.5%) patients in the derivation cohort. Rule-out by the hs-cTnI-Access 0/2-h algorithm was defined as 0-h hs-cTnI-Access concentration <4 ng/L in patients with an onset of chest pain >3 h (direct rule-out) or a 0-h hs-cTnI-Access concentration <5 ng/L and an absolute change within 2 h <5 ng/L in all other patients. Derived thresholds for rule-in were a 0-h hs-cTnI-Access concentration ≥50 ng/L (direct rule-in) or an absolute change within 2 h ≥20 ng/L. In the derivation cohort, these cutoffs ruled out 55% of patients with a negative predictive value (NPV) of 99.8% (95% CI, 99.3–100) and sensitivity of 99.4% (95% CI, 96.5–99.9), and ruled in 30% of patients with a positive predictive value (PPV) of 73% (95% CI, 66.1–79). In the validation cohort, AMI was the adjudicated final diagnosis in 88 of 1280 (6.9%) patients. These cutoffs ruled out 77.9% of patients with an NPV of 99.8% (95% CI, 99.3–100) and sensitivity of 97.7% (95% CI, 92.0–99.7), and ruled in 5.8% of patients with a PPV of 77% (95% CI, 65.8–86) in the validation cohort.CONCLUSIONSSafety and efficacy of the l hs-cTnI-Access 0/2-h algorithm for triage toward rule-out or rule-in of AMI are very high.

UR - http://europepmc.org/abstract/med/31570634

U2 - 10.1373/clinchem.2019.305193

DO - 10.1373/clinchem.2019.305193

M3 - SCORING: Journal article

C2 - 31570634

VL - 65

JO - CLIN CHEM

JF - CLIN CHEM

SN - 0009-9147

IS - 11

ER -