A Biomarker Model to Distinguish Types of Myocardial Infarction and Injury
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A Biomarker Model to Distinguish Types of Myocardial Infarction and Injury. / Neumann, Johannes T; Weimann, Jessica; Sörensen, Nils A; Hartikainen, Tau S; Haller, Paul M; Lehmacher, Jonas; Brocks, Celine; Tenhaeff, Sophia; Karakas, Mahir; Renné, Thomas; Blankenberg, Stefan; Zeller, Tanja; Westermann, Dirk.
In: J AM COLL CARDIOL, Vol. 78, No. 8, 24.08.2021, p. 781-790.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - A Biomarker Model to Distinguish Types of Myocardial Infarction and Injury
AU - Neumann, Johannes T
AU - Weimann, Jessica
AU - Sörensen, Nils A
AU - Hartikainen, Tau S
AU - Haller, Paul M
AU - Lehmacher, Jonas
AU - Brocks, Celine
AU - Tenhaeff, Sophia
AU - Karakas, Mahir
AU - Renné, Thomas
AU - Blankenberg, Stefan
AU - Zeller, Tanja
AU - Westermann, Dirk
N1 - Copyright © 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
PY - 2021/8/24
Y1 - 2021/8/24
N2 - BACKGROUND: Discrimination among patients with type 1 myocardial infarction (T1MI), type 2 myocardial infarction (T2MI), and myocardial injury is difficult.OBJECTIVES: The aim of this study was to investigate the discriminative value of a 29-biomarker panel in an emergency department setting.METHODS: Patients presenting with suspected myocardial infarction (MI) were recruited. The final diagnosis in all patients was adjudicated on the basis of the fourth universal definition of MI. A panel of 29 biomarkers was measured, and multivariable logistic regression analysis was used to evaluate the associations of these biomarkers with the diagnosis of MI or myocardial injury. Biomarkers were chosen using backward selection. The model was internally validated using bootstrapping.RESULTS: Overall, 748 patients were recruited (median age 64 years), of whom 138 had MI (107 T1MI and 31 T2MI) and 221 had myocardial injury. In the multivariable model, 4 biomarkers (apolipoprotein A-II, N-terminal prohormone of brain natriuretic peptide, copeptin, and high-sensitivity cardiac troponin I) remained significant discriminators between T1MI and T2MI. Internal validation of the model showed an area under the curve of 0.82. For discrimination between MI and myocardial injury, 6 biomarkers (adiponectin, N-terminal prohormone of brain natriuretic peptide, pulmonary and activation-regulated chemokine, transthyretin, copeptin, and high-sensitivity troponin I) were selected. Internal validation showed an area under the curve of 0.84.CONCLUSIONS: Among 29 biomarkers, 7 were identified to be the most relevant discriminators between subtypes of MI or myocardial injury. Regression models based on these biomarkers allowed good discrimination. (Biomarkers in Acute Cardiac Care [BACC]; NCT02355457).
AB - BACKGROUND: Discrimination among patients with type 1 myocardial infarction (T1MI), type 2 myocardial infarction (T2MI), and myocardial injury is difficult.OBJECTIVES: The aim of this study was to investigate the discriminative value of a 29-biomarker panel in an emergency department setting.METHODS: Patients presenting with suspected myocardial infarction (MI) were recruited. The final diagnosis in all patients was adjudicated on the basis of the fourth universal definition of MI. A panel of 29 biomarkers was measured, and multivariable logistic regression analysis was used to evaluate the associations of these biomarkers with the diagnosis of MI or myocardial injury. Biomarkers were chosen using backward selection. The model was internally validated using bootstrapping.RESULTS: Overall, 748 patients were recruited (median age 64 years), of whom 138 had MI (107 T1MI and 31 T2MI) and 221 had myocardial injury. In the multivariable model, 4 biomarkers (apolipoprotein A-II, N-terminal prohormone of brain natriuretic peptide, copeptin, and high-sensitivity cardiac troponin I) remained significant discriminators between T1MI and T2MI. Internal validation of the model showed an area under the curve of 0.82. For discrimination between MI and myocardial injury, 6 biomarkers (adiponectin, N-terminal prohormone of brain natriuretic peptide, pulmonary and activation-regulated chemokine, transthyretin, copeptin, and high-sensitivity troponin I) were selected. Internal validation showed an area under the curve of 0.84.CONCLUSIONS: Among 29 biomarkers, 7 were identified to be the most relevant discriminators between subtypes of MI or myocardial injury. Regression models based on these biomarkers allowed good discrimination. (Biomarkers in Acute Cardiac Care [BACC]; NCT02355457).
U2 - 10.1016/j.jacc.2021.06.027
DO - 10.1016/j.jacc.2021.06.027
M3 - SCORING: Journal article
C2 - 34412811
VL - 78
SP - 781
EP - 790
JO - J AM COLL CARDIOL
JF - J AM COLL CARDIOL
SN - 0735-1097
IS - 8
ER -
