Research ExplorerPublicationsComparison of conventional and high-sensitivity troponin in ...

Comparison of conventional and high-sensitivity troponin in patients with chest pain: A collaborative meta-analysis

Standard

Comparison of conventional and high-sensitivity troponin in patients with chest pain: A collaborative meta-analysis. / Lipinski, Michael J.; Baker, Nevin C.; Escárcega, Ricardo O.; Torguson, Rebecca; Chen, Fang; Aldous, Sally J.; Christ, Michael; Collinson, Paul O.; Goodacre, Steve W.; Mair, Johannes; Inoue, Kenji; Lotze, Ulrich; Sebbane, Mustapha; Cristol, Jean Paul; Freund, Yonathan; Chenevier-Gobeaux, Camille; Meune, Christophe; Eggers, Kai M.; Pracoń, Radosław; Schreiber, Donald H.; Wu, Alan H.B.; Ordõez-Llanos, Jordi; Jaffe, Allan S.; Twerenbold, Raphael; Mueller, Christian; Waksman, Ron.

In: AM HEART J, Vol. 169, No. 1, 01.2015, p. 6-16.e6.

Research output: SCORING: Contribution to journal › SCORING: Review article › Research

Harvard

Lipinski, MJ, Baker, NC, Escárcega, RO, Torguson, R, Chen, F, Aldous, SJ, Christ, M, Collinson, PO, Goodacre, SW, Mair, J, Inoue, K, Lotze, U, Sebbane, M, Cristol, JP, Freund, Y, Chenevier-Gobeaux, C, Meune, C, Eggers, KM, Pracoń, R, Schreiber, DH, Wu, AHB, Ordõez-Llanos, J, Jaffe, AS, Twerenbold, R, Mueller, C & Waksman, R 2015, 'Comparison of conventional and high-sensitivity troponin in patients with chest pain: A collaborative meta-analysis', AM HEART J, vol. 169, no. 1, pp. 6-16.e6. https://doi.org/10.1016/j.ahj.2014.10.007

APA

Lipinski, M. J., Baker, N. C., Escárcega, R. O., Torguson, R., Chen, F., Aldous, S. J., Christ, M., Collinson, P. O., Goodacre, S. W., Mair, J., Inoue, K., Lotze, U., Sebbane, M., Cristol, J. P., Freund, Y., Chenevier-Gobeaux, C., Meune, C., Eggers, K. M., Pracoń, R., ... Waksman, R. (2015). Comparison of conventional and high-sensitivity troponin in patients with chest pain: A collaborative meta-analysis. AM HEART J, 169(1), 6-16.e6. https://doi.org/10.1016/j.ahj.2014.10.007

Vancouver

Lipinski MJ, Baker NC, Escárcega RO, Torguson R, Chen F, Aldous SJ et al. Comparison of conventional and high-sensitivity troponin in patients with chest pain: A collaborative meta-analysis. AM HEART J. 2015 Jan;169(1):6-16.e6. https://doi.org/10.1016/j.ahj.2014.10.007

Bibtex

@article{37dea50a155f429182fc21d9d7ba9026,
title = "Comparison of conventional and high-sensitivity troponin in patients with chest pain: A collaborative meta-analysis",
abstract = "Background Multiple studies have evaluated the diagnostic and prognostic performance of conventional troponin (cTn) and high-sensitivity troponin (hs-cTn). We performed a collaborative meta-analysis comparing cTn and hs-cTn for diagnosis of acute myocardial infarction (AMI) and assessment of prognosis in patients with chest pain. Methods MEDLINE/PubMed, Cochrane CENTRAL, and EMBASE were searched for studies assessing both cTn and hscTn in patients with chest pain. Study authors were contacted and many provided previously unpublished data. Results From 17 included studies, there were 8,644 patients. Compared with baseline cTn, baseline hs-cTn had significantly greater sensitivity (0.884 vs 0.749, P b .001) and negative predictive value (NPV; 0.964 vs 0.935, P b .001), whereas specificity (0.816 vs 0.938, P b .001) and positive predictive value (0.558 vs 0.759, P b .001) were significantly reduced. Based on summary receiver operating characteristic curves, test performance for the diagnosis of AMI was not significantly different between baseline cTn and hs-cTn (0.90 [95% CI 0.85-0.95] vs 0.92 [95% CI 0.90-0.94]). In a subanalysis of 6 studies that alternatively defined AMI based on hs-cTn, cTn had lower sensitivity (0.666, P b .001) and NPV (0.906, P b .001). Elevation of baseline hs-cTn, but negative baseline cTn, was associated with increased risk of death or nonfatal myocardial infarction during follow-up (P b .001) compared with both negative. Conclusion High-sensitivity troponin has significantly greater early sensitivity and NPV for the diagnosis of AMI at the cost of specificity and positive predictive value, which may enable early rule in/out of AMI in patients with chest pain. Baseline hs-cTn elevation in the setting of negative cTn is also associated with increased nonfatal myocardial infarction or death during follow-up.",
author = "Lipinski, {Michael J.} and Baker, {Nevin C.} and Esc{\'a}rcega, {Ricardo O.} and Rebecca Torguson and Fang Chen and Aldous, {Sally J.} and Michael Christ and Collinson, {Paul O.} and Goodacre, {Steve W.} and Johannes Mair and Kenji Inoue and Ulrich Lotze and Mustapha Sebbane and Cristol, {Jean Paul} and Yonathan Freund and Camille Chenevier-Gobeaux and Christophe Meune and Eggers, {Kai M.} and Rados{\l}aw Praco{\'n} and Schreiber, {Donald H.} and Wu, {Alan H.B.} and Jordi Ord{\~o}ez-Llanos and Jaffe, {Allan S.} and Raphael Twerenbold and Christian Mueller and Ron Waksman",
note = "Publisher Copyright: {\textcopyright} 2014 Elsevier Inc. All rights reserved.",
year = "2015",
month = jan,
doi = "10.1016/j.ahj.2014.10.007",
language = "English",
volume = "169",
pages = "6--16.e6",
journal = "AM HEART J",
issn = "0002-8703",
publisher = "Mosby Inc.",
number = "1",

}

RIS

TY - JOUR

T1 - Comparison of conventional and high-sensitivity troponin in patients with chest pain: A collaborative meta-analysis

AU - Lipinski, Michael J.

AU - Baker, Nevin C.

AU - Escárcega, Ricardo O.

AU - Torguson, Rebecca

AU - Chen, Fang

AU - Aldous, Sally J.

AU - Christ, Michael

AU - Collinson, Paul O.

AU - Goodacre, Steve W.

AU - Mair, Johannes

AU - Inoue, Kenji

AU - Lotze, Ulrich

AU - Sebbane, Mustapha

AU - Cristol, Jean Paul

AU - Freund, Yonathan

AU - Chenevier-Gobeaux, Camille

AU - Meune, Christophe

AU - Eggers, Kai M.

AU - Pracoń, Radosław

AU - Schreiber, Donald H.

AU - Wu, Alan H.B.

AU - Ordõez-Llanos, Jordi

AU - Jaffe, Allan S.

AU - Twerenbold, Raphael

AU - Mueller, Christian

AU - Waksman, Ron

N1 - Publisher Copyright: © 2014 Elsevier Inc. All rights reserved.

PY - 2015/1

Y1 - 2015/1

N2 - Background Multiple studies have evaluated the diagnostic and prognostic performance of conventional troponin (cTn) and high-sensitivity troponin (hs-cTn). We performed a collaborative meta-analysis comparing cTn and hs-cTn for diagnosis of acute myocardial infarction (AMI) and assessment of prognosis in patients with chest pain. Methods MEDLINE/PubMed, Cochrane CENTRAL, and EMBASE were searched for studies assessing both cTn and hscTn in patients with chest pain. Study authors were contacted and many provided previously unpublished data. Results From 17 included studies, there were 8,644 patients. Compared with baseline cTn, baseline hs-cTn had significantly greater sensitivity (0.884 vs 0.749, P b .001) and negative predictive value (NPV; 0.964 vs 0.935, P b .001), whereas specificity (0.816 vs 0.938, P b .001) and positive predictive value (0.558 vs 0.759, P b .001) were significantly reduced. Based on summary receiver operating characteristic curves, test performance for the diagnosis of AMI was not significantly different between baseline cTn and hs-cTn (0.90 [95% CI 0.85-0.95] vs 0.92 [95% CI 0.90-0.94]). In a subanalysis of 6 studies that alternatively defined AMI based on hs-cTn, cTn had lower sensitivity (0.666, P b .001) and NPV (0.906, P b .001). Elevation of baseline hs-cTn, but negative baseline cTn, was associated with increased risk of death or nonfatal myocardial infarction during follow-up (P b .001) compared with both negative. Conclusion High-sensitivity troponin has significantly greater early sensitivity and NPV for the diagnosis of AMI at the cost of specificity and positive predictive value, which may enable early rule in/out of AMI in patients with chest pain. Baseline hs-cTn elevation in the setting of negative cTn is also associated with increased nonfatal myocardial infarction or death during follow-up.

AB - Background Multiple studies have evaluated the diagnostic and prognostic performance of conventional troponin (cTn) and high-sensitivity troponin (hs-cTn). We performed a collaborative meta-analysis comparing cTn and hs-cTn for diagnosis of acute myocardial infarction (AMI) and assessment of prognosis in patients with chest pain. Methods MEDLINE/PubMed, Cochrane CENTRAL, and EMBASE were searched for studies assessing both cTn and hscTn in patients with chest pain. Study authors were contacted and many provided previously unpublished data. Results From 17 included studies, there were 8,644 patients. Compared with baseline cTn, baseline hs-cTn had significantly greater sensitivity (0.884 vs 0.749, P b .001) and negative predictive value (NPV; 0.964 vs 0.935, P b .001), whereas specificity (0.816 vs 0.938, P b .001) and positive predictive value (0.558 vs 0.759, P b .001) were significantly reduced. Based on summary receiver operating characteristic curves, test performance for the diagnosis of AMI was not significantly different between baseline cTn and hs-cTn (0.90 [95% CI 0.85-0.95] vs 0.92 [95% CI 0.90-0.94]). In a subanalysis of 6 studies that alternatively defined AMI based on hs-cTn, cTn had lower sensitivity (0.666, P b .001) and NPV (0.906, P b .001). Elevation of baseline hs-cTn, but negative baseline cTn, was associated with increased risk of death or nonfatal myocardial infarction during follow-up (P b .001) compared with both negative. Conclusion High-sensitivity troponin has significantly greater early sensitivity and NPV for the diagnosis of AMI at the cost of specificity and positive predictive value, which may enable early rule in/out of AMI in patients with chest pain. Baseline hs-cTn elevation in the setting of negative cTn is also associated with increased nonfatal myocardial infarction or death during follow-up.

UR - http://www.scopus.com/inward/record.url?scp=84921900997&partnerID=8YFLogxK

U2 - 10.1016/j.ahj.2014.10.007

DO - 10.1016/j.ahj.2014.10.007

M3 - SCORING: Review article

C2 - 25497242

AN - SCOPUS:84921900997

VL - 169

SP - 6-16.e6

JO - AM HEART J

JF - AM HEART J

SN - 0002-8703

IS - 1

ER -