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Identification of acute myocardial infarction in elderly patients using optimized highly sensitive troponin I thresholds

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Identification of acute myocardial infarction in elderly patients using optimized highly sensitive troponin I thresholds. / von Jeinsen, Beatrice; Liebetrau, Christoph; Palapies, Lars; Tzikas, Stergios; Zeller, Tanja; Bickel, Christoph; Schmidt, Alexander; Tubaro, Marco; Lackner, Karl J; Sar, Fachrie; Baldus, Stephan; Zeiher, Andreas M; Blankenberg, Stefan; Gori, Tommaso; Münzel, Thomas; Hamm, Christian W; Wild, Philipp S; Keller, Till.

In: BIOMARKERS, Vol. 24, No. 6, 09.2019, p. 549-555.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

von Jeinsen, B, Liebetrau, C, Palapies, L, Tzikas, S, Zeller, T, Bickel, C, Schmidt, A, Tubaro, M, Lackner, KJ, Sar, F, Baldus, S, Zeiher, AM, Blankenberg, S, Gori, T, Münzel, T, Hamm, CW, Wild, PS & Keller, T 2019, 'Identification of acute myocardial infarction in elderly patients using optimized highly sensitive troponin I thresholds', BIOMARKERS, vol. 24, no. 6, pp. 549-555. https://doi.org/10.1080/1354750X.2019.1606276

APA

von Jeinsen, B., Liebetrau, C., Palapies, L., Tzikas, S., Zeller, T., Bickel, C., Schmidt, A., Tubaro, M., Lackner, K. J., Sar, F., Baldus, S., Zeiher, A. M., Blankenberg, S., Gori, T., Münzel, T., Hamm, C. W., Wild, P. S., & Keller, T. (2019). Identification of acute myocardial infarction in elderly patients using optimized highly sensitive troponin I thresholds. BIOMARKERS, 24(6), 549-555. https://doi.org/10.1080/1354750X.2019.1606276

Vancouver

von Jeinsen B, Liebetrau C, Palapies L, Tzikas S, Zeller T, Bickel C et al. Identification of acute myocardial infarction in elderly patients using optimized highly sensitive troponin I thresholds. BIOMARKERS. 2019 Sep;24(6):549-555. https://doi.org/10.1080/1354750X.2019.1606276

Bibtex

@article{3a5043b60c6047a194f9c056001c3dec,
title = "Identification of acute myocardial infarction in elderly patients using optimized highly sensitive troponin I thresholds",
abstract = "Purpose: Established diagnostic thresholds for high-sensitivity cardiac troponins (hs-cTn) might not apply for elderly patients as they are elevated irrespective of the presence of an acute myocardial infarction (AMI). Aim of the present study was to investigate hs-cTnI in elderly patients with suspected AMI and to calculate optimized diagnostic cutoffs. Material and methods: Data from a prospective multi-centre study and from a second independent prospective single-centre cohort study were analysed. A number of 2903 patients were eligible for further analysis. Patients > 70 years were classified as elderly. hs-cTnI was measured upon admission. Results: Around 34.7% of 2903 patients were classified as elderly. Around 22.5% of elderly patients were finally diagnosed with AMI. Elderly patients had higher hs-cTnI levels at admission irrespective of the final diagnosis (p < 0.001). According to the AUROC, hs-cTnI was a strong marker for detection of AMI in elderly patients. Application of the 99th percentile cutoffs showed a substantially lower specificity in elderly. By using optimized thresholds, specificity was improved to levels as in younger patients in both cohorts but accompanied with a decrease in sensitivity. Conclusions: hs-cTnI levels have a lower specificity for detecting AMI in elderly patients. This lower specificity can be improved by using hs-cTnI thresholds optimized for elderly patients.",
keywords = "Adult, Aged, Aged, 80 and over, Biomarkers/blood, Female, Humans, Hyperlipidemias/blood, Hypertension/blood, Male, Middle Aged, Myocardial Infarction/blood, Prospective Studies, Risk Factors, Sensitivity and Specificity, Smoking/blood, Troponin I/blood",
author = "{von Jeinsen}, Beatrice and Christoph Liebetrau and Lars Palapies and Stergios Tzikas and Tanja Zeller and Christoph Bickel and Alexander Schmidt and Marco Tubaro and Lackner, {Karl J} and Fachrie Sar and Stephan Baldus and Zeiher, {Andreas M} and Stefan Blankenberg and Tommaso Gori and Thomas M{\"u}nzel and Hamm, {Christian W} and Wild, {Philipp S} and Till Keller",
year = "2019",
month = sep,
doi = "10.1080/1354750X.2019.1606276",
language = "English",
volume = "24",
pages = "549--555",
journal = "BIOMARKERS",
issn = "1354-750X",
publisher = "informa healthcare",
number = "6",

}

RIS

TY - JOUR

T1 - Identification of acute myocardial infarction in elderly patients using optimized highly sensitive troponin I thresholds

AU - von Jeinsen, Beatrice

AU - Liebetrau, Christoph

AU - Palapies, Lars

AU - Tzikas, Stergios

AU - Zeller, Tanja

AU - Bickel, Christoph

AU - Schmidt, Alexander

AU - Tubaro, Marco

AU - Lackner, Karl J

AU - Sar, Fachrie

AU - Baldus, Stephan

AU - Zeiher, Andreas M

AU - Blankenberg, Stefan

AU - Gori, Tommaso

AU - Münzel, Thomas

AU - Hamm, Christian W

AU - Wild, Philipp S

AU - Keller, Till

PY - 2019/9

Y1 - 2019/9

N2 - Purpose: Established diagnostic thresholds for high-sensitivity cardiac troponins (hs-cTn) might not apply for elderly patients as they are elevated irrespective of the presence of an acute myocardial infarction (AMI). Aim of the present study was to investigate hs-cTnI in elderly patients with suspected AMI and to calculate optimized diagnostic cutoffs. Material and methods: Data from a prospective multi-centre study and from a second independent prospective single-centre cohort study were analysed. A number of 2903 patients were eligible for further analysis. Patients > 70 years were classified as elderly. hs-cTnI was measured upon admission. Results: Around 34.7% of 2903 patients were classified as elderly. Around 22.5% of elderly patients were finally diagnosed with AMI. Elderly patients had higher hs-cTnI levels at admission irrespective of the final diagnosis (p < 0.001). According to the AUROC, hs-cTnI was a strong marker for detection of AMI in elderly patients. Application of the 99th percentile cutoffs showed a substantially lower specificity in elderly. By using optimized thresholds, specificity was improved to levels as in younger patients in both cohorts but accompanied with a decrease in sensitivity. Conclusions: hs-cTnI levels have a lower specificity for detecting AMI in elderly patients. This lower specificity can be improved by using hs-cTnI thresholds optimized for elderly patients.

AB - Purpose: Established diagnostic thresholds for high-sensitivity cardiac troponins (hs-cTn) might not apply for elderly patients as they are elevated irrespective of the presence of an acute myocardial infarction (AMI). Aim of the present study was to investigate hs-cTnI in elderly patients with suspected AMI and to calculate optimized diagnostic cutoffs. Material and methods: Data from a prospective multi-centre study and from a second independent prospective single-centre cohort study were analysed. A number of 2903 patients were eligible for further analysis. Patients > 70 years were classified as elderly. hs-cTnI was measured upon admission. Results: Around 34.7% of 2903 patients were classified as elderly. Around 22.5% of elderly patients were finally diagnosed with AMI. Elderly patients had higher hs-cTnI levels at admission irrespective of the final diagnosis (p < 0.001). According to the AUROC, hs-cTnI was a strong marker for detection of AMI in elderly patients. Application of the 99th percentile cutoffs showed a substantially lower specificity in elderly. By using optimized thresholds, specificity was improved to levels as in younger patients in both cohorts but accompanied with a decrease in sensitivity. Conclusions: hs-cTnI levels have a lower specificity for detecting AMI in elderly patients. This lower specificity can be improved by using hs-cTnI thresholds optimized for elderly patients.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Biomarkers/blood

KW - Female

KW - Humans

KW - Hyperlipidemias/blood

KW - Hypertension/blood

KW - Male

KW - Middle Aged

KW - Myocardial Infarction/blood

KW - Prospective Studies

KW - Risk Factors

KW - Sensitivity and Specificity

KW - Smoking/blood

KW - Troponin I/blood

U2 - 10.1080/1354750X.2019.1606276

DO - 10.1080/1354750X.2019.1606276

M3 - SCORING: Journal article

C2 - 31159594

VL - 24

SP - 549

EP - 555

JO - BIOMARKERS

JF - BIOMARKERS

SN - 1354-750X

IS - 6

ER -