Research ExplorerPublicationsPatients with acute coronary syndrome and normal high-sensit...

Patients with acute coronary syndrome and normal high-sensitivity troponin

Standard

Patients with acute coronary syndrome and normal high-sensitivity troponin. / Meune, Christophe; Balmelli, Cathrin; Twerenbold, Raphael; Reichlin, Tobias; Reiter, Miriam; Haaf, Philip; Steuer, Stephan; Bassetti, Stefano; Sakarikos, Konstantin; Campodarve, Isabel; Zellweger, Christa; Irfan, Affan; Drexler, Beatrice; Mueller, Christian.

In: AM J MED, Vol. 124, No. 12, 12.2011, p. 1151-1157.

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

Harvard

Meune, C, Balmelli, C, Twerenbold, R, Reichlin, T, Reiter, M, Haaf, P, Steuer, S, Bassetti, S, Sakarikos, K, Campodarve, I, Zellweger, C, Irfan, A, Drexler, B & Mueller, C 2011, 'Patients with acute coronary syndrome and normal high-sensitivity troponin', AM J MED, vol. 124, no. 12, pp. 1151-1157. https://doi.org/10.1016/j.amjmed.2011.07.032

APA

Meune, C., Balmelli, C., Twerenbold, R., Reichlin, T., Reiter, M., Haaf, P., Steuer, S., Bassetti, S., Sakarikos, K., Campodarve, I., Zellweger, C., Irfan, A., Drexler, B., & Mueller, C. (2011). Patients with acute coronary syndrome and normal high-sensitivity troponin. AM J MED, 124(12), 1151-1157. https://doi.org/10.1016/j.amjmed.2011.07.032

Vancouver

Meune C, Balmelli C, Twerenbold R, Reichlin T, Reiter M, Haaf P et al. Patients with acute coronary syndrome and normal high-sensitivity troponin. AM J MED. 2011 Dec;124(12):1151-1157. https://doi.org/10.1016/j.amjmed.2011.07.032

Bibtex

@article{317687ee3bcd4c4ba70800afc3c0f260,
title = "Patients with acute coronary syndrome and normal high-sensitivity troponin",
abstract = "Background: Failure to identify patients with acute coronary syndrome (ACS) is a serious clinical problem. The incidence, characteristics, and outcome of ACS patients with normal high-sensitivity cardiac troponin T (hs-cTnT) levels at presentation are unknown. Methods: In a prospective multicenter study, hs-cTnT was determined in a blinded fashion in 1181 consecutive patients presenting with acute chest pain to the emergency department. The final diagnosis of ACS was adjudicated by 2 independent cardiologists. Patients were followed for 12 months. Results: ACS was the adjudicated diagnosis in 351 patients (30%), including 187 patients with acute myocardial infarction (AMI) and 164 patients with unstable angina (UA). At presentation, hs-cTnT was normal (<.014 ug/L) in 112 ACS patients (32%), including 11 patients (6%) with AMI and 101 patients (62%) with UA (P <.001). Multivariable analysis revealed previous statin treatment, younger age, preserved renal function, and the absence of ST deviation on the electrocardiogram as independently associated with normal hs-cTnT levels. Mortality rates in ACS patients with normal hs-cTnT level were 0.0% at 30 days, 0.0% at 90 days, and 2.0% (95% confidence interval, 0.5-7.9) at 360 days, which was significantly lower than in ACS patients with elevated hs-cTnT level at presentation (17.5% at 360 days, P <.001). Conversely, AMI rates at 360 days was higher in ACS patients with normal versus elevated hs-cTnT levels (P =.004). Conclusion: Almost one third of ACS patients have normal hs-cTnT levels at presentation, mostly patients with UA. ACS patients with normal hs-cTnT have a very low mortality, but an increased rate of AMI during the subsequent 360 days.",
keywords = "Acute coronary syndrome, False negative, High-sensitivity troponin, Prognosis",
author = "Christophe Meune and Cathrin Balmelli and Raphael Twerenbold and Tobias Reichlin and Miriam Reiter and Philip Haaf and Stephan Steuer and Stefano Bassetti and Konstantin Sakarikos and Isabel Campodarve and Christa Zellweger and Affan Irfan and Beatrice Drexler and Christian Mueller",
note = "Funding Information: Funding: This study was supported by grants from the Swiss National Science Foundation ( PP00B-102853 ), the Swiss Heart Foundation , Abbott , Roche , Siemens , and the Department of Internal Medicine , University Hospital Basel. Funding Information: Conflict of Interest: Dr Mueller reports receiving research grant support from Abbott , Brahms , Nanosphere Inc. , Roche , and Siemens , consulting fees from Abbott, and lecture fees from Abbott, Biosite, Brahms, Roche, and Siemens. Dr Reichlin has received research grants from the University of Basel and the Department of Internal Medicine , University Hospital Basel as well as speaker honoraria from Brahms and Roche. Dr Meune was supported by a grant from the Freie Akademische Gesellschaft Basel (FAG). ",
year = "2011",
month = dec,
doi = "10.1016/j.amjmed.2011.07.032",
language = "English",
volume = "124",
pages = "1151--1157",
journal = "AM J MED",
issn = "0002-9343",
publisher = "Elsevier Inc.",
number = "12",

}

RIS

TY - JOUR

T1 - Patients with acute coronary syndrome and normal high-sensitivity troponin

AU - Meune, Christophe

AU - Balmelli, Cathrin

AU - Twerenbold, Raphael

AU - Reichlin, Tobias

AU - Reiter, Miriam

AU - Haaf, Philip

AU - Steuer, Stephan

AU - Bassetti, Stefano

AU - Sakarikos, Konstantin

AU - Campodarve, Isabel

AU - Zellweger, Christa

AU - Irfan, Affan

AU - Drexler, Beatrice

AU - Mueller, Christian

N1 - Funding Information: Funding: This study was supported by grants from the Swiss National Science Foundation ( PP00B-102853 ), the Swiss Heart Foundation , Abbott , Roche , Siemens , and the Department of Internal Medicine , University Hospital Basel. Funding Information: Conflict of Interest: Dr Mueller reports receiving research grant support from Abbott , Brahms , Nanosphere Inc. , Roche , and Siemens , consulting fees from Abbott, and lecture fees from Abbott, Biosite, Brahms, Roche, and Siemens. Dr Reichlin has received research grants from the University of Basel and the Department of Internal Medicine , University Hospital Basel as well as speaker honoraria from Brahms and Roche. Dr Meune was supported by a grant from the Freie Akademische Gesellschaft Basel (FAG).

PY - 2011/12

Y1 - 2011/12

N2 - Background: Failure to identify patients with acute coronary syndrome (ACS) is a serious clinical problem. The incidence, characteristics, and outcome of ACS patients with normal high-sensitivity cardiac troponin T (hs-cTnT) levels at presentation are unknown. Methods: In a prospective multicenter study, hs-cTnT was determined in a blinded fashion in 1181 consecutive patients presenting with acute chest pain to the emergency department. The final diagnosis of ACS was adjudicated by 2 independent cardiologists. Patients were followed for 12 months. Results: ACS was the adjudicated diagnosis in 351 patients (30%), including 187 patients with acute myocardial infarction (AMI) and 164 patients with unstable angina (UA). At presentation, hs-cTnT was normal (<.014 ug/L) in 112 ACS patients (32%), including 11 patients (6%) with AMI and 101 patients (62%) with UA (P <.001). Multivariable analysis revealed previous statin treatment, younger age, preserved renal function, and the absence of ST deviation on the electrocardiogram as independently associated with normal hs-cTnT levels. Mortality rates in ACS patients with normal hs-cTnT level were 0.0% at 30 days, 0.0% at 90 days, and 2.0% (95% confidence interval, 0.5-7.9) at 360 days, which was significantly lower than in ACS patients with elevated hs-cTnT level at presentation (17.5% at 360 days, P <.001). Conversely, AMI rates at 360 days was higher in ACS patients with normal versus elevated hs-cTnT levels (P =.004). Conclusion: Almost one third of ACS patients have normal hs-cTnT levels at presentation, mostly patients with UA. ACS patients with normal hs-cTnT have a very low mortality, but an increased rate of AMI during the subsequent 360 days.

AB - Background: Failure to identify patients with acute coronary syndrome (ACS) is a serious clinical problem. The incidence, characteristics, and outcome of ACS patients with normal high-sensitivity cardiac troponin T (hs-cTnT) levels at presentation are unknown. Methods: In a prospective multicenter study, hs-cTnT was determined in a blinded fashion in 1181 consecutive patients presenting with acute chest pain to the emergency department. The final diagnosis of ACS was adjudicated by 2 independent cardiologists. Patients were followed for 12 months. Results: ACS was the adjudicated diagnosis in 351 patients (30%), including 187 patients with acute myocardial infarction (AMI) and 164 patients with unstable angina (UA). At presentation, hs-cTnT was normal (<.014 ug/L) in 112 ACS patients (32%), including 11 patients (6%) with AMI and 101 patients (62%) with UA (P <.001). Multivariable analysis revealed previous statin treatment, younger age, preserved renal function, and the absence of ST deviation on the electrocardiogram as independently associated with normal hs-cTnT levels. Mortality rates in ACS patients with normal hs-cTnT level were 0.0% at 30 days, 0.0% at 90 days, and 2.0% (95% confidence interval, 0.5-7.9) at 360 days, which was significantly lower than in ACS patients with elevated hs-cTnT level at presentation (17.5% at 360 days, P <.001). Conversely, AMI rates at 360 days was higher in ACS patients with normal versus elevated hs-cTnT levels (P =.004). Conclusion: Almost one third of ACS patients have normal hs-cTnT levels at presentation, mostly patients with UA. ACS patients with normal hs-cTnT have a very low mortality, but an increased rate of AMI during the subsequent 360 days.

KW - Acute coronary syndrome

KW - False negative

KW - High-sensitivity troponin

KW - Prognosis

UR - http://www.scopus.com/inward/record.url?scp=81855194268&partnerID=8YFLogxK

U2 - 10.1016/j.amjmed.2011.07.032

DO - 10.1016/j.amjmed.2011.07.032

M3 - SCORING: Journal article

C2 - 22014790

AN - SCOPUS:81855194268

VL - 124

SP - 1151

EP - 1157

JO - AM J MED

JF - AM J MED

SN - 0002-9343

IS - 12

ER -