Research ExplorerPublicationsProhormones in the Early Diagnosis of Cardiac Syncope

Prohormones in the Early Diagnosis of Cardiac Syncope

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Prohormones in the Early Diagnosis of Cardiac Syncope. / Badertscher, Patrick; Nestelberger, Thomas; de Lavallaz, Jeanne du Fay; Than, Martin; Morawiec, Beata; Kawecki, Damian; Miró, Òscar; López, Beatriz; Martin-Sanchez, F Javier; Bustamante, José; Geigy, Nicolas; Christ, Michael; Di Somma, Salvatore; Peacock, W Frank; Cullen, Louise; Sarasin, François; Flores, Dayana; Tschuck, Michael; Boeddinghaus, Jasper; Twerenbold, Raphael; Wildi, Karin; Sabti, Zaid; Puelacher, Christian; Rubini Giménez, Maria; Kozhuharov, Nikola; Shrestha, Samyut; Strebel, Ivo; Rentsch, Katharina; Keller, Dagmar I; Poepping, Imke; Buser, Andreas; Kloos, Wanda; Lohrmann, Jens; Kuehne, Michael; Osswald, Stefan; Reichlin, Tobias; Mueller, Christian.

In: J AM HEART ASSOC, Vol. 6, No. 12, 14.12.2017.

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

Harvard

Badertscher, P, Nestelberger, T, de Lavallaz, JDF, Than, M, Morawiec, B, Kawecki, D, Miró, Ò, López, B, Martin-Sanchez, FJ, Bustamante, J, Geigy, N, Christ, M, Di Somma, S, Peacock, WF, Cullen, L, Sarasin, F, Flores, D, Tschuck, M, Boeddinghaus, J, Twerenbold, R, Wildi, K, Sabti, Z, Puelacher, C, Rubini Giménez, M, Kozhuharov, N, Shrestha, S, Strebel, I, Rentsch, K, Keller, DI, Poepping, I, Buser, A, Kloos, W, Lohrmann, J, Kuehne, M, Osswald, S, Reichlin, T & Mueller, C 2017, 'Prohormones in the Early Diagnosis of Cardiac Syncope', J AM HEART ASSOC, vol. 6, no. 12. https://doi.org/10.1161/JAHA.117.006592

APA

Badertscher, P., Nestelberger, T., de Lavallaz, J. D. F., Than, M., Morawiec, B., Kawecki, D., Miró, Ò., López, B., Martin-Sanchez, F. J., Bustamante, J., Geigy, N., Christ, M., Di Somma, S., Peacock, W. F., Cullen, L., Sarasin, F., Flores, D., Tschuck, M., Boeddinghaus, J., ... Mueller, C. (2017). Prohormones in the Early Diagnosis of Cardiac Syncope. J AM HEART ASSOC, 6(12). https://doi.org/10.1161/JAHA.117.006592

Vancouver

Badertscher P, Nestelberger T, de Lavallaz JDF, Than M, Morawiec B, Kawecki D et al. Prohormones in the Early Diagnosis of Cardiac Syncope. J AM HEART ASSOC. 2017 Dec 14;6(12). https://doi.org/10.1161/JAHA.117.006592

Bibtex

@article{ad1a5f1482ea407ea323a63ae65a31aa,
title = "Prohormones in the Early Diagnosis of Cardiac Syncope",
abstract = "BACKGROUND: The early detection of cardiac syncope is challenging. We aimed to evaluate the diagnostic value of 4 novel prohormones, quantifying different neurohumoral pathways, possibly involved in the pathophysiological features of cardiac syncope: midregional-pro-A-type natriuretic peptide (MRproANP), C-terminal proendothelin 1, copeptin, and midregional-proadrenomedullin.METHODS AND RESULTS: We prospectively enrolled unselected patients presenting with syncope to the emergency department (ED) in a diagnostic multicenter study. ED probability of cardiac syncope was quantified by the treating ED physician using a visual analogue scale. Prohormones were measured in a blinded manner. Two independent cardiologists adjudicated the final diagnosis on the basis of all clinical information, including 1-year follow-up. Among 689 patients, cardiac syncope was the adjudicated final diagnosis in 125 (18%). Plasma concentrations of MRproANP, C-terminal proendothelin 1, copeptin, and midregional-proadrenomedullin were all significantly higher in patients with cardiac syncope compared with patients with other causes (P<0.001). The diagnostic accuracies for cardiac syncope, as quantified by the area under the curve, were 0.80 (95% confidence interval [CI], 0.76-0.84), 0.69 (95% CI, 0.64-0.74), 0.58 (95% CI, 0.52-0.63), and 0.68 (95% CI, 0.63-0.73), respectively. In conjunction with the ED probability (0.86; 95% CI, 0.82-0.90), MRproANP, but not the other prohormone, improved the area under the curve to 0.90 (95% CI, 0.87-0.93), which was significantly higher than for the ED probability alone (P=0.003). An algorithm to rule out cardiac syncope combining an MRproANP level of <77 pmol/L and an ED probability of <20% had a sensitivity and a negative predictive value of 99%.CONCLUSIONS: The use of MRproANP significantly improves the early detection of cardiac syncope among unselected patients presenting to the ED with syncope.CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01548352.",
keywords = "Adrenomedullin/blood, Aged, Atrial Natriuretic Factor/blood, Biomarkers/blood, Early Diagnosis, Emergency Service, Hospital, Endothelin-1/blood, Female, Follow-Up Studies, Glycopeptides/blood, Humans, Male, Middle Aged, Peptide Fragments/blood, Predictive Value of Tests, Prospective Studies, Protein Precursors/blood, Syncope/blood",
author = "Patrick Badertscher and Thomas Nestelberger and {de Lavallaz}, {Jeanne du Fay} and Martin Than and Beata Morawiec and Damian Kawecki and {\`O}scar Mir{\'o} and Beatriz L{\'o}pez and Martin-Sanchez, {F Javier} and Jos{\'e} Bustamante and Nicolas Geigy and Michael Christ and {Di Somma}, Salvatore and Peacock, {W Frank} and Louise Cullen and Fran{\c c}ois Sarasin and Dayana Flores and Michael Tschuck and Jasper Boeddinghaus and Raphael Twerenbold and Karin Wildi and Zaid Sabti and Christian Puelacher and {Rubini Gim{\'e}nez}, Maria and Nikola Kozhuharov and Samyut Shrestha and Ivo Strebel and Katharina Rentsch and Keller, {Dagmar I} and Imke Poepping and Andreas Buser and Wanda Kloos and Jens Lohrmann and Michael Kuehne and Stefan Osswald and Tobias Reichlin and Christian Mueller",
note = "{\textcopyright} 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.",
year = "2017",
month = dec,
day = "14",
doi = "10.1161/JAHA.117.006592",
language = "English",
volume = "6",
journal = "J AM HEART ASSOC",
issn = "2047-9980",
publisher = "Wiley-Blackwell",
number = "12",

}

RIS

TY - JOUR

T1 - Prohormones in the Early Diagnosis of Cardiac Syncope

AU - Badertscher, Patrick

AU - Nestelberger, Thomas

AU - de Lavallaz, Jeanne du Fay

AU - Than, Martin

AU - Morawiec, Beata

AU - Kawecki, Damian

AU - Miró, Òscar

AU - López, Beatriz

AU - Martin-Sanchez, F Javier

AU - Bustamante, José

AU - Geigy, Nicolas

AU - Christ, Michael

AU - Di Somma, Salvatore

AU - Peacock, W Frank

AU - Cullen, Louise

AU - Sarasin, François

AU - Flores, Dayana

AU - Tschuck, Michael

AU - Boeddinghaus, Jasper

AU - Twerenbold, Raphael

AU - Wildi, Karin

AU - Sabti, Zaid

AU - Puelacher, Christian

AU - Rubini Giménez, Maria

AU - Kozhuharov, Nikola

AU - Shrestha, Samyut

AU - Strebel, Ivo

AU - Rentsch, Katharina

AU - Keller, Dagmar I

AU - Poepping, Imke

AU - Buser, Andreas

AU - Kloos, Wanda

AU - Lohrmann, Jens

AU - Kuehne, Michael

AU - Osswald, Stefan

AU - Reichlin, Tobias

AU - Mueller, Christian

N1 - © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

PY - 2017/12/14

Y1 - 2017/12/14

N2 - BACKGROUND: The early detection of cardiac syncope is challenging. We aimed to evaluate the diagnostic value of 4 novel prohormones, quantifying different neurohumoral pathways, possibly involved in the pathophysiological features of cardiac syncope: midregional-pro-A-type natriuretic peptide (MRproANP), C-terminal proendothelin 1, copeptin, and midregional-proadrenomedullin.METHODS AND RESULTS: We prospectively enrolled unselected patients presenting with syncope to the emergency department (ED) in a diagnostic multicenter study. ED probability of cardiac syncope was quantified by the treating ED physician using a visual analogue scale. Prohormones were measured in a blinded manner. Two independent cardiologists adjudicated the final diagnosis on the basis of all clinical information, including 1-year follow-up. Among 689 patients, cardiac syncope was the adjudicated final diagnosis in 125 (18%). Plasma concentrations of MRproANP, C-terminal proendothelin 1, copeptin, and midregional-proadrenomedullin were all significantly higher in patients with cardiac syncope compared with patients with other causes (P<0.001). The diagnostic accuracies for cardiac syncope, as quantified by the area under the curve, were 0.80 (95% confidence interval [CI], 0.76-0.84), 0.69 (95% CI, 0.64-0.74), 0.58 (95% CI, 0.52-0.63), and 0.68 (95% CI, 0.63-0.73), respectively. In conjunction with the ED probability (0.86; 95% CI, 0.82-0.90), MRproANP, but not the other prohormone, improved the area under the curve to 0.90 (95% CI, 0.87-0.93), which was significantly higher than for the ED probability alone (P=0.003). An algorithm to rule out cardiac syncope combining an MRproANP level of <77 pmol/L and an ED probability of <20% had a sensitivity and a negative predictive value of 99%.CONCLUSIONS: The use of MRproANP significantly improves the early detection of cardiac syncope among unselected patients presenting to the ED with syncope.CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01548352.

AB - BACKGROUND: The early detection of cardiac syncope is challenging. We aimed to evaluate the diagnostic value of 4 novel prohormones, quantifying different neurohumoral pathways, possibly involved in the pathophysiological features of cardiac syncope: midregional-pro-A-type natriuretic peptide (MRproANP), C-terminal proendothelin 1, copeptin, and midregional-proadrenomedullin.METHODS AND RESULTS: We prospectively enrolled unselected patients presenting with syncope to the emergency department (ED) in a diagnostic multicenter study. ED probability of cardiac syncope was quantified by the treating ED physician using a visual analogue scale. Prohormones were measured in a blinded manner. Two independent cardiologists adjudicated the final diagnosis on the basis of all clinical information, including 1-year follow-up. Among 689 patients, cardiac syncope was the adjudicated final diagnosis in 125 (18%). Plasma concentrations of MRproANP, C-terminal proendothelin 1, copeptin, and midregional-proadrenomedullin were all significantly higher in patients with cardiac syncope compared with patients with other causes (P<0.001). The diagnostic accuracies for cardiac syncope, as quantified by the area under the curve, were 0.80 (95% confidence interval [CI], 0.76-0.84), 0.69 (95% CI, 0.64-0.74), 0.58 (95% CI, 0.52-0.63), and 0.68 (95% CI, 0.63-0.73), respectively. In conjunction with the ED probability (0.86; 95% CI, 0.82-0.90), MRproANP, but not the other prohormone, improved the area under the curve to 0.90 (95% CI, 0.87-0.93), which was significantly higher than for the ED probability alone (P=0.003). An algorithm to rule out cardiac syncope combining an MRproANP level of <77 pmol/L and an ED probability of <20% had a sensitivity and a negative predictive value of 99%.CONCLUSIONS: The use of MRproANP significantly improves the early detection of cardiac syncope among unselected patients presenting to the ED with syncope.CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01548352.

KW - Adrenomedullin/blood

KW - Aged

KW - Atrial Natriuretic Factor/blood

KW - Biomarkers/blood

KW - Early Diagnosis

KW - Emergency Service, Hospital

KW - Endothelin-1/blood

KW - Female

KW - Follow-Up Studies

KW - Glycopeptides/blood

KW - Humans

KW - Male

KW - Middle Aged

KW - Peptide Fragments/blood

KW - Predictive Value of Tests

KW - Prospective Studies

KW - Protein Precursors/blood

KW - Syncope/blood

U2 - 10.1161/JAHA.117.006592

DO - 10.1161/JAHA.117.006592

M3 - SCORING: Journal article

C2 - 29426039

VL - 6

JO - J AM HEART ASSOC

JF - J AM HEART ASSOC

SN - 2047-9980

IS - 12

ER -