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Serial changes in high-sensitivity cardiac troponin i in the early diagnosis of acute myocardial infarction

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Serial changes in high-sensitivity cardiac troponin i in the early diagnosis of acute myocardial infarction. / Wildi, Karin; Reichlin, Tobias; Twerenbold, Raphael; Mäder, Fabienne; Zellweger, Christa; Moehring, Berit; Stallone, Fabio; Minners, Jan; Rubini Gimenez, Maria; Hoeller, Rebeca; Murray, Karsten; Sou, Seoung Mann; Mueller, Mira; Denhaerynck, Kris; Mosimann, Tamina; Reiter, Miriam; Haaf, Philip; Meller, Bernadette; Freidank, Heike; Osswald, Stefan; Mueller, Christian.

In: INT J CARDIOL, Vol. 168, No. 4, 09.10.2013, p. 4103-4110.

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

Harvard

Wildi, K, Reichlin, T, Twerenbold, R, Mäder, F, Zellweger, C, Moehring, B, Stallone, F, Minners, J, Rubini Gimenez, M, Hoeller, R, Murray, K, Sou, SM, Mueller, M, Denhaerynck, K, Mosimann, T, Reiter, M, Haaf, P, Meller, B, Freidank, H, Osswald, S & Mueller, C 2013, 'Serial changes in high-sensitivity cardiac troponin i in the early diagnosis of acute myocardial infarction', INT J CARDIOL, vol. 168, no. 4, pp. 4103-4110. https://doi.org/10.1016/j.ijcard.2013.07.078

APA

Wildi, K., Reichlin, T., Twerenbold, R., Mäder, F., Zellweger, C., Moehring, B., Stallone, F., Minners, J., Rubini Gimenez, M., Hoeller, R., Murray, K., Sou, S. M., Mueller, M., Denhaerynck, K., Mosimann, T., Reiter, M., Haaf, P., Meller, B., Freidank, H., ... Mueller, C. (2013). Serial changes in high-sensitivity cardiac troponin i in the early diagnosis of acute myocardial infarction. INT J CARDIOL, 168(4), 4103-4110. https://doi.org/10.1016/j.ijcard.2013.07.078

Vancouver

Wildi K, Reichlin T, Twerenbold R, Mäder F, Zellweger C, Moehring B et al. Serial changes in high-sensitivity cardiac troponin i in the early diagnosis of acute myocardial infarction. INT J CARDIOL. 2013 Oct 9;168(4):4103-4110. https://doi.org/10.1016/j.ijcard.2013.07.078

Bibtex

@article{77f46980a44740eea109c8c83f4705ee,
title = "Serial changes in high-sensitivity cardiac troponin i in the early diagnosis of acute myocardial infarction",
abstract = "Background Current guidelines require a change (rise and/or fall) in levels of cardiac troponin (cTn) for the diagnosis of acute myocardial infarction (AMI). It is unknown whether absolute or relative changes provide higher accuracy when using high-sensitivity cTnI assays. Methods In a prospective international multicentre study, we assessed the diagnostic accuracy of early absolute and relative changes in cTnI measured with two novel pre-commercial high-sensitivity assays (Siemens and Beckman Coulter) in 943 unselected patients presenting to the ED with suspected AMI. The final diagnosis of AMI was adjudicated using all available data including serial hs-cTnT levels by two independent cardiologists. Results The diagnostic accuracy of absolute changes in the diagnosis of AMI as quantified by the area under the receiver operating characteristics curve (AUC) was very high (e.g. at 2 h, Siemens high-sensitivity cTnI AUC 0.93, 95%Cl 0.90-0.96; Beckman Coulter high-sensitivity cTnI AUC 0.93, 95%Cl 0.90-0.96) and superior to relative changes at all time points (p < 0.001). The results were consistent in clinically important subgroups. Direct comparison of the absolute changes in the two high-sensitivity cTnI assays showed similar accuracy. When combined with the baseline cTnI levels, the difference between absolute and relative changes became much smaller and remained statistically significant only for the Siemens assay. Conclusions As single variables early absolute changes in high-sensitivity cTnI levels have significantly higher diagnostic accuracy than relative changes. When combined with the baseline cTn level, reflecting clinical practice, both absolute and relative changes provided very high accuracy with much smaller differences between both approaches.",
keywords = "Absolute and relative changes, Diagnosis of acute myocardial infarction, High-sensitivity troponin I",
author = "Karin Wildi and Tobias Reichlin and Raphael Twerenbold and Fabienne M{\"a}der and Christa Zellweger and Berit Moehring and Fabio Stallone and Jan Minners and {Rubini Gimenez}, Maria and Rebeca Hoeller and Karsten Murray and Sou, {Seoung Mann} and Mira Mueller and Kris Denhaerynck and Tamina Mosimann and Miriam Reiter and Philip Haaf and Bernadette Meller and Heike Freidank and Stefan Osswald and Christian Mueller",
year = "2013",
month = oct,
day = "9",
doi = "10.1016/j.ijcard.2013.07.078",
language = "English",
volume = "168",
pages = "4103--4110",
journal = "INT J CARDIOL",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",
number = "4",

}

RIS

TY - JOUR

T1 - Serial changes in high-sensitivity cardiac troponin i in the early diagnosis of acute myocardial infarction

AU - Wildi, Karin

AU - Reichlin, Tobias

AU - Twerenbold, Raphael

AU - Mäder, Fabienne

AU - Zellweger, Christa

AU - Moehring, Berit

AU - Stallone, Fabio

AU - Minners, Jan

AU - Rubini Gimenez, Maria

AU - Hoeller, Rebeca

AU - Murray, Karsten

AU - Sou, Seoung Mann

AU - Mueller, Mira

AU - Denhaerynck, Kris

AU - Mosimann, Tamina

AU - Reiter, Miriam

AU - Haaf, Philip

AU - Meller, Bernadette

AU - Freidank, Heike

AU - Osswald, Stefan

AU - Mueller, Christian

PY - 2013/10/9

Y1 - 2013/10/9

N2 - Background Current guidelines require a change (rise and/or fall) in levels of cardiac troponin (cTn) for the diagnosis of acute myocardial infarction (AMI). It is unknown whether absolute or relative changes provide higher accuracy when using high-sensitivity cTnI assays. Methods In a prospective international multicentre study, we assessed the diagnostic accuracy of early absolute and relative changes in cTnI measured with two novel pre-commercial high-sensitivity assays (Siemens and Beckman Coulter) in 943 unselected patients presenting to the ED with suspected AMI. The final diagnosis of AMI was adjudicated using all available data including serial hs-cTnT levels by two independent cardiologists. Results The diagnostic accuracy of absolute changes in the diagnosis of AMI as quantified by the area under the receiver operating characteristics curve (AUC) was very high (e.g. at 2 h, Siemens high-sensitivity cTnI AUC 0.93, 95%Cl 0.90-0.96; Beckman Coulter high-sensitivity cTnI AUC 0.93, 95%Cl 0.90-0.96) and superior to relative changes at all time points (p < 0.001). The results were consistent in clinically important subgroups. Direct comparison of the absolute changes in the two high-sensitivity cTnI assays showed similar accuracy. When combined with the baseline cTnI levels, the difference between absolute and relative changes became much smaller and remained statistically significant only for the Siemens assay. Conclusions As single variables early absolute changes in high-sensitivity cTnI levels have significantly higher diagnostic accuracy than relative changes. When combined with the baseline cTn level, reflecting clinical practice, both absolute and relative changes provided very high accuracy with much smaller differences between both approaches.

AB - Background Current guidelines require a change (rise and/or fall) in levels of cardiac troponin (cTn) for the diagnosis of acute myocardial infarction (AMI). It is unknown whether absolute or relative changes provide higher accuracy when using high-sensitivity cTnI assays. Methods In a prospective international multicentre study, we assessed the diagnostic accuracy of early absolute and relative changes in cTnI measured with two novel pre-commercial high-sensitivity assays (Siemens and Beckman Coulter) in 943 unselected patients presenting to the ED with suspected AMI. The final diagnosis of AMI was adjudicated using all available data including serial hs-cTnT levels by two independent cardiologists. Results The diagnostic accuracy of absolute changes in the diagnosis of AMI as quantified by the area under the receiver operating characteristics curve (AUC) was very high (e.g. at 2 h, Siemens high-sensitivity cTnI AUC 0.93, 95%Cl 0.90-0.96; Beckman Coulter high-sensitivity cTnI AUC 0.93, 95%Cl 0.90-0.96) and superior to relative changes at all time points (p < 0.001). The results were consistent in clinically important subgroups. Direct comparison of the absolute changes in the two high-sensitivity cTnI assays showed similar accuracy. When combined with the baseline cTnI levels, the difference between absolute and relative changes became much smaller and remained statistically significant only for the Siemens assay. Conclusions As single variables early absolute changes in high-sensitivity cTnI levels have significantly higher diagnostic accuracy than relative changes. When combined with the baseline cTn level, reflecting clinical practice, both absolute and relative changes provided very high accuracy with much smaller differences between both approaches.

KW - Absolute and relative changes

KW - Diagnosis of acute myocardial infarction

KW - High-sensitivity troponin I

UR - http://www.scopus.com/inward/record.url?scp=84886254873&partnerID=8YFLogxK

U2 - 10.1016/j.ijcard.2013.07.078

DO - 10.1016/j.ijcard.2013.07.078

M3 - SCORING: Journal article

C2 - 23910445

AN - SCOPUS:84886254873

VL - 168

SP - 4103

EP - 4110

JO - INT J CARDIOL

JF - INT J CARDIOL

SN - 0167-5273

IS - 4

ER -