The association of anaemia and high-sensitivity cardiac troponin and its effect on diagnosing myocardial infarction

Paul Michael Haller; Johannes T Neumann; Nils A Sörensen; Tau S Hartikainen; Alina Goßling; Jonas Lehmacher; Till Keller; Tanja Zeller; Stefan Blankenberg; Dirk Westermann

doi:10.1093/ehjacc/zuab066

The association of anaemia and high-sensitivity cardiac troponin and its effect on diagnosing myocardial infarction

Standard

The association of anaemia and high-sensitivity cardiac troponin and its effect on diagnosing myocardial infarction. / Haller, Paul Michael ; Neumann, Johannes T ; Sörensen, Nils A; Hartikainen, Tau S; Goßling, Alina ; Lehmacher, Jonas; Keller, Till; Zeller, Tanja ; Blankenberg, Stefan ; Westermann, Dirk.

In: EUR HEART J-ACUTE CA, Vol. 10, No. 10, 18.12.2021, p. 1187-1196.

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

Harvard

Haller, PM , Neumann, JT , Sörensen, NA, Hartikainen, TS, Goßling, A , Lehmacher, J, Keller, T, Zeller, T , Blankenberg, S & Westermann, D 2021, 'The association of anaemia and high-sensitivity cardiac troponin and its effect on diagnosing myocardial infarction', EUR HEART J-ACUTE CA, vol. 10, no. 10, pp. 1187-1196. https://doi.org/10.1093/ehjacc/zuab066

APA

Haller, P. M., Neumann, J. T., Sörensen, N. A., Hartikainen, T. S., Goßling, A., Lehmacher, J., Keller, T., Zeller, T., Blankenberg, S., & Westermann, D. (2021). The association of anaemia and high-sensitivity cardiac troponin and its effect on diagnosing myocardial infarction. EUR HEART J-ACUTE CA, 10(10), 1187-1196. https://doi.org/10.1093/ehjacc/zuab066

Vancouver

Haller PM , Neumann JT , Sörensen NA, Hartikainen TS, Goßling A , Lehmacher J et al. The association of anaemia and high-sensitivity cardiac troponin and its effect on diagnosing myocardial infarction. EUR HEART J-ACUTE CA. 2021 Dec 18;10(10):1187-1196. https://doi.org/10.1093/ehjacc/zuab066

Bibtex

@article{f778f35112384fd1aab6beaa53a8281b,

title = "The association of anaemia and high-sensitivity cardiac troponin and its effect on diagnosing myocardial infarction",

abstract = "AIMS: Anaemia is common in patients with acute myocardial infarction (MI). We investigated the association of high-sensitivity cardiac troponin (hs-cTn) and haemoglobin (Hb) and the influence of anaemia on the performance of diagnostic protocols for suspected MI.METHODS AND RESULTS: Patients with suspected MI were consecutively enrolled at a tertiary centre. Final diagnoses were independently adjudicated by two cardiologists. Performance measures of hs-cTn-based algorithms were compared for anaemic and non-anaemic patients (Hb <12 g/dL in women and <13 g/dL in men). The influence of anaemia on survival (median follow-up 1.7 years) was investigated using multivariable cox-regression analysis and the association of Hb and hs-cTn by multivariable linear regression analysis. Overall, 2223 patients were included, of whom 415 (18.7%) had anaemia. In anaemic patients, the incidence of MI was similar; however, chronic myocardial injury was significantly more prevalent (20.1% vs. 48.2%). The negative predictive value to rule-out MI was similar for both algorithms and all assays in patients with anaemia, although the positive predictive value to rule-in MI was partly reduced for the 0/3-h algorithm. Fewer anaemic patients were triaged after 1 h. Anaemia was an independent predictor of death. Adjusted for patient characteristics, Hb was significantly associated with hs-cTn. By providing a point-based tool, the Hb-associated hs-cTn concentration and thus chronic myocardial injury may be predicted.CONCLUSION : Anaemia partly affects the rule-in, but not the rule-out of MI in hs-cTn-based diagnostic protocols. Hs-cTn concentrations and thus chronic myocardial injury may be predicted by clinical variables and Hb.TRIAL REGISTRATION: clinicaltrials.gov (NCT02355457 and NCT03227159).",

author = "Haller, {Paul Michael} and Neumann, {Johannes T} and S{\"o}rensen, {Nils A} and Hartikainen, {Tau S} and Alina Go{\ss}ling and Jonas Lehmacher and Till Keller and Tanja Zeller and Stefan Blankenberg and Dirk Westermann",

year = "2021",

month = dec,

day = "18",

doi = "10.1093/ehjacc/zuab066",

language = "English",

volume = "10",

pages = "1187--1196",

journal = "EUR HEART J-ACUTE CA",

issn = "2048-8726",

publisher = "SAGE Publications",

number = "10",

}

RIS

TY - JOUR

T1 - The association of anaemia and high-sensitivity cardiac troponin and its effect on diagnosing myocardial infarction

AU - Haller, Paul Michael

AU - Neumann, Johannes T

AU - Sörensen, Nils A

AU - Hartikainen, Tau S

AU - Goßling, Alina

AU - Lehmacher, Jonas

AU - Keller, Till

AU - Zeller, Tanja

AU - Blankenberg, Stefan

AU - Westermann, Dirk

PY - 2021/12/18

Y1 - 2021/12/18

N2 - AIMS: Anaemia is common in patients with acute myocardial infarction (MI). We investigated the association of high-sensitivity cardiac troponin (hs-cTn) and haemoglobin (Hb) and the influence of anaemia on the performance of diagnostic protocols for suspected MI.METHODS AND RESULTS: Patients with suspected MI were consecutively enrolled at a tertiary centre. Final diagnoses were independently adjudicated by two cardiologists. Performance measures of hs-cTn-based algorithms were compared for anaemic and non-anaemic patients (Hb <12 g/dL in women and <13 g/dL in men). The influence of anaemia on survival (median follow-up 1.7 years) was investigated using multivariable cox-regression analysis and the association of Hb and hs-cTn by multivariable linear regression analysis. Overall, 2223 patients were included, of whom 415 (18.7%) had anaemia. In anaemic patients, the incidence of MI was similar; however, chronic myocardial injury was significantly more prevalent (20.1% vs. 48.2%). The negative predictive value to rule-out MI was similar for both algorithms and all assays in patients with anaemia, although the positive predictive value to rule-in MI was partly reduced for the 0/3-h algorithm. Fewer anaemic patients were triaged after 1 h. Anaemia was an independent predictor of death. Adjusted for patient characteristics, Hb was significantly associated with hs-cTn. By providing a point-based tool, the Hb-associated hs-cTn concentration and thus chronic myocardial injury may be predicted.CONCLUSION : Anaemia partly affects the rule-in, but not the rule-out of MI in hs-cTn-based diagnostic protocols. Hs-cTn concentrations and thus chronic myocardial injury may be predicted by clinical variables and Hb.TRIAL REGISTRATION: clinicaltrials.gov (NCT02355457 and NCT03227159).

AB - AIMS: Anaemia is common in patients with acute myocardial infarction (MI). We investigated the association of high-sensitivity cardiac troponin (hs-cTn) and haemoglobin (Hb) and the influence of anaemia on the performance of diagnostic protocols for suspected MI.METHODS AND RESULTS: Patients with suspected MI were consecutively enrolled at a tertiary centre. Final diagnoses were independently adjudicated by two cardiologists. Performance measures of hs-cTn-based algorithms were compared for anaemic and non-anaemic patients (Hb <12 g/dL in women and <13 g/dL in men). The influence of anaemia on survival (median follow-up 1.7 years) was investigated using multivariable cox-regression analysis and the association of Hb and hs-cTn by multivariable linear regression analysis. Overall, 2223 patients were included, of whom 415 (18.7%) had anaemia. In anaemic patients, the incidence of MI was similar; however, chronic myocardial injury was significantly more prevalent (20.1% vs. 48.2%). The negative predictive value to rule-out MI was similar for both algorithms and all assays in patients with anaemia, although the positive predictive value to rule-in MI was partly reduced for the 0/3-h algorithm. Fewer anaemic patients were triaged after 1 h. Anaemia was an independent predictor of death. Adjusted for patient characteristics, Hb was significantly associated with hs-cTn. By providing a point-based tool, the Hb-associated hs-cTn concentration and thus chronic myocardial injury may be predicted.CONCLUSION : Anaemia partly affects the rule-in, but not the rule-out of MI in hs-cTn-based diagnostic protocols. Hs-cTn concentrations and thus chronic myocardial injury may be predicted by clinical variables and Hb.TRIAL REGISTRATION: clinicaltrials.gov (NCT02355457 and NCT03227159).

U2 - 10.1093/ehjacc/zuab066

DO - 10.1093/ehjacc/zuab066

M3 - SCORING: Journal article

C2 - 34350455

VL - 10

SP - 1187

EP - 1196

JO - EUR HEART J-ACUTE CA

JF - EUR HEART J-ACUTE CA

SN - 2048-8726

IS - 10

ER -