High Baseline High-Sensitivity Cardiac Troponin T Concentrations and Risk of Index Acute Myocardial Infarction
Copyright © 2024 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved..
OBJECTIVE: To evaluate the diagnostic performance of the previously recommended baseline high-sensitivity cardiac troponin T (hs-cTnT) thresholds of 52 and 100 ng/L in identifying patients at high risk of acute myocardial infarction (AMI).
PATIENTS AND METHODS: This study compared the positive predictive value (PPV) for index AMI of these high-risk hs-cTnT thresholds in adult patients in the emergency department undergoing hs-cTnT measurement.
RESULTS: The adjudicated MAyo Southwest Wisconsin 5th Gen Troponin T ImplementatiON cohort included 2053 patients, with 157 (7.6%) who received a diagnosis of AMI. The hs-cTnT concentrations of greater than 52 and greater than 100 ng/L resulted in PPVs of 41% (95% CI, 35%-48%) and 57% (95% CI, 48%-66%). In patients with chest discomfort, hs-cTnT concentrations greater than 52 ng/L resulted in a PPV of 66% (95% CI, 56%-76%) and hs-cTnT concentrations greater than 100 ng/L resulted in a PPV of 77% (95% CI, 65%-87%). The CV Data Mart Biomarker cohort included 143,709 patients, and 3003 (2.1%) received a diagnosis of AMI. Baseline hs-cTnT concentrations greater than 52 and greater than 100 ng/L resulted in PPVs of 12% (95% CI, 11%-12%) and 17% (95% CI, 17%-19%), respectively. In patients with chest pain and hs-cTnT concentrations greater than 52 ng/L, the PPV for MI was 17% (95% CI, 15%-18%) and in those with concentrations greater than 100 ng/L, only 22% (95% CI, 19%-25%).
CONCLUSION: In unselected patients undergoing hs-cTnT measurement, the hs-cTnT thresholds of greater than 52 and greater than 100 ng/L provide suboptimal performance for identifying high-risk patients. In patients with chest discomfort, an hs-cTnT concentration of greater than 100 ng/L, but not the European Society of Cardiology-recommended threshold of greater than 52 ng/L, provides an acceptable performance but should be used only with other clinical features.
Medienart: |
E-Artikel |
---|
Erscheinungsjahr: |
2024 |
---|---|
Erschienen: |
2024 |
Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
---|---|
Enthalten in: |
Mayo Clinic proceedings - (2024) vom: 15. März |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Knott, Jonathan D [VerfasserIn] |
---|
Links: |
---|
Themen: |
---|
Anmerkungen: |
Date Revised 17.03.2024 published: Print-Electronic Citation Status Publisher |
---|
doi: |
10.1016/j.mayocp.2023.12.019 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM369830792 |
---|
LEADER | 01000naa a22002652 4500 | ||
---|---|---|---|
001 | NLM369830792 | ||
003 | DE-627 | ||
005 | 20240317233521.0 | ||
007 | cr uuu---uuuuu | ||
008 | 240317s2024 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1016/j.mayocp.2023.12.019 |2 doi | |
028 | 5 | 2 | |a pubmed24n1333.xml |
035 | |a (DE-627)NLM369830792 | ||
035 | |a (NLM)38493402 | ||
035 | |a (PII)S0025-6196(24)00026-0 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Knott, Jonathan D |e verfasserin |4 aut | |
245 | 1 | 0 | |a High Baseline High-Sensitivity Cardiac Troponin T Concentrations and Risk of Index Acute Myocardial Infarction |
264 | 1 | |c 2024 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ƒaComputermedien |b c |2 rdamedia | ||
338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
500 | |a Date Revised 17.03.2024 | ||
500 | |a published: Print-Electronic | ||
500 | |a Citation Status Publisher | ||
520 | |a Copyright © 2024 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved. | ||
520 | |a OBJECTIVE: To evaluate the diagnostic performance of the previously recommended baseline high-sensitivity cardiac troponin T (hs-cTnT) thresholds of 52 and 100 ng/L in identifying patients at high risk of acute myocardial infarction (AMI) | ||
520 | |a PATIENTS AND METHODS: This study compared the positive predictive value (PPV) for index AMI of these high-risk hs-cTnT thresholds in adult patients in the emergency department undergoing hs-cTnT measurement | ||
520 | |a RESULTS: The adjudicated MAyo Southwest Wisconsin 5th Gen Troponin T ImplementatiON cohort included 2053 patients, with 157 (7.6%) who received a diagnosis of AMI. The hs-cTnT concentrations of greater than 52 and greater than 100 ng/L resulted in PPVs of 41% (95% CI, 35%-48%) and 57% (95% CI, 48%-66%). In patients with chest discomfort, hs-cTnT concentrations greater than 52 ng/L resulted in a PPV of 66% (95% CI, 56%-76%) and hs-cTnT concentrations greater than 100 ng/L resulted in a PPV of 77% (95% CI, 65%-87%). The CV Data Mart Biomarker cohort included 143,709 patients, and 3003 (2.1%) received a diagnosis of AMI. Baseline hs-cTnT concentrations greater than 52 and greater than 100 ng/L resulted in PPVs of 12% (95% CI, 11%-12%) and 17% (95% CI, 17%-19%), respectively. In patients with chest pain and hs-cTnT concentrations greater than 52 ng/L, the PPV for MI was 17% (95% CI, 15%-18%) and in those with concentrations greater than 100 ng/L, only 22% (95% CI, 19%-25%) | ||
520 | |a CONCLUSION: In unselected patients undergoing hs-cTnT measurement, the hs-cTnT thresholds of greater than 52 and greater than 100 ng/L provide suboptimal performance for identifying high-risk patients. In patients with chest discomfort, an hs-cTnT concentration of greater than 100 ng/L, but not the European Society of Cardiology-recommended threshold of greater than 52 ng/L, provides an acceptable performance but should be used only with other clinical features | ||
650 | 4 | |a Journal Article | |
700 | 1 | |a Ola, Olatunde |e verfasserin |4 aut | |
700 | 1 | |a De Michieli, Laura |e verfasserin |4 aut | |
700 | 1 | |a Akula, Ashok |e verfasserin |4 aut | |
700 | 1 | |a Yang, Eric H |e verfasserin |4 aut | |
700 | 1 | |a Gharacholou, S Michael |e verfasserin |4 aut | |
700 | 1 | |a Slusser, Josh |e verfasserin |4 aut | |
700 | 1 | |a Lewis, Bradley |e verfasserin |4 aut | |
700 | 1 | |a Mehta, Ramila A |e verfasserin |4 aut | |
700 | 1 | |a Gulati, Rajiv |e verfasserin |4 aut | |
700 | 1 | |a Sandoval, Yader |e verfasserin |4 aut | |
700 | 1 | |a Jaffe, Allan S |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t Mayo Clinic proceedings |d 1964 |g (2024) vom: 15. März |w (DE-627)NLM000074527 |x 1942-5546 |7 nnns |
773 | 1 | 8 | |g year:2024 |g day:15 |g month:03 |
856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.mayocp.2023.12.019 |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |j 2024 |b 15 |c 03 |