Universität zu Köln

von Jeinsen, Beatrice, Liebetrau, Christoph, Palapies, Lars, Tzikas, Stergios ORCID: 0000-0002-7811-5620, Zelle, Tanja, Bickel, Christoph, Schmidt, Alexander, Tubaro, Marco, Lackner, Karl J., Sar, Fachrie, Baldus, Stephan, Zeiher, Andreas M., Blankenberg, Stefan, Gori, Tommaso, Muenzel, Thomas, Hamm, Christian W., Wild, Philipp S. and Keller, Till (2019). Identification of acute myocardial infarction in elderly patients using optimized highly sensitive troponin I thresholds. Biomarkers, 24 (6). S. 549 - 556. ABINGDON: TAYLOR & FRANCIS LTD. ISSN 1366-5804

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Abstract

Purpose: Established diagnostic thresholds for high-sensitivity cardiac troponins (hs-cTn) might not apply for elderly patients as they are elevated irrespective of the presence of an acute myocardial infarction (AMI). Aim of the present study was to investigate hs-cTnI in elderly patients with suspected AMI and to calculate optimized diagnostic cutoffs. Material and methods: Data from a prospective multi-centre study and from a second independent prospective single-centre cohort study were analysed. A number of 2903 patients were eligible for further analysis. Patients > 70 years were classified as elderly. hs-cTnI was measured upon admission. Results: Around 34.7% of 2903 patients were classified as elderly. Around 22.5% of elderly patients were finally diagnosed with AMI. Elderly patients had higher hs-cTnI levels at admission irrespective of the final diagnosis (p < 0.001). According to the AUROC, hs-cTnI was a strong marker for detection of AMI in elderly patients. Application of the 99th percentile cutoffs showed a substantially lower specificity in elderly. By using optimized thresholds, specificity was improved to levels as in younger patients in both cohorts but accompanied with a decrease in sensitivity. Conclusions: hs-cTnI levels have a lower specificity for detecting AMI in elderly patients. This lower specificity can be improved by using hs-cTnI thresholds optimized for elderly patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code von Jeinsen, Beatrice UNSPECIFIED UNSPECIFIED UNSPECIFIED Liebetrau, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Palapies, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED Tzikas, Stergios UNSPECIFIED orcid.org/0000-0002-7811-5620 UNSPECIFIED Zelle, Tanja UNSPECIFIED UNSPECIFIED UNSPECIFIED Bickel, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Tubaro, Marco UNSPECIFIED UNSPECIFIED UNSPECIFIED Lackner, Karl J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sar, Fachrie UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Zeiher, Andreas M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Blankenberg, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Gori, Tommaso UNSPECIFIED UNSPECIFIED UNSPECIFIED Muenzel, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamm, Christian W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wild, Philipp S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Keller, Till UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-137991
DOI:	10.1080/1354750X.2019.1606276
Journal or Publication Title:	Biomarkers
Volume:	24
Number:	6
Page Range:	S. 549 - 556
Date:	2019
Publisher:	TAYLOR & FRANCIS LTD
Place of Publication:	ABINGDON
ISSN:	1366-5804
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EARLY-DIAGNOSIS; REFERENCE POPULATION; MORTALITY; SAMPLE; ASSAY Multiple languages Biotechnology & Applied Microbiology; Toxicology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13799