Universität zu Köln

Schofer, Niklas, Brunner, Fabian J., Schlueter, Michael, Ojeda, Francisco, Zeller, Tanja, Baldus, Stephan, Bickel, Christoph, Lackner, Karl J., Muenzel, Thomas, Tzikas, Stergios ORCID: 0000-0002-7811-5620, Genth-Zotz, Sabine, Warnholtz, Ascan, Post, Felix, Keller, Till ORCID: 0000-0002-0895-6491, Goldmann, Britta U. and Blankenberg, Stefan (2017). Gender-specific diagnostic performance of a new high-sensitivity cardiac troponin I assay for detection of acute myocardial infarction. Eur. Heart J.-Acute Cardiovasc. Care, 6 (1). S. 60 - 69. LONDON: SAGE PUBLICATIONS LTD. ISSN 2048-8734

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Abstract

Background: The determination of cardiac troponin is essential for diagnosing myocardial infarction. A troponin I assay has recently been developed that provides the highest analytical sensitivity to date. Methods: The analysis included 1560 patients with chest pain, of whom 1098 were diagnosed with non-coronary chest pain, 189 with unstable angina pectoris and 273 with non-ST-segment elevation myocardial infarction. The troponin I concentration was determined on admission (0 hours) and 3 hours later. The diagnostic algorithm incorporated troponin I elevation above the gender-specific 99th percentile as well as predefined relative or absolute 3-hour changes in the troponin I concentration (delta). Results: The diagnostic criterion of troponin I above the 99th percentile resulted in a negative predictive value of 98.0% and 98.2% in men and women, respectively. For rule-in of non-ST-segment elevation myocardial infarction, the use of absolute deltas yielded higher positive predictive values and sensitivities compared to relative deltas. With detection rates of about 85% and 82% in men and women, respectively, non-ST-segment elevation myocardial infarction was diagnosed with a positive predictive value close to 84% in men and 80% in women. Conclusions: The investigational troponin I assay provides an excellent non-ST-segment elevation myocardial infarction rule out. With gender-specific differences, the application of absolute changes in troponin concentration was superior to relative changes to rule in patients with non-ST-segment elevation myocardial infarction.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schofer, Niklas UNSPECIFIED UNSPECIFIED UNSPECIFIED Brunner, Fabian J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schlueter, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Ojeda, Francisco UNSPECIFIED UNSPECIFIED UNSPECIFIED Zeller, Tanja UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Bickel, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Lackner, Karl J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Muenzel, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Tzikas, Stergios UNSPECIFIED orcid.org/0000-0002-7811-5620 UNSPECIFIED Genth-Zotz, Sabine UNSPECIFIED UNSPECIFIED UNSPECIFIED Warnholtz, Ascan UNSPECIFIED UNSPECIFIED UNSPECIFIED Post, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Keller, Till UNSPECIFIED orcid.org/0000-0002-0895-6491 UNSPECIFIED Goldmann, Britta U. UNSPECIFIED UNSPECIFIED UNSPECIFIED Blankenberg, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-240400
DOI:	10.1177/2048872615626660
Journal or Publication Title:	Eur. Heart J.-Acute Cardiovasc. Care
Volume:	6
Number:	1
Page Range:	S. 60 - 69
Date:	2017
Publisher:	SAGE PUBLICATIONS LTD
Place of Publication:	LONDON
ISSN:	2048-8734
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACUTE CORONARY SYNDROME; UNIVERSAL DEFINITION; 99TH PERCENTILE; POPULATION; ABSOLUTE Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/24040