Diagnostic Accuracy of High-Sensitivity Cardiac Troponin T at Presentation Combined With History and ECG for Ruling Out Major Adverse Cardiac Events

Annals of Emergency Medicine

Volumn 68, Issue 6, 2016, Pages 649-658.e3

  Mokhtari, Arash ^a,b   Lindahl, Bertil ^c   Smith, J Gustav ^a,b   Holzmann, Martin J ^d   Khoshnood, Ardavan ^a,b   Ekelund, Ulf ^a,b  

^a LUND UNIVERSITY HOSPITAL   (Sweden)

^b LUND UNIVERSITY   (Sweden)

^c UPPSALA UNIVERSITY   (Sweden)

^d KAROLINSKA UNIVERSITY HOSPITAL   (Sweden)

Author keywords

[No Author keywords available]

Indexed keywords

TROPONIN T; BIOLOGICAL MARKER;

ACUTE HEART INFARCTION; ADULT; AGED; ARTICLE; ATRIOVENTRICULAR BLOCK; CARDIOGENIC SHOCK; CONTROLLED STUDY; DIAGNOSTIC ACCURACY; DIAGNOSTIC TEST ACCURACY STUDY; ELECTROCARDIOGRAM; EMERGENCY PHYSICIAN; EMERGENCY WARD; FEMALE; HEART ARREST; HEART DEATH; HEART DISEASE; HEART VENTRICLE ARRHYTHMIA; HUMAN; MAJOR CLINICAL STUDY; MALE; MEDICAL HISTORY; MIDDLE AGED; OBSERVATIONAL STUDY; OUTCOME ASSESSMENT; PREDICTIVE VALUE; PRIORITY JOURNAL; SENSITIVITY ANALYSIS; THORAX PAIN; UNSTABLE ANGINA PECTORIS; VERY ELDERLY; YOUNG ADULT; ANGINA, UNSTABLE; ARRHYTHMIAS, CARDIAC; BLOOD; ELECTROCARDIOGRAPHY; HOSPITAL EMERGENCY SERVICE; MORTALITY; MYOCARDIAL INFARCTION; MYOCARDIAL ISCHEMIA; PROSPECTIVE STUDY; SHOCK, CARDIOGENIC;

AGED; ANGINA, UNSTABLE; ARRHYTHMIAS, CARDIAC; ATRIOVENTRICULAR BLOCK; BIOMARKERS; ELECTROCARDIOGRAPHY; EMERGENCY SERVICE, HOSPITAL; FEMALE; HUMANS; MALE; MIDDLE AGED; MYOCARDIAL INFARCTION; MYOCARDIAL ISCHEMIA; PROSPECTIVE STUDIES; SHOCK, CARDIOGENIC; TROPONIN T;

EID: 84979707948     PISSN: 01960644     EISSN: 10976760     Source Type: Journal    
DOI: 10.1016/j.annemergmed.2016.06.008     Document Type: Article

References (38)

1. 1 Bandstein, N., Ljung, R., Johansson, M., et al. Undetectable high-sensitivity cardiac troponin T level in the emergency department and risk of myocardial infarction. J Am Coll Cardiol 63 (2014), 2569–2578.
2. 2 Body, R., Burrows, G., Carley, S., et al. High-sensitivity cardiac troponin T concentrations below the limit of detection to exclude acute myocardial infarction: a prospective evaluation. Clin Chem 61 (2015), 983–989.
3. 3 Zhelev, Z., Hyde, C., Youngman, E., et al. Diagnostic accuracy of single baseline measurement of Elecsys troponin T high-sensitive assay for diagnosis of acute myocardial infarction in emergency department: systematic review and meta-analysis. BMJ, 350, 2015, h15.
4. 4 Meune, C., Balmelli, C., Vogler, E., et al. Consideration of high-sensitivity troponin values below the 99th percentile at presentation: does it improve diagnostic accuracy?. Int J Cardiol 168 (2013), 3752–3757.
5. 5 Thelin, J., Melander, O., Ohlin, B., Early rule-out of acute coronary syndrome using undetectable levels of high sensitivity troponin T. Eur Heart J 4 (2015), 403–409.
6. 6 Body, R., Cook, G., Burrows, G., et al. Can emergency physicians “rule in” and “rule out” acute myocardial infarction with clinical judgement?. Emerg Med J 31 (2014), 872–876.
7. 7 Chase, M., Robey, J.L., Zogby, K.E., et al. Prospective validation of the Thrombolysis in Myocardial Infarction Risk Score in the emergency department chest pain population. Ann Emerg Med 48 (2006), 252–259.
8. 8 Christenson, J., Innes, G., McKnight, D., et al. Safety and efficiency of emergency department assessment of chest discomfort. CMAJ 170 (2004), 1803–1807.
9. 9 Cullen, L., Greenslade, J., Merollini, K., et al. Cost and outcomes of assessing patients with chest pain in an Australian emergency department. Med J Aust 202 (2015), 427–432.
10. 10 Mokhtari, A., Borna, C., Gilje, P., et al. A 1-h combination algorithm allows fast rule-out and rule-in of major adverse cardiac events. J Am Coll Cardiol 67 (2016), 1531–1540.
11. 11 Thygesen, K., Alpert, J.S., Jaffe, A.S., et al. Third universal definition of myocardial infarction. Eur Heart J 33 (2012), 2551–2567.
12. 12 Giannitsis, E., Kurz, K., Hallermayer, K., et al. Analytical validation of a high-sensitivity cardiac troponin T assay. Clin Chem 56 (2010), 254–261.
13. 13 Hess, E.P., Brison, R.J., Perry, J.J., et al. Development of a clinical prediction rule for 30-day cardiac events in emergency department patients with chest pain and possible acute coronary syndrome. Ann Emerg Med 59 (2012), 115–125.e111.
14. 14 Biener, M., Mueller, M., Vafaie, M., et al. Comparison of a 3-hour versus a 6-hour sampling-protocol using high-sensitivity cardiac troponin T for rule-out and rule-in of non-STEMI in an unselected emergency department population. Int J Cardiol 167 (2013), 1134–1140.
15. 15 Mueller, M., Biener, M., Vafaie, M., et al. Absolute and relative kinetic changes of high-sensitivity cardiac troponin T in acute coronary syndrome and in patients with increased troponin in the absence of acute coronary syndrome. Clin Chem 58 (2012), 209–218.
16. 16 Reichlin, T., Irfan, A., Twerenbold, R., et al. Utility of absolute and relative changes in cardiac troponin concentrations in the early diagnosis of acute myocardial infarction. Circulation 124 (2011), 136–145.
17. 17 Thygesen, K., Mair, J., Giannitsis, E., et al. How to use high-sensitivity cardiac troponins in acute cardiac care. Eur Heart J 33 (2012), 2252–2257.
18. 18 Bjurman, C., Larsson, M., Johanson, P., et al. Small changes in troponin T levels are common in patients with non-ST-segment elevation myocardial infarction and are linked to higher mortality. J Am Coll Cardiol 62 (2013), 1231–1238.
19. 19 Cullen, L., Than, M., Brown, A.F., et al. Comprehensive standardized data definitions for acute coronary syndrome research in emergency departments in Australasia. Emerg Med Australas 22 (2010), 35–55.
20. 20 Kline, J.A., Johnson, C.L., Pollack, C.V. Jr., et al. Pretest probability assessment derived from attribute matching. BMC Med Informat Decision Mak, 5, 2005, 26.
21. 21 Than, M., Herbert, M., Flaws, D., et al. What is an acceptable risk of major adverse cardiac event in chest pain patients soon after discharge from the emergency department?: a clinical survey. Int J Cardiol 166 (2013), 752–754.
22. 22 Mokhtari, A.B.C., Gilje, P., Tydén, P., et al. A 1-hour combination algorithm allows fast rule-out and rule-in of major adverse cardiac events. J Am Coll Cardiol 67 (2016), 1531–1540.
23. 23 Mokhtari, A., Dryver, E., Soderholm, M., et al. Diagnostic values of chest pain history, ECG, troponin and clinical gestalt in patients with chest pain and potential acute coronary syndrome assessed in the emergency department. SpringerPlus, 4, 2015, 219.
24. 24 Ekelund, U., Nilsson, H.J., Frigyesi, A., et al. Patients with suspected acute coronary syndrome in a university hospital emergency department: an observational study. BMC Emerg Med, 2, 2002, 1.
25. 25 Fanaroff, A.C., Rymer, J.A., Goldstein, S.A., et al. Does this patient with chest pain have acute coronary syndrome? the Rational Clinical Examination systematic review. JAMA 314 (2015), 1955–1965.
26. 26 Rubini Gimenez, M., Hoeller, R., Reichlin, T., et al. Rapid rule out of acute myocardial infarction using undetectable levels of high-sensitivity cardiac troponin. Int J Cardiol 168 (2013), 3896–3901.
27. 27 Shah, A.S., Anand, A., Sandoval, Y., et al. High-sensitivity cardiac troponin I at presentation in patients with suspected acute coronary syndrome: a cohort study. Lancet 386 (2015), 2481–2488.
28. 28 Weinstock, M.B., Weingart, S., Orth, F., et al. Risk for clinically relevant adverse cardiac events in patients with chest pain at hospital admission. JAMA Intern Med 175 (2015), 1207–1212.
29. 29 Jaffe, A.S., TRAPID or trapped?. Ann Emerg Med 68 (2016), 88–91.
30. 30 Vorlat, A., Van Hoof, V.O., Hammami, R., et al. Usefulness of early rule-in and rule-out biomarker protocols to estimate ischemia-induced myocardial injury in early chest pain presenters. Am J Cardiol 115 (2015), 1667–1671.
31. 31 Body, R., Mueller, C., Giannitsis, E., et al. The use of very low concentrations of high sensitivity troponin T to rule out acute myocardial infarction using a single blood test. Acad Emerg Med, 2016, 10.1111/acem.13012.
32. 32 Freund, Y., Chenevier-Gobeaux, C., Bonnet, P., et al. High-sensitivity versus conventional troponin in the emergency department for the diagnosis of acute myocardial infarction. Crit Care, 15, 2011, R147.
33. 33 Collinson, P.O., Premachandram, S., Hashemi, K., Prospective audit of incidence of prognostically important myocardial damage in patients discharged from emergency department. BMJ 320 (2000), 1702–1705.
34. 34 Mueller, C., Giannitsis, E., Christ, M., et al. Multicenter evaluation of a 0-hour/1-hour algorithm in the diagnosis of myocardial infarction with high-sensitivity cardiac troponin T. Ann Emerg Med. 68 (2016), 76–87.e4.
35. 35 Than, M., Aldous, S., Lord, S.J., et al. A 2-hour diagnostic protocol for possible cardiac chest pain in the emergency department: a randomized clinical trial. JAMA Intern Med 174 (2014), 51–58.
36. 36 Mahler, S.A., Hiestand, B.C., Goff, D.C. Jr., et al. Can the HEART score safely reduce stress testing and cardiac imaging in patients at low risk for major adverse cardiac events?. Crit Pathw Cardiol 10 (2011), 128–133.
37. 37 Mahler, S.A., Riley, R.F., Hiestand, B.C., et al. The HEART Pathway randomized trial: identifying emergency department patients with acute chest pain for early discharge. Circ Cardiovasc Qual Outcomes 8 (2015), 195–203.
38. 38 Roffi, M., Patrono, C., Collet, J.P., et al. 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting Without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J 37 (2016), 267–315.