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Is high-sensitivity troponin, alone or in combination with copeptin, sensitive enough for ruling out NSTEMI in very early presenters at admission? A post hoc analysis performed in emergency departments
- Source :
- BMJ Open, BMJ Open, BMJ Publishing Group, 2019, 9 (6), pp.e023994. ⟨10.1136/bmjopen-2018-023994⟩, BMJ Open, Vol 9, Iss 6 (2019)
- Publication Year :
- 2019
- Publisher :
- HAL CCSD, 2019.
-
Abstract
- Objectives: Copeptin and high-sensitivity cardiac troponin (HS-cTn) assays improve the early detection of non-ST-segment elevation myocardial infarction (NSTEMI). Their sensitivities may, however, be reduced in very early presenters.Setting: We performed a post hoc analysis of three prospective studies that included patients who presented to the emergency department for chest pain onset (CPO) of less than 6 hours.Participants: 449 patients were included, in whom 12% had NSTEMI. CPO occurred 4 hours in 146 patients. The prevalence of NSTEMI was similar in all groups (9%, 13% and 12%, respectively, p=0.281).Measures: Diagnostic performances of HS-cTn and copeptin at presentation were examined according to CPO. The discharge diagnosis was adjudicated by two experts, including cardiac troponin I (cTnI). HS-cTn and copeptin were blindly measured.Results: Diagnostic accuracies of cTnI, cTnI +copeptin and HS-cardiac troponin T (HS-cTnT) (but not HS-cTnT +copeptin) lower through CPO categories. For patients with CPO<br />DC-2009-1052.
- Subjects :
- Male
Time Factors
030204 cardiovascular system & hematology
Chest pain
0302 clinical medicine
high sensitive cardiac troponin
Troponin I
Medicine
Prospective Studies
030212 general & internal medicine
Myocardial infarction
Non-ST Elevated Myocardial Infarction
Prospective cohort study
non st-elevation acute myocardial infarction
[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology
Troponin T
Glycopeptides
General Medicine
Middle Aged
3. Good health
chest pain onset
Emergency Medicine
Cardiology
Female
very early presenters
medicine.symptom
Emergency Service, Hospital
Adult
medicine.medical_specialty
chest pain
03 medical and health sciences
Copeptin
Predictive Value of Tests
Internal medicine
Post-hoc analysis
Humans
Aged
business.industry
Research
copeptin
Emergency department
medicine.disease
business
Biomarkers
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Subjects
Details
- Language :
- English
- ISSN :
- 20091052 and 20446055
- Database :
- OpenAIRE
- Journal :
- BMJ Open, BMJ Open, BMJ Publishing Group, 2019, 9 (6), pp.e023994. ⟨10.1136/bmjopen-2018-023994⟩, BMJ Open, Vol 9, Iss 6 (2019)
- Accession number :
- edsair.doi.dedup.....2cfddeea63186185bfa622e1cf445b92