Prognostic value of undetectable hs troponin T in suspected acute coronary syndrome

• Verfasst von: Vafaie, Mehrshad [VerfasserIn]
• Verfasst von: Slagman, Anna [VerfasserIn]
• Verfasst von: Möckel, Martin [VerfasserIn]
• Verfasst von: Hamm, Christian [VerfasserIn]
• Verfasst von: Huber, Kurt [VerfasserIn]
• Verfasst von: Müller, Christian [VerfasserIn]
• Verfasst von: Vollert, Jörn O. [VerfasserIn]
• Verfasst von: Blankenberg, Stefan [VerfasserIn]
• Verfasst von: Katus, Hugo [VerfasserIn]
• Verfasst von: Liebetrau, Christoph [VerfasserIn]
• Verfasst von: Giannitsis, Evangelos [VerfasserIn]
• Verfasst von: Searle, Julia [VerfasserIn]
• Titel: Prognostic value of undetectable hs troponin T in suspected acute coronary syndrome
• Verf.angabe: Mehrshad Vafaie, Anna Slagman, Martin Möckel, Christian Hamm, Kurt Huber, Christian Müller, Jörn O. Vollert, Stefan Blankenberg, Hugo A. Katus, Christoph Liebetrau, Evangelos Giannitsis, Julia Searle
• E-Jahr: 2016
• Jahr: [2016]
• Umfang: 11 S.
• Illustrationen: Diagramme
• Fussnoten: Gesehen am 29.05.2020
• Titel Quelle: Enthalten in: The American journal of medicine
• Ort Quelle: New York, NY : Excerpta Medica, 1946
• Jahr Quelle: 2016
• Band/Heft Quelle: 129(2016), 3, Seite 274-282, 282.e1-282.e2
• ISSN Quelle: 1555-7162
• DOI: doi:10.1016/j.amjmed.2015.10.016
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Acute coronary syndrome (ACS)
• Sach-SW: Acute myocardial infarction (AMI)
• Sach-SW: Copeptin
• Sach-SW: High-sensitivity troponin T (hsTnT)
• Sach-SW: Limit of detection (LoD)
• Sach-SW: Rule-out
• K10plus-PPN: 1699058644

Abstract

Background - The search for improved strategies for safe and early discharge of patients with suspected acute coronary syndrome in emergency departments is ongoing. This Biomarkers in Cardiology (BIC)-8 biomarker substudy evaluated the usefulness of high-sensitivity troponin T (hsTnT) below or above the limit of detection (LoD) in low-to-intermediate-risk patients with suspected acute coronary syndrome in the emergency department. - Methods - Patients were categorized into hsTnT ≥ the 99th percentile, between the 99th percentile and LoD, or undetectable hsTnT (<LoD). HsTnT and copeptin were measured at admission, using a copeptin cut-off of 10 pmol/L. The primary endpoint was death and myocardial infarction within 90 days after admission. - Results - Of 882 patients with all biomarker results, 577 (65.4%) had detectable hsTnT levels (≥LoD). Among the 305 patients (34.6%) with undetectable hsTnT, no myocardial infarctions or deaths occurred within 90 days. In patients with detectable hsTnT at admission (≥LoD but ≤99th percentile), the combined endpoint occurred in 1.5% (6/410) of the copeptin-negative patients and in 6.3% (6/96) of copeptin-positive patients within 90 days (hazard ratio 4.39; 95% confidence interval, 1.42-13.61; P = .01). In patients with an initially elevated hsTnT (≥14 ng/L), 9.7% (3/31) of the copeptin-negative patients and 15.4% (4/26) of the copeptin-positive patients experienced the combined endpoint (hazard ratio 1.61; 95% confidence interval, 0.36-7.17; P = .536). - Conclusions - In low-to-intermediate-risk patients with suspected acute coronary syndrome, undetectable hsTnT values at admission allow a safe discharge without occurrence of death or myocardial infarction within 90 days.