Symptoms predictive of acute myocardial infarction in the troponin era

• Verfasst von: McCord, James [VerfasserIn]
• Verfasst von: Aurora, Lindsey [VerfasserIn]
• Verfasst von: Lindahl, Bertil [VerfasserIn]
• Verfasst von: Giannitsis, Evangelos [VerfasserIn]
• Verfasst von: Calle-Muller, Carlos [VerfasserIn]
• Verfasst von: Nowak, Richard [VerfasserIn]
• Verfasst von: Body, Richard [VerfasserIn]
• Verfasst von: Christ, Michael [VerfasserIn]
• Verfasst von: deFilippi, Christopher R. [VerfasserIn]
• Verfasst von: Christenson, Robert H. [VerfasserIn]
• Verfasst von: Jacobsen, Gordon [VerfasserIn]
• Verfasst von: Alquezar, Aitor [VerfasserIn]
• Verfasst von: Panteghini, Mauro [VerfasserIn]
• Verfasst von: Melki, Dina [VerfasserIn]
• Verfasst von: Plebani, Mario [VerfasserIn]
• Verfasst von: Verschuren, Franck [VerfasserIn]
• Verfasst von: French, John [VerfasserIn]
• Verfasst von: Bendig, Garnet [VerfasserIn]
• Verfasst von: Weiser, Silvia [VerfasserIn]
• Verfasst von: Mueller, Christian [VerfasserIn]
• Titel: Symptoms predictive of acute myocardial infarction in the troponin era
• Titelzusatz: analysis from the TRAPID-AMI study
• Verf.angabe: James McCord, Lindsey Aurora, Bertil Lindahl, Evangelos Giannitsis, Carlos Calle-Muller, Richard Nowak, Richard Body, Michael Christ, Christopher R. deFilippi, Robert H. Christenson, Gordon Jacobsen, Aitor Alquezar, Mauro Panteghini, Dina Melki, Mario Plebani, Franck Verschuren, John French, Garnet Bendig, Silvia Weiser, Christian Mueller, TRAPID-AMI Investigators
• Jahr: 2019
• Umfang: 6 S.
• Fussnoten: Gesehen am 07.12.2020
• Titel Quelle: Enthalten in: Critical pathways in cardiology
• Ort Quelle: Philadelphia, Pa. : Lippincott Williams & Wilkins, 2002
• Jahr Quelle: 2019
• Band/Heft Quelle: 18(2019), 1, Seite 10-15
• ISSN Quelle: 1535-2811
• DOI: doi:10.1097/HPC.0000000000000163
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Aged
• Sach-SW: Biomarkers
• Sach-SW: Diagnosis, Differential
• Sach-SW: Electrocardiography
• Sach-SW: Emergency Service, Hospital
• Sach-SW: Female
• Sach-SW: Follow-Up Studies
• Sach-SW: Humans
• Sach-SW: Male
• Sach-SW: Middle Aged
• Sach-SW: Myocardial Infarction
• Sach-SW: Predictive Value of Tests
• Sach-SW: Reproducibility of Results
• Sach-SW: Retrospective Studies
• Sach-SW: Time Factors
• Sach-SW: Troponin
• K10plus-PPN: 1742196535

Abstract

The TRAPID-AMI (High Sensitivity Cardiac Troponin T assay for rapid Rule-out of Acute Myocardial Infarction) study evaluated a rapid "rule-out" acute myocardial infarction (AMI). We evaluated what symptoms were associated with AMI as part of a substudy of TRAPID-AMI. There were 1282 patients evaluated from 12 centers in Europe, the United States of America, and Australia from 2011 to 2013. Multiple symptom variables were prospectively obtained and evaluated for association with the final diagnosis of AMI. Multivariate logistic regression analysis was done, and odds ratios (OR) were calculated. There were 213/1282 (17%) AMIs. Four independent predictors for the diagnosis of AMI were identified: radiation to right arm or shoulder [OR = 3.0; confidence interval (CI): 1.8-5.0], chest pressure (OR = 2.5; CI: 1.3-4.6), worsened by physical activity (OR = 1.7; CI: 1.2-2.5), and radiation to left arm or shoulder (OR = 1.7; CI: 1.1-2.4). In the entire group, 131 (10%) had radiation to right arm or shoulder, 897 (70%) had chest pressure, 385 (30%) worsened with physical activity, and 448 (35%) had radiation to left arm or shoulder. Duration of symptoms was not predictive of AMI. There were no symptoms predictive of non-AMI. Relationship between AMI size and symptoms was also studied. For 213 AMI patients, cardiac troponins I values were divided into 4 quartiles. Symptoms including pulling chest pain, supramammillary right location, and right arm/shoulder radiation were significantly more likely to occur in patients with larger AMIs. In a large multicenter trial, only 4 symptoms were associated with the diagnosis of AMI, and no symptoms that were associated with a non-AMI diagnosis.