Combined Use of High-Sensitive Cardiac Troponin, Copeptin, and the Modified HEART Score for Rapid Evaluation of Chest Pain Patients
Joint Authors
Nowalany-Kozielska, Ewa
Muller, Olivier
Morawiec, Beata
Kawecki, Damian
Przywara-Chowaniec, Brygida
Opara, Mariusz
Muzyk, Piotr
Tat, Lui Chun
Ho, Lam
Source
Issue
Vol. 2018, Issue 2018 (31 Dec. 2018), pp.1-7, 7 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2018-11-12
Country of Publication
Egypt
No. of Pages
7
Main Subjects
Abstract EN
Background.
Clinical short-term risk stratification is a recommended approach in patients with chest pain and possible acute myocardial infarction (AMI) to further improve high safety of biomarker-based rule-out algorithms.
The study aim was to assess clinical performance of baseline concentrations of high-sensitivity cardiac troponin T (hs-TnT) and copeptin and the modified HEART score (mHS) in early presenters to the emergency department with chest pain.
Methods.
This cohort study included patients with chest pain with onset maximum of 6 h before admission and no persistent ST-segment elevation on electrocardiogram.
hs-TnT, copeptin, and the mHS were assessed from admission data.
The diagnostic and prognostic value for three baseline rule-out algorithms: (1) single hs-TnT < 14 ng/l, (2) hs-TnT < 14 ng/l/mHS ≤ 3, and (3) hs-TnT < 14 ng/l/mHS ≤ 3/copeptin < 17.4 pmol/l, was assessed with sensitivity and negative predictive value.
Primary diagnostic endpoint was the diagnosis of AMI.
Prognostic endpoint was death and/or AMI within 30 days.
Results.
Among 154 enrolled patients, 44 (29%) were classified as low-risk according to the mHS; AMI was diagnosed in 105 patients (68%).
For ruling out AMI, the highest sensitivity and NPV from all studied algorithms were observed for hs-TnT/mHS/copeptin (100%, 95% CI 96.6–100, and 100%, 95% CI 75.3–100).
At 30 days, the highest event-free survival was achieved in patients stratified with hs-TnT/mHS/copeptin algorithm (100%) with 100% (95% CI 75.3–100) NPV and 100% (95% CI 96.6–100) sensitivity.
Conclusions.
The combination of baseline hs-TnT, copeptin, and the mHS has an excellent sensitivity and NPV for short-term risk stratification.
Such approach might improve the triage system in emergency departments and be a bridge for inclusion to serial blood sampling algorithms.
American Psychological Association (APA)
Morawiec, Beata& Przywara-Chowaniec, Brygida& Muzyk, Piotr& Opara, Mariusz& Ho, Lam& Tat, Lui Chun…[et al.]. 2018. Combined Use of High-Sensitive Cardiac Troponin, Copeptin, and the Modified HEART Score for Rapid Evaluation of Chest Pain Patients. Disease Markers،Vol. 2018, no. 2018, pp.1-7.
https://search.emarefa.net/detail/BIM-1153744
Modern Language Association (MLA)
Morawiec, Beata…[et al.]. Combined Use of High-Sensitive Cardiac Troponin, Copeptin, and the Modified HEART Score for Rapid Evaluation of Chest Pain Patients. Disease Markers No. 2018 (2018), pp.1-7.
https://search.emarefa.net/detail/BIM-1153744
American Medical Association (AMA)
Morawiec, Beata& Przywara-Chowaniec, Brygida& Muzyk, Piotr& Opara, Mariusz& Ho, Lam& Tat, Lui Chun…[et al.]. Combined Use of High-Sensitive Cardiac Troponin, Copeptin, and the Modified HEART Score for Rapid Evaluation of Chest Pain Patients. Disease Markers. 2018. Vol. 2018, no. 2018, pp.1-7.
https://search.emarefa.net/detail/BIM-1153744
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1153744