Academic Journal
Diagnosis of acute myocardial infarction in patients with renal failure using high-sensitivity cardiac troponin T
| العنوان: | Diagnosis of acute myocardial infarction in patients with renal failure using high-sensitivity cardiac troponin T |
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| المؤلفون: | Knott, Jonathan D, Ola, Olatunde, De Michieli, Laura, Akula, Ashok, Mehta, Ramila A, Dworak, Marshall, Crockford, Erika, Lobo, Ronstan, Slusser, Joshua, Rastas, Nicholas, Karturi, Swetha, Wohlrab, Scott, Hodge, David O, Grube, Eric, Tak, Tahir, Cagin, Charles, Gulati, Rajiv, Sandoval, Yader, Jaffe, Allan S |
| المساهمون: | Knott, Jonathan D, Ola, Olatunde, De Michieli, Laura, Akula, Ashok, Mehta, Ramila A, Dworak, Marshall, Crockford, Erika, Lobo, Ronstan, Slusser, Joshua, Rastas, Nichola, Karturi, Swetha, Wohlrab, Scott, Hodge, David O, Grube, Eric, Tak, Tahir, Cagin, Charle, Gulati, Rajiv, Sandoval, Yader, Jaffe, Allan S |
| بيانات النشر: | OXFORD UNIV PRESS |
| سنة النشر: | 2024 |
| المجموعة: | Padua Research Archive (IRIS - Università degli Studi di Padova) |
| مصطلحات موضوعية: | Chronic kidney disease, High-sensitivity cardiac troponin T, Myocardial infarction |
| الوصف: | Aims Diagnosing myocardial infarction (MI) in patients with chronic kidney disease (CKD) is difficult as they often have increased high-sensitivity cardiac troponin T (hs-cTnT) concentrations. Methods and results Observational US cohort study of emergency department patients undergoing hs-cTnT measurement. Cases with >= 1 hs-cTnT increase > 99th percentile were adjudicated following the Fourth Universal Definition of MI. Diagnostic performance of baseline and serial 2 h hs-cTnT thresholds for ruling-in acute MI was compared between those without and with CKD (estimated glomerular filtration rate < 60 mL/min/1.73 m(2)). The study cohort included 1992 patients, amongst whom 501 (25%) had CKD. There were 75 (15%) and 350 (70%) patients with CKD and 80 (5%) and 351 (24%) without CKD who had acute MI and myocardial injury. In CKD patients with baseline hs-cTnT thresholds of >= 52, >100, >200, or >300 ng/L, positive predictive values (PPVs) for MI were 36% (95% CI 28-45), 53% (95% CI 39-67), 73% (95% CI 50-89), and 80% (95% CI 44-98), and in those without CKD, 61% (95% CI 47-73), 69% (95% CI 49-85), 59% (95% CI 33-82), and 54% (95% CI 25-81). In CKD patients with a 2 h hs-cTnT delta of >= 10, >20, or >30 ng/L, PPVs were 66% (95% CI 51-79), 86% (95% CI 68-96), and 88% (95% CI 68-97), and in those without CKD, 64% (95% CI 50-76), 73% (95% CI 57-86), and 75% (95% CI 58-88). Conclusion Diagnostic performance of standard baseline and serial 2 h hs-cTnT thresholds to rule-in MI is suboptimal in CKD patients. It significantly improves when using higher baseline thresholds and delta values. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/38954535; info:eu-repo/semantics/altIdentifier/wos/WOS:001268878500001; volume:13; issue:7; journal:EUROPEAN HEART JOURNAL. ACUTE CARDIOVASCULAR CARE; https://hdl.handle.net/11577/3531322 |
| DOI: | 10.1093/ehjacc/zuae079 |
| الاتاحة: | https://hdl.handle.net/11577/3531322 https://doi.org/10.1093/ehjacc/zuae079 |
| رقم الانضمام: | edsbas.72BC884E |
| قاعدة البيانات: | BASE |
| DOI: | 10.1093/ehjacc/zuae079 |
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