Abstract
Originalsprog | Engelsk |
---|---|
Tidsskrift | European Heart Journal - Quality of Care and Clinical Outcomes |
Vol/bind | 9 |
Udgave nummer | 6 |
Sider (fra-til) | 592–599 |
Antal sider | 8 |
ISSN | 2058-5225 |
DOI | |
Status | Udgivet - 2023 |
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Predictive and prognostic value of different cardiac troponin assays : a nationwide register-based cohort study. / Hasselbalch, Rasmus Bo; Schultz, Martin; Schytz, Philip Andreas; Kristensen, Jonas Henrik; Strandkjaer, Nina; Pries-Heje, Mia; Carlson, Nicholas; Schou, Morten; Bundgaard, Henning; Torp-Pedersen, Christian; Iversen, Kasper Karmark.
I: European Heart Journal - Quality of Care and Clinical Outcomes, Bind 9, Nr. 6, 2023, s. 592–599.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review
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TY - JOUR
T1 - Predictive and prognostic value of different cardiac troponin assays
T2 - a nationwide register-based cohort study
AU - Hasselbalch, Rasmus Bo
AU - Schultz, Martin
AU - Schytz, Philip Andreas
AU - Kristensen, Jonas Henrik
AU - Strandkjaer, Nina
AU - Pries-Heje, Mia
AU - Carlson, Nicholas
AU - Schou, Morten
AU - Bundgaard, Henning
AU - Torp-Pedersen, Christian
AU - Iversen, Kasper Karmark
PY - 2023
Y1 - 2023
N2 - Aims Guidelines do not differentiate between the available assays of cardiac troponin (cTn). We compared the prognostic and predictive ability of cTn assays. Methods and results This was a nationwide cohort study of patients with acute coronary syndrome (ACS) and >= 2 cTn measurements of one of four assays: Roche high-sensitivity cTnT (hs-cTnT), Abbott high sensitivity cTnI (hs-cTnI), Siemens Vista cTnI, and Siemens cTnI Ultra. Data were collected from Danish registries from 2009-18. Peak cTn concentration normalized to the 99(th) percentile was used. Outcomes were myocardial infarction (MI) during admission, one-year all-cause-, cardiovascular-, and non-cardiovascular mortality. Receiver operating characteristics and logistic regression calculating odds ratios (OR) were used. A total of 90 705 patients were included, of which 20 550 (23%) had MI. Siemens Vista cTnI was the strongest predictor of MI, Area under the curve (auc) 0.93 (95% CI 0.93-0.93). In 1 year 9012 (9.9%) of patients had died. An inverted U-shape relationship was observed between concentration of cTn and all-cause mortality. Hs-cTnT OR 21.3 (95% CI 18.4-24.8) at 2-5 times the 99(th) percentile and 12.1 (95% CI 10.3-14.1) for concentrations >100 times the 99(th) percentile. The inverted U-shape relationship was only present for non-cardiovascular mortality. The strongest predictor of cardiovascular mortality was hs-cTnT, OR 11.3 (95% CI 6.4-21.8) at 1-2 times the 99(th) percentile and 88.8 (95% CI 53.2-163.0) for concentrations >100 times the 99(th) percentile. Conclusion Siemens Vista cTnI was the strongest predictor of MI and hs-cTnT was the strongest predictor of mortality. An inverted U-shape relationship was observed between cTn concentration and non-cardiovascular mortality.
AB - Aims Guidelines do not differentiate between the available assays of cardiac troponin (cTn). We compared the prognostic and predictive ability of cTn assays. Methods and results This was a nationwide cohort study of patients with acute coronary syndrome (ACS) and >= 2 cTn measurements of one of four assays: Roche high-sensitivity cTnT (hs-cTnT), Abbott high sensitivity cTnI (hs-cTnI), Siemens Vista cTnI, and Siemens cTnI Ultra. Data were collected from Danish registries from 2009-18. Peak cTn concentration normalized to the 99(th) percentile was used. Outcomes were myocardial infarction (MI) during admission, one-year all-cause-, cardiovascular-, and non-cardiovascular mortality. Receiver operating characteristics and logistic regression calculating odds ratios (OR) were used. A total of 90 705 patients were included, of which 20 550 (23%) had MI. Siemens Vista cTnI was the strongest predictor of MI, Area under the curve (auc) 0.93 (95% CI 0.93-0.93). In 1 year 9012 (9.9%) of patients had died. An inverted U-shape relationship was observed between concentration of cTn and all-cause mortality. Hs-cTnT OR 21.3 (95% CI 18.4-24.8) at 2-5 times the 99(th) percentile and 12.1 (95% CI 10.3-14.1) for concentrations >100 times the 99(th) percentile. The inverted U-shape relationship was only present for non-cardiovascular mortality. The strongest predictor of cardiovascular mortality was hs-cTnT, OR 11.3 (95% CI 6.4-21.8) at 1-2 times the 99(th) percentile and 88.8 (95% CI 53.2-163.0) for concentrations >100 times the 99(th) percentile. Conclusion Siemens Vista cTnI was the strongest predictor of MI and hs-cTnT was the strongest predictor of mortality. An inverted U-shape relationship was observed between cTn concentration and non-cardiovascular mortality.
KW - Cardiac troponin
KW - biomarkers
KW - myocardial infarction
KW - HIGH-SENSITIVITY TROPONIN
KW - ACUTE CORONARY SYNDROME
KW - 99TH PERCENTILE
KW - SYSTEM
U2 - 10.1093/ehjqcco/qcac065
DO - 10.1093/ehjqcco/qcac065
M3 - Journal article
C2 - 36264293
VL - 9
SP - 592
EP - 599
JO - European Heart Journal - Quality of Care and Clinical Outcomes
JF - European Heart Journal - Quality of Care and Clinical Outcomes
SN - 2058-5225
IS - 6
ER -