Prognostication in emergency room patients: comparing ultrasensitive and contemporary quantification of cardiac troponin levels below the 99th percentile
IntroductionCardiac troponin levels below the 99th percentile improve the predictive efficacy for cardiovascular events when associated with relevant clinical variables. However, whether ultra-sensitive analytical methods improve this predictive efficacy over less sensitive or contemporary analytica...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-01-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1450619/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841543763876380672 |
|---|---|
| author | Anna Carrasquer Anna Carrasquer Anna Carrasquer Germán Cediel Germán Cediel Germán Cediel Alma Gómez-Sanz Alma Gómez-Sanz Óscar M. Peiró Óscar M. Peiró Óscar M. Peiró Isabel Fort-Gallifa Isabel Fort-Gallifa Isabel Fort-Gallifa Alfredo Bardaji Alfredo Bardaji Alfredo Bardaji Jose Luis Ferreiro Jose Luis Ferreiro Jose Luis Ferreiro |
| author_facet | Anna Carrasquer Anna Carrasquer Anna Carrasquer Germán Cediel Germán Cediel Germán Cediel Alma Gómez-Sanz Alma Gómez-Sanz Óscar M. Peiró Óscar M. Peiró Óscar M. Peiró Isabel Fort-Gallifa Isabel Fort-Gallifa Isabel Fort-Gallifa Alfredo Bardaji Alfredo Bardaji Alfredo Bardaji Jose Luis Ferreiro Jose Luis Ferreiro Jose Luis Ferreiro |
| author_sort | Anna Carrasquer |
| collection | DOAJ |
| description | IntroductionCardiac troponin levels below the 99th percentile improve the predictive efficacy for cardiovascular events when associated with relevant clinical variables. However, whether ultra-sensitive analytical methods improve this predictive efficacy over less sensitive or contemporary analytical methods remains unknown.MethodsThis retrospective observational study involved consecutive patients who presented to the emergency department for suspected acute coronary syndrome and underwent measurement of ultra-sensitive cardiac troponin I (Singulex) and contemporary cardiac troponin I (Siemens) with levels below the 99th percentile. The clinical characteristics of these patients were analysed, and the efficacy of both analytical methods for predicting cardiovascular events over a 4-year follow-up period was compared.ResultsIn total, 838 patients were analysed (mean age, 62.9 ± 16.6 years; 42.2% women). Their cumulative incidence of the composite cardiovascular event (death, readmission for myocardial infarction, and readmission for heart failure) was 25.9% over the 4-year follow-up. Both Singulex cardiac troponin I (analysed by quartiles) and Siemens cardiac troponin (analysed as detectable/undetectable) improved the predictive efficacy for the combined event over clinical variables [Harrell's C-index (95% confidence interval): 0.77 (0.74–0.80) vs. 0.79 (0.76–0.81) and 0.77 (0.74–0.80) vs. 0.78 (0.75–0.81), respectively; p = 0.018]. However, there were no statistically significant difference between the two predictive models that included the aforementioned troponin assays.ConclusionsDetectable levels of cardiac troponin using a contemporary analytical method or those near the 99th percentile using an ultra-sensitive analytical method improve the predictive efficacy for cardiovascular events, with no differences between the two methods |
| format | Article |
| id | doaj-art-741b6f40d6ee465db9d0c235a012b9e6 |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-741b6f40d6ee465db9d0c235a012b9e62025-01-13T06:10:44ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-01-011110.3389/fcvm.2024.14506191450619Prognostication in emergency room patients: comparing ultrasensitive and contemporary quantification of cardiac troponin levels below the 99th percentileAnna Carrasquer0Anna Carrasquer1Anna Carrasquer2Germán Cediel3Germán Cediel4Germán Cediel5Alma Gómez-Sanz6Alma Gómez-Sanz7Óscar M. Peiró8Óscar M. Peiró9Óscar M. Peiró10Isabel Fort-Gallifa11Isabel Fort-Gallifa12Isabel Fort-Gallifa13Alfredo Bardaji14Alfredo Bardaji15Alfredo Bardaji16Jose Luis Ferreiro17Jose Luis Ferreiro18Jose Luis Ferreiro19Department of Cardiology, Joan XXIII University Hospital, Tarragona, SpainPere Virgili Health Research Institute, Rovira I Virgili University, Tarragona, SpainDepartment of Medicine and Surgery, Rovira I Virgili University, Tarragona, SpainDepartment of Cardiology, Joan XXIII University Hospital, Tarragona, SpainPere Virgili Health Research Institute, Rovira I Virgili University, Tarragona, SpainDepartment of Medicine and Surgery, Rovira I Virgili University, Tarragona, SpainDepartment of Cardiology, Joan XXIII University Hospital, Tarragona, SpainPere Virgili Health Research Institute, Rovira I Virgili University, Tarragona, SpainDepartment of Cardiology, Joan XXIII University Hospital, Tarragona, SpainPere Virgili Health Research Institute, Rovira I Virgili University, Tarragona, SpainDepartment of Medicine and Surgery, Rovira I Virgili University, Tarragona, SpainPere Virgili Health Research Institute, Rovira I Virgili University, Tarragona, SpainDepartment of Medicine and Surgery, Rovira I Virgili University, Tarragona, SpainClinical Analysis Service, University Hospital of Tarragona Joan XXIII, Tarragona, SpainDepartment of Cardiology, Joan XXIII University Hospital, Tarragona, SpainPere Virgili Health Research Institute, Rovira I Virgili University, Tarragona, SpainDepartment of Medicine and Surgery, Rovira I Virgili University, Tarragona, SpainDepartment of Cardiology, Joan XXIII University Hospital, Tarragona, SpainPere Virgili Health Research Institute, Rovira I Virgili University, Tarragona, SpainDepartment of Medicine and Surgery, Rovira I Virgili University, Tarragona, SpainIntroductionCardiac troponin levels below the 99th percentile improve the predictive efficacy for cardiovascular events when associated with relevant clinical variables. However, whether ultra-sensitive analytical methods improve this predictive efficacy over less sensitive or contemporary analytical methods remains unknown.MethodsThis retrospective observational study involved consecutive patients who presented to the emergency department for suspected acute coronary syndrome and underwent measurement of ultra-sensitive cardiac troponin I (Singulex) and contemporary cardiac troponin I (Siemens) with levels below the 99th percentile. The clinical characteristics of these patients were analysed, and the efficacy of both analytical methods for predicting cardiovascular events over a 4-year follow-up period was compared.ResultsIn total, 838 patients were analysed (mean age, 62.9 ± 16.6 years; 42.2% women). Their cumulative incidence of the composite cardiovascular event (death, readmission for myocardial infarction, and readmission for heart failure) was 25.9% over the 4-year follow-up. Both Singulex cardiac troponin I (analysed by quartiles) and Siemens cardiac troponin (analysed as detectable/undetectable) improved the predictive efficacy for the combined event over clinical variables [Harrell's C-index (95% confidence interval): 0.77 (0.74–0.80) vs. 0.79 (0.76–0.81) and 0.77 (0.74–0.80) vs. 0.78 (0.75–0.81), respectively; p = 0.018]. However, there were no statistically significant difference between the two predictive models that included the aforementioned troponin assays.ConclusionsDetectable levels of cardiac troponin using a contemporary analytical method or those near the 99th percentile using an ultra-sensitive analytical method improve the predictive efficacy for cardiovascular events, with no differences between the two methodshttps://www.frontiersin.org/articles/10.3389/fcvm.2024.1450619/fullAMIacute myocardial infarctioncTncardiac troponin 2troponinprognosis |
| spellingShingle | Anna Carrasquer Anna Carrasquer Anna Carrasquer Germán Cediel Germán Cediel Germán Cediel Alma Gómez-Sanz Alma Gómez-Sanz Óscar M. Peiró Óscar M. Peiró Óscar M. Peiró Isabel Fort-Gallifa Isabel Fort-Gallifa Isabel Fort-Gallifa Alfredo Bardaji Alfredo Bardaji Alfredo Bardaji Jose Luis Ferreiro Jose Luis Ferreiro Jose Luis Ferreiro Prognostication in emergency room patients: comparing ultrasensitive and contemporary quantification of cardiac troponin levels below the 99th percentile Frontiers in Cardiovascular Medicine AMI acute myocardial infarction cTn cardiac troponin 2 troponin prognosis |
| title | Prognostication in emergency room patients: comparing ultrasensitive and contemporary quantification of cardiac troponin levels below the 99th percentile |
| title_full | Prognostication in emergency room patients: comparing ultrasensitive and contemporary quantification of cardiac troponin levels below the 99th percentile |
| title_fullStr | Prognostication in emergency room patients: comparing ultrasensitive and contemporary quantification of cardiac troponin levels below the 99th percentile |
| title_full_unstemmed | Prognostication in emergency room patients: comparing ultrasensitive and contemporary quantification of cardiac troponin levels below the 99th percentile |
| title_short | Prognostication in emergency room patients: comparing ultrasensitive and contemporary quantification of cardiac troponin levels below the 99th percentile |
| title_sort | prognostication in emergency room patients comparing ultrasensitive and contemporary quantification of cardiac troponin levels below the 99th percentile |
| topic | AMI acute myocardial infarction cTn cardiac troponin 2 troponin prognosis |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1450619/full |
| work_keys_str_mv | AT annacarrasquer prognosticationinemergencyroompatientscomparingultrasensitiveandcontemporaryquantificationofcardiactroponinlevelsbelowthe99thpercentile AT annacarrasquer prognosticationinemergencyroompatientscomparingultrasensitiveandcontemporaryquantificationofcardiactroponinlevelsbelowthe99thpercentile AT annacarrasquer prognosticationinemergencyroompatientscomparingultrasensitiveandcontemporaryquantificationofcardiactroponinlevelsbelowthe99thpercentile AT germancediel prognosticationinemergencyroompatientscomparingultrasensitiveandcontemporaryquantificationofcardiactroponinlevelsbelowthe99thpercentile AT germancediel prognosticationinemergencyroompatientscomparingultrasensitiveandcontemporaryquantificationofcardiactroponinlevelsbelowthe99thpercentile AT germancediel prognosticationinemergencyroompatientscomparingultrasensitiveandcontemporaryquantificationofcardiactroponinlevelsbelowthe99thpercentile AT almagomezsanz prognosticationinemergencyroompatientscomparingultrasensitiveandcontemporaryquantificationofcardiactroponinlevelsbelowthe99thpercentile AT almagomezsanz prognosticationinemergencyroompatientscomparingultrasensitiveandcontemporaryquantificationofcardiactroponinlevelsbelowthe99thpercentile AT oscarmpeiro prognosticationinemergencyroompatientscomparingultrasensitiveandcontemporaryquantificationofcardiactroponinlevelsbelowthe99thpercentile AT oscarmpeiro prognosticationinemergencyroompatientscomparingultrasensitiveandcontemporaryquantificationofcardiactroponinlevelsbelowthe99thpercentile AT oscarmpeiro prognosticationinemergencyroompatientscomparingultrasensitiveandcontemporaryquantificationofcardiactroponinlevelsbelowthe99thpercentile AT isabelfortgallifa prognosticationinemergencyroompatientscomparingultrasensitiveandcontemporaryquantificationofcardiactroponinlevelsbelowthe99thpercentile AT isabelfortgallifa prognosticationinemergencyroompatientscomparingultrasensitiveandcontemporaryquantificationofcardiactroponinlevelsbelowthe99thpercentile AT isabelfortgallifa prognosticationinemergencyroompatientscomparingultrasensitiveandcontemporaryquantificationofcardiactroponinlevelsbelowthe99thpercentile AT alfredobardaji prognosticationinemergencyroompatientscomparingultrasensitiveandcontemporaryquantificationofcardiactroponinlevelsbelowthe99thpercentile AT alfredobardaji prognosticationinemergencyroompatientscomparingultrasensitiveandcontemporaryquantificationofcardiactroponinlevelsbelowthe99thpercentile AT alfredobardaji prognosticationinemergencyroompatientscomparingultrasensitiveandcontemporaryquantificationofcardiactroponinlevelsbelowthe99thpercentile AT joseluisferreiro prognosticationinemergencyroompatientscomparingultrasensitiveandcontemporaryquantificationofcardiactroponinlevelsbelowthe99thpercentile AT joseluisferreiro prognosticationinemergencyroompatientscomparingultrasensitiveandcontemporaryquantificationofcardiactroponinlevelsbelowthe99thpercentile AT joseluisferreiro prognosticationinemergencyroompatientscomparingultrasensitiveandcontemporaryquantificationofcardiactroponinlevelsbelowthe99thpercentile |