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Undetectable hs-troponin and hs-troponin algorithms (+references 28-30 and 45)

Оглавление

1 47. Chapman AR, Hesse K, Andrews J, et al. High-sensitivity cardiac troponin I and clinical risk scores in patients with suspected acute coronary syndrome. Circulation 2018; 138:1654-65. +Also: Modified HEART score and hs-troponin in suspected acute myocardial infarction. JACC 2019; 73: 873

2 48.Chapman AR, Anand A, Boeddinghaus J. Comparison of the efficacy and safety of early rule-out pathways for acute myocardial infarction. Circulation 2017; 135(17):1586–1596. This study validates the 0/3hr delta algorithm of reference 45 and 49, called High STEAS algorithm: negative predictive value 99.5% for MI, 100% for death (4 missed cases, all had detectable troponin with a delta troponin less than cutoff)

3 49. Shah ASV, Anand A, Chapman AR, et al. Measurement of cardiac troponin for exclusion of myocardial infarction—Authors’ reply. Lancet 2016; 387:2289–2291.

4 50. Bandstein N, Ljung R, Johansson M, Holzmann MJ. Undetectable high-sensitivity cardiac troponin T level in the emergency department and risk of myocardial infarction. J Am Coll Cardiol 2014; 63 (23): 2569–2578. Single admission non-detectable hs-troponin+nonischemic ECG → Negative predictive value 99.8% for MI, 100% for death.

5 51. Chapman AR, Lee KK, McAllister DA, et al. Association of high-sensitivity cardiac troponin I concentration with cardiac outcomes in patients with suspected acute coronary syndromes. JAMA 2017; 318(19):1913–1924. (Meta-analysis of undetectable hs-troponin on presentation).

6 52. Pickering JW, Than MP, Cullen L, et al. Rapid rule-out of acute myocardial infarction with a single high-sensitivity cardiac troponin T measurement below the limit of detection: a collaborative meta-analysis. Ann Intern Med 2017; 166(10):715–724.

7 53. Badertscher P, Boeddinghaus J, Twerenbold R, et al. Direct comparison of the 0/1h and 0/3h algorithms for early rule-out of acute myocardial infarction. Circulation 2018; 137:2536–2538: 0/1 hour is superior to old protocol (using MI cutoff). High negative predictive value of 99.8%.

8 54. Sandoval Y, Nowak R, deFellipi CR, et al. Myocardial infarction risk stratification with a single measurement of troponin I. J Am Coll Cardiol 2019; 74:271–282: A single very low hs-troponin I has a 30-day negative predictive value of 99.8% for MI/death, using troponin I US assays (very low defined as <0.005 ng/ml, the detection cutoff being 0.002). It seems <0.005 ng/ml is a good rule-out cutoff in all hs-troponin assays; hs troponin does not have to be undetectable, as assays are becoming more sensitive.

9 55. Twerenbold R., Costabel J.P., Nestelberger T., et al. Outcome of applying the ESC 0/1-hour algorithm in patients with suspected myocardial infarction. J Am Coll Cardiol 2019; 74:483–494. Very low cardiovascular death 0.1% at 30 days in the rule out group.

10 56.Antman EM, Tanasijevic MJ, Thompson B, et al. Cardiac-specific troponin I levels to predict the risk of mortality in patients with acute coronary syndromes. N Engl J Med 1996; 201: 335: 1342–9.

11 57. Sabatine M.S., Morrow D.A., de Lemos J.A., et al. Detection of acute changes in circulating troponin in the setting of transient stress test-induced myocardial ischaemia using an ultrasensitive assay: results from TIMI 35. Eur Heart J 2009; 30:162–169.

12 58. Topol EJ, Yadav JS. Recognition of the importance of embolization in atherosclerotic vascular disease. Circulation 2000; 101: 570–80.

13 59. Stone GW, McLaurin BT, Cox DA, et al. Bivalirudin for patients with acute coronary syndromes. N Engl J Med 2006; 355: 2203–16. ACUITY trial.

14 60. Giugliano RP, White JA, Boden C, et al. Early versus delayed, provisional eptifibatide in acute coronary syndromes. N Engl J Med 2009; 360: 2176–90. EARLY ACS trial.

15 61. Mehta SR, Granger CB, Boden WE, et al. Early versus delayed invasive intervention in acute coronary syndromes. N Engl J Med 2009; 360: 2165–75. TIMACS trial.

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