Implications of lowering threshold of plasma troponin concentration in diagnosis of myocardial infarction:cohort study
| Autor: | Simon Walker, Antonia M. D. Churchhouse, Mary Stoddart, Kuan Ken Lee, David E. Newby, Margaret MacLeod, Martin A. Denvir, David A. McAllister, Keith A.A. Fox, Nicholas L. Mills |
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| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Acute coronary syndrome Myocardial Infarction Risk Assessment Sensitivity and Specificity Cohort Studies Recurrence Reference Values Internal medicine Outcome Assessment Health Care Troponin I medicine Humans In patient Myocardial infarction Acute Coronary Syndrome Aged General Environmental Science biology business.industry General Engineering Outcome measures General Medicine Middle Aged Prognosis medicine.disease Troponin Scotland biology.protein Cardiology General Earth and Planetary Sciences Female Reagent Kits Diagnostic business Risk assessment Cohort study |
| Zdroj: | Mills, N L, Lee, K K, McAllister, D A, Churchhouse, A M D, Macleod, M, Stoddart, M, Walker, S, Denvir, M A, Fox, K A A & Newby, D E 2012, ' Implications of lowering threshold of plasma troponin concentration in diagnosis of myocardial infarction : cohort study ', British Medical Journal (BMJ), vol. 344, no. 7852, e1533 . https://doi.org/10.1136/bmj.e1533 |
| ISSN: | 0959-535X |
| Popis: | ObjectiveTo assess the relation between troponin concentration, assay precision, and clinical outcomes in patients with suspected acute coronary syndrome.DesignCohort study.SettingTertiary centre in Scotland.Participants2092 consecutive patients admitted with suspected acute coronary syndrome were stratified with a sensitive troponin I assay into three groups (Main outcome measureOne year survival without events (recurrent myocardial infarction, death) in patients grouped by troponin concentration.ResultsTroponin I concentrations were ConclusionLowering the diagnostic threshold to the 99th centile and accepting greater assay imprecision would identify more patients with acute coronary syndrome at risk of recurrent myocardial infarction and death but would increase the diagnosis of myocardial infarction by 47%. It remains to be established whether reclassification of these patients and treatment for myocardial infarction would improve outcome. |
| Databáze: | OpenAIRE |
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