Identification of acute myocardial infarction in elderly patients using optimized highly sensitive troponin I thresholds

Autor: Thomas Münzel, Karl J. Lackner, Philipp S. Wild, Stergios Tzikas, Tanja Zeller, Till Keller, Christoph Bickel, Fachrie Sar, Marco Tubaro, Beatrice von Jeinsen, Stephan Baldus, Tommaso Gori, Christian W. Hamm, Andreas M. Zeiher, Alexander F. Schmidt, Christoph Liebetrau, Lars Palapies, Stefan Blankenberg
Rok vydání: 2019
Předmět:
DOI: 10.6084/m9.figshare.9879281
Popis: Purpose: Established diagnostic thresholds for high-sensitivity cardiac troponins (hs-cTn) might not apply for elderly patients as they are elevated irrespective of the presence of an acute myocardial infarction (AMI). Aim of the present study was to investigate hs-cTnI in elderly patients with suspected AMI and to calculate optimized diagnostic cutoffs. Material and methods: Data from a prospective multi-centre study and from a second independent prospective single-centre cohort study were analysed. A number of 2903 patients were eligible for further analysis. Patients > 70 years were classified as elderly. hs-cTnI was measured upon admission. Results: Around 34.7% of 2903 patients were classified as elderly. Around 22.5% of elderly patients were finally diagnosed with AMI. Elderly patients had higher hs-cTnI levels at admission irrespective of the final diagnosis (p Conclusions: hs-cTnI levels have a lower specificity for detecting AMI in elderly patients. This lower specificity can be improved by using hs-cTnI thresholds optimized for elderly patients.
Databáze: OpenAIRE