Asset Details
Do you wish to reserve the book?
112 High-Sensitivity Cardiac Troponin, Pre-Test Probability and the Diagnosis of Myocardial Infarction: A Prospective Cohort Study
Hey, we have placed the reservation for you!
By the way, why not check out events that you can attend while you pick your title.
Oops! Something went wrong.
Looks like we were not able to place the reservation. Kindly try again later.
Are you sure you want to remove the book from the shelf?
112 High-Sensitivity Cardiac Troponin, Pre-Test Probability and the Diagnosis of Myocardial Infarction: A Prospective Cohort Study
Do you wish to request the book?
112 High-Sensitivity Cardiac Troponin, Pre-Test Probability and the Diagnosis of Myocardial Infarction: A Prospective Cohort Study
Please be aware that the book you have requested cannot be checked out. If you would like to checkout this book, you can reserve another copy
We have requested the book for you!
Your request is successful and it will be processed during the Library working hours. Please check the status of your request in My Requests.
Oops! Something went wrong.
Looks like we were not able to place your request. Kindly try again later.
Journal Article
112 High-Sensitivity Cardiac Troponin, Pre-Test Probability and the Diagnosis of Myocardial Infarction: A Prospective Cohort Study
2016
Overview
BackgroundCardiac troponin is integral to the diagnosis of myocardial infarction, but is elevated in many patients without acute coronary syndrome. We evaluate the impact of a clinical assessment of pre-test probability on the positive predictive value (PPV) of cardiac troponin for a diagnosis of myocardial infarction.MethodsIn 1,054 consecutive patients undergoing blood sampling in the Emergency Department, cardiac troponin I was measured in excess serum using a high-sensitivity assay. Patients were classified as type 1 or type 2 myocardial infarction, or myocardial injury, and the prevalence determined in the entire cohort and in those where testing was requested by the attending physician. We determine the predicted PPV for type 1 myocardial infarction across different pre-test probabilities.ResultsCardiac troponin was requested in 136 patients identifying 15 (11.3%) with type 1 myocardial infarction. Testing everyone identified 2 further patients with type 1 (17/1,054 [1.7%]), but 127 (12%) patients with type 2 myocardial infarction or myocardial injury. In patients selected for testing the PPV for type 1 myocardial infarction was 50.0% (95% confidence interval [CI] 32.8%-67.2%), falling to 13.6% (95% CI 8.0%-19.7%) when measured across the cohort. The PPV was heavily influenced by the pre-test probability (Figure 1). Irrespective of diagnosis, cardiac troponin was a independent predictor of death (hazard ratio 1.26 per 2-fold increase, 95% CI 1.06 to 1.49) (Figure 2).Abstract 112 Figure 1Abstract 112 Figure 2ConclusionsCardiac troponin concentrations are elevated in one in eight patients in the Emergency Department. If testing is performed without an assessment of pre-test probability, interpretation of cardiac troponin will be challenging and may adversely impact on the diagnosis of acute myocardial infarction.
Publisher
BMJ Publishing Group LTD
We currently cannot retrieve any items related to this title. Kindly check back at a later time.