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202. Predicting Major Adverse Events in Patients With Acute Myocardial Infarction

Author

Nestelberger, Thomas, primary, Boeddinghaus, Jasper, additional, Wussler, Desiree, additional, Twerenbold, Raphael, additional, Badertscher, Patrick, additional, Wildi, Karin, additional, Miró, Òscar, additional, López, Beatriz, additional, Martin-Sanchez, F. Javier, additional, Muzyk, Piotr, additional, Koechlin, Luca, additional, Baumgartner, Benjamin, additional, Meier, Mario, additional, Troester, Valentina, additional, Rubini Giménez, Maria, additional, Puelacher, Christian, additional, du Fay de Lavallaz, Jeanne, additional, Walter, Joan, additional, Kozhuharov, Nikola, additional, Zimmermann, Tobias, additional, Gualandro, Danielle M., additional, Michou, Eleni, additional, Potlukova, Eliska, additional, Geigy, Nicolas, additional, Keller, Dagmar I., additional, Reichlin, Tobias, additional, Mueller, Christian, additional, Hafner, Benjamin, additional, Flores, Dayana, additional, Meissner, Kathrin, additional, Kulangara, Caroline, additional, Freese, Michael, additional, Osswald, Stefan, additional, Stelzig, Claudia, additional, Bingisser, Roland, additional, Fuenzalida Inostroza, Carolina Isabel, additional, Rodríguez Adrada, Esther, additional, Nowalany-Kozielska, Ewa, additional, Kawecki, Damian, additional, Parenica, Jiri, additional, Ganovská, Eva, additional, Lohrmann, Jens, additional, Amrein, Melissa, additional, Steude, Jana, additional, Buser, Andreas, additional, Grimm, Karin, additional, Hartmann, Beate, additional, Morawiec, Beata, additional, Rentsch, Katharina, additional, von Eckardstein, Arnold, additional, Biskup, Ewalina, additional, Campodarve, Isabel, additional, and Gea, Joachim, additional

Published
2019
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203. Diagnostic Accuracy of a High-Sensitivity Cardiac Troponin Assay with a Single Serum Test in the Emergency Department

Author

Body, Richard, primary, Twerenbold, Raphael, primary, Austin, Catrin, primary, Boeddinghaus, Jasper, primary, Almashali, Malak, primary, Nestelberger, Thomas, primary, Morris, Niall, primary, Badertscher, Patrick, primary, McDowell, Garry, primary, Wildi, Karin, primary, Moss, Phil, primary, Rubini Gimenez, Maria, primary, Jarman, Heather, primary, Bigler, Nina, primary, Einemann, Rachael, primary, Koechlin, Luca, primary, Pourmahram, Ghazaleh, primary, Todd, John, primary, Mueller, Christian, primary, and Freemont, Anthony, primary

Published
2019
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204. Prevalence of Pulmonary Embolism in Patients With Syncope

Author

Badertscher, Patrick, primary, du Fay de Lavallaz, Jeanne, additional, Hammerer-Lercher, Angelika, additional, Nestelberger, Thomas, additional, Zimmermann, Tobias, additional, Geiger, Marc, additional, Imahorn, Orell, additional, Miró, Òscar, additional, Salgado, Emilio, additional, Christ, Michael, additional, Cullen, Louise, additional, Than, Martin, additional, Martin-Sanchez, F. Javier, additional, Di Somma, Salvatore, additional, Peacock, W. Frank, additional, Keller, Dagmar I., additional, Costabel, Juan Pablo, additional, Walter, Joan, additional, Boeddinghaus, Jasper, additional, Twerenbold, Raphael, additional, Méndez, Adriana, additional, Gospodinov, Boris, additional, Puelacher, Christian, additional, Wussler, Desiree, additional, Koechlin, Luca, additional, Kawecki, Damian, additional, Geigy, Nicolas, additional, Strebel, Ivo, additional, Lohrmann, Jens, additional, Kühne, Michael, additional, Reichlin, Tobias, additional, Mueller, Christian, additional, Rubini Giménez, Maria, additional, Kozhuharov, Nikola, additional, Shrestha, Samyut, additional, Sazgary, Lorraine, additional, Morawiec, Beata, additional, Muzyk, Piotr, additional, Nowalany-Kozielska, Ewa, additional, Bustamante Mandrión, José, additional, Poepping, Imke, additional, Freese, Michael, additional, Meissner, Kathrin, additional, Kulangara, Caroline, additional, Fuenzalida Inostroza, Carolina Isabel, additional, Greenslade, Jaimi, additional, Hawkins, Tracey, additional, Rentsch, Katharina, additional, von Eckardstein, Arnold, additional, Buser, Andreas, additional, Kloos, Wanda, additional, Steude, Jana, additional, and Osswald, Stefan, additional

Published
2019
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205. Relative hypochromia and mortality in acute heart failure

Author

Kleber, Martina, primary, Kozhuharov, Nikola, additional, Sabti, Zaid, additional, Glatz, Bettina, additional, Isenreich, Rahel, additional, Wussler, Desiree, additional, Nowak, Albina, additional, Twerenbold, Raphael, additional, Badertscher, Patrick, additional, Puelacher, Christian, additional, du Fay de Lavallaz, Jeanne, additional, Nestelberger, Thomas, additional, Boeddinghaus, Jasper, additional, Wildi, Karin, additional, Flores, Dayana, additional, Walter, Joan, additional, Rentsch, Katharina, additional, von Eckardstein, Arnold, additional, Goudev, Assen, additional, Breidthardt, Tobias, additional, and Mueller, Christian, additional

Published
2019
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206. Early Diagnosis of Myocardial Infarction in Patients With a History of Coronary Artery Bypass Grafting

Author

Koechlin, Luca, primary, Boeddinghaus, Jasper, additional, Nestelberger, Thomas, additional, Wussler, Desiree, additional, Walter, Joan, additional, Martin-Sanchez, F. Javier, additional, Geigy, Nicolas, additional, Keller, Dagmar I., additional, Twerenbold, Raphael, additional, Mueller, Christian, additional, Reichlin, Tobias, additional, Zimmermann, Tobias, additional, Meier, Mario, additional, Troester, Valentina, additional, Huber, Jeffrey, additional, Christ, Michael, additional, Badertscher, Patrick, additional, Wildi, Karin, additional, Puelacher, Christian, additional, du Fay de Lavallaz, Jeanne, additional, Giménez, Maria Rubini, additional, Strebel, Ivo, additional, Kozhuharov, Nikola, additional, Gualandro, Danielle M., additional, Potlukova, Eliska, additional, Rentsch, Katharina, additional, Miró, Òscar, additional, Fuenzalida, Carolina, additional, Shrestha, Samyut, additional, Kawecki, Damian, additional, Morawiec, Beata, additional, Munzk, Piotr, additional, Breidthardt, Tobias, additional, Flores, Dayana, additional, Freese, Michael, additional, Stelzig, Claudia, additional, Kulangara, Caroline, additional, Meissner, Kathrin, additional, Fahrni, Gregor, additional, Michou, Eleni, additional, Osswald, Stefan, additional, Jeger, Raban, additional, Kaiser, Christoph, additional, López, Beatriz, additional, Calderón, Sofia, additional, Adrada, Esther Rodriguez, additional, Ganovská, Eva, additional, Parenica, Jiri, additional, von Eckardstein, Arnold, additional, Campodarve, Isabel, additional, Gea, Joachim, additional, Reuthebuch, Oliver, additional, Grapow, Martin, additional, and Eckstein, Friedrich, additional

Published
2019
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207. High-Sensitivity Cardiac Troponin I Assay for Early Diagnosis of Acute Myocardial Infarction

Author

Boeddinghaus, Jasper, primary, Nestelberger, Thomas, primary, Twerenbold, Raphael, primary, Koechlin, Luca, primary, Meier, Mario, primary, Troester, Valentina, primary, Wussler, Desiree, primary, Badertscher, Patrick, primary, Wildi, Karin, primary, Puelacher, Christian, primary, du Fay de Lavallaz, Jeanne, primary, Rubini Giménez, Maria, primary, Zimmermann, Tobias, primary, Hafner, Benjamin, primary, Potlukova, Eliska, primary, Miró, Òscar, primary, Martin-Sanchez, F Javier, primary, Keller, Dagmar I, primary, Reichlin, Tobias, primary, Mueller, Christian, primary, Walter, Joan Elias, additional, Strebel, Ivo, additional, Kozhuharov, Nikola, additional, Freese, Michael, additional, Fuenzalida, Carolina, additional, Stelzig, Claudia, additional, Gualandro, Danielle M, additional, Michou, Eleni, additional, Meissner, Kathrin, additional, Kulangara, Caroline, additional, Shrestha, Samyut, additional, Fahrni, Gregor, additional, Osswald, Stefan, additional, López, Beatriz, additional, Adrada, Esther Rodriguez, additional, Ganovská, Eva, additional, Lohrmann, Jens, additional, Kloos, Wanda, additional, Steude, Jana, additional, Buser, Andreas, additional, von Eckardstein, Arnold, additional, Morawiec, Beata, additional, Kawecki, Damian, additional, Nowalany-Kozielska, Ewa, additional, Muzyk, Piotr, additional, Geigy, Nicolas, additional, and Rentsch, Katharina, additional

Published
2019
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208. Application of High-Sensitivity Troponin in Suspected Myocardial Infarction

Author

Neumann, Johannes T., primary, Twerenbold, Raphael, additional, Ojeda, Francisco, additional, Sörensen, Nils A., additional, Chapman, Andrew R., additional, Shah, Anoop S.V., additional, Anand, Atul, additional, Boeddinghaus, Jasper, additional, Nestelberger, Thomas, additional, Badertscher, Patrick, additional, Mokhtari, Arash, additional, Pickering, John W., additional, Troughton, Richard W., additional, Greenslade, Jaimi, additional, Parsonage, William, additional, Mueller-Hennessen, Matthias, additional, Gori, Tommaso, additional, Jernberg, Tomas, additional, Morris, Niall, additional, Liebetrau, Christoph, additional, Hamm, Christian, additional, Katus, Hugo A., additional, Münzel, Thomas, additional, Landmesser, Ulf, additional, Salomaa, Veikko, additional, Iacoviello, Licia, additional, Ferrario, Marco M., additional, Giampaoli, Simona, additional, Kee, Frank, additional, Thorand, Barbara, additional, Peters, Annette, additional, Borchini, Rossana, additional, Jørgensen, Torben, additional, Söderberg, Stefan, additional, Sans, Susana, additional, Tunstall-Pedoe, Hugh, additional, Kuulasmaa, Kari, additional, Renné, Thomas, additional, Lackner, Karl J., additional, Worster, Andrew, additional, Body, Richard, additional, Ekelund, Ulf, additional, Kavsak, Peter A., additional, Keller, Till, additional, Lindahl, Bertil, additional, Wild, Philipp, additional, Giannitsis, Evangelos, additional, Than, Martin, additional, Cullen, Louise A., additional, Mills, Nicholas L., additional, Mueller, Christian, additional, Zeller, Tanja, additional, Westermann, Dirk, additional, and Blankenberg, Stefan, additional

Published
2019
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209. Diagnosis of acute myocardial infarction in the presence of left bundle branch block

Author

Nestelberger, Thomas, primary, Cullen, Louise, additional, Lindahl, Bertil, additional, Reichlin, Tobias, additional, Greenslade, Jaimi H, additional, Giannitsis, Evangelos, additional, Christ, Michael, additional, Morawiec, Beata, additional, Miro, Oscar, additional, Martín-Sánchez, Francisco Javier, additional, Wussler, Desiree Nadine, additional, Koechlin, Luca, additional, Twerenbold, Raphael, additional, Parsonage, William, additional, Boeddinghaus, Jasper, additional, Rubini Gimenez, Maria, additional, Puelacher, Christian, additional, Wildi, Karin, additional, Buerge, Tobias, additional, Badertscher, Patrick, additional, DuFaydeLavallaz, Jeanne, additional, Strebel, Ivo, additional, Croton, Lukas, additional, Bendig, Garnet, additional, Osswald, Stefan, additional, Pickering, John William, additional, Than, Martin, additional, and Mueller, Christian, additional

Published
2019
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210. Prevalence and determinants of exercise‐induced left ventricular dysfunction in patients with coronary artery disease

Author

Honegger, Ursina, primary, Walter, Joan E., additional, Mueller, Deborah, additional, Puelacher, Christian, additional, Schaerli, Nicolas, additional, Twerenbold, Raphael, additional, Badertscher, Patrick, additional, Boeddinghaus, Jasper, additional, Nestelberger, Thomas, additional, du Fay de Lavallaz, Jeanne, additional, Wussler, Desiree, additional, Pfister, Otmar, additional, Jeger, Raban, additional, Kaiser, Christoph, additional, Wild, Damian, additional, Schmidt‐Trucksäss, Arno, additional, Reichlin, Tobias, additional, and Mueller, Christian, additional

Published
2019
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211. Comparison of fourteen rule-out strategies for acute myocardial infarction

Author

Wildi, Karin, primary, Boeddinghaus, Jasper, additional, Nestelberger, Thomas, additional, Twerenbold, Raphael, additional, Badertscher, Patrick, additional, Wussler, Desiree, additional, Giménez, Maria Rubini, additional, Puelacher, Christian, additional, du Fay de Lavallaz, Jeanne, additional, Dietsche, Sebastian, additional, Walter, Joan, additional, Kozhuharov, Nikola, additional, Morawiec, Beata, additional, Miró, Òscar, additional, Javier Martin-Sanchez, F., additional, Subramaniam, Sinthuri, additional, Geigy, Nicolas, additional, Keller, Dagmar I., additional, Reichlin, Tobias, additional, Mueller, Christian, additional, Mueller, Deborah, additional, Sazgary, Lorraine, additional, Marbot, Stella, additional, Sabti, Zaid, additional, Flores, Dayana, additional, Meissner, Kathrin, additional, Kulangara, Caroline, additional, Freese, Michael, additional, Osswald, Stefan, additional, Stelzig, Claudia, additional, Bingisser, Roland, additional, López, Beatriz, additional, Agüero, María Martínez, additional, Nowalany-Kozielska, Ewa, additional, Kawecki, Damian, additional, Parenica, Jiri, additional, Ganovská, Eva, additional, Lohrmann, Jens, additional, Buser, Andreas, additional, Grimm, Karin, additional, Hartmann, Beate, additional, Muzyk, Piotr, additional, Rentsch, Katharina, additional, and von Eckardstein, Arnold, additional

Published
2019
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212. Incidence and outcomes of unstable angina compared with non-ST-elevation myocardial infarction

Author

Puelacher, Christian, primary, Gugala, Mathias, additional, Adamson, Philip D, additional, Shah, Anoop, additional, Chapman, Andrew R, additional, Anand, Atul, additional, Sabti, Zaid, additional, Boeddinghaus, Jasper, additional, Nestelberger, Thomas, additional, Twerenbold, Raphael, additional, Wildi, Karin, additional, Badertscher, Patrick, additional, Rubini Gimenez, Maria, additional, Shrestha, Samyut, additional, Sazgary, Lorraine, additional, Mueller, Deborah, additional, Schumacher, Lukas, additional, Kozhuharov, Nikola, additional, Flores, Dayana, additional, du Fay de Lavallaz, Jeanne, additional, Miro, Oscar, additional, Martín-Sánchez, Francisco Javier, additional, Morawiec, Beata, additional, Fahrni, Gregor, additional, Osswald, Stefan, additional, Reichlin, Tobias, additional, Mills, Nicholas L, additional, and Mueller, Christian, additional

Published
2019
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213. Incremental diagnostic and prognostic value of the QRS-T angle, a 12-lead ECG marker quantifying heterogeneity of depolarization and repolarization, in patients with suspected non-ST-elevation myocardial infarction

Author

Strebel, Ivo, primary, Twerenbold, Raphael, additional, Wussler, Desiree, additional, Boeddinghaus, Jasper, additional, Nestelberger, Thomas, additional, du Fay de Lavallaz, Jeanne, additional, Abächerli, Roger, additional, Maechler, Patrick, additional, Mannhart, Diego, additional, Kozhuharov, Nikola, additional, Rubini Giménez, Maria, additional, Wildi, Karin, additional, Sazgary, Lorraine, additional, Sabti, Zaid, additional, Puelacher, Christian, additional, Badertscher, Patrick, additional, Keller, Dagmar I., additional, Miró, Òscar, additional, Fuenzalida, Carolina, additional, Calderón, Sofia, additional, Martin-Sanchez, F. Javier, additional, Iglesias, Sergio Lopez, additional, Osswald, Stefan, additional, Mueller, Christian, additional, and Reichlin, Tobias, additional

Published
2019
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214. External Validation of the MEESSI Acute Heart Failure Risk Score

Author

Wussler, Desiree, primary, Kozhuharov, Nikola, additional, Sabti, Zaid, additional, Walter, Joan, additional, Strebel, Ivo, additional, Scholl, Letizia, additional, Miró, Oscar, additional, Rossello, Xavier, additional, Martín-Sánchez, Francisco Javier, additional, Pocock, Stuart J., additional, Nowak, Albina, additional, Badertscher, Patrick, additional, Twerenbold, Raphael, additional, Wildi, Karin, additional, Puelacher, Christian, additional, du Fay de Lavallaz, Jeanne, additional, Shrestha, Samyut, additional, Strauch, Olivia, additional, Flores, Dayana, additional, Nestelberger, Thomas, additional, Boeddinghaus, Jasper, additional, Schumacher, Carmela, additional, Goudev, Assen, additional, Pfister, Otmar, additional, Breidthardt, Tobias, additional, and Mueller, Christian, additional

Published
2019
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216. Clinical utility of circulating interleukin-6 concentrations in the detection of functionally relevant coronary artery disease

Author

Walter, Joan, primary, Tanglay, Yunus, additional, du Fay de Lavallaz, Jeanne, additional, Strebel, Ivo, additional, Boeddinghaus, Jasper, additional, Twerenbold, Raphael, additional, Doerflinger, Stephanie, additional, Puelacher, Christian, additional, Nestelberger, Thomas, additional, Wussler, Desiree, additional, Amrein, Melissa, additional, Badertscher, Patrick, additional, Todd, John, additional, Rentsch, Katharina, additional, Fahrni, Gregor, additional, Jeger, Raban, additional, Kaiser, Christoph, additional, Reichlin, Tobias, additional, and Mueller, Christian, additional

Published
2019
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217. Incidence, clinical presentation, management, and outcome of acute pericarditis and myopericarditis

Author

Prepoudis, Alexandra, Koechlin, Luca, Nestelberger, Thomas, Boeddinghaus, Jasper, Lopez-Ayala, Pedro, Wussler, Desiree, Zimmermann, Tobias, Rubini Giménez, Maria, Strebel, Ivo, Puelacher, Christian, Shrestha, Samyut, Keller, Dagmar I, Christ, Michael, Gualandro, Danielle M, Twerenbold, Raphael, Martinez-Nadal, Gemma, Lopez-Barbeito, Beatriz, Miro, Oscar, and Mueller, Christian

Published
2022
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218. Direct comparison of high-sensitivity cardiac troponin T and I in the early differentiation of type 1 vs. type 2 myocardial infarction

Author

Nestelberger, Thomas, Boeddinghaus, Jasper, Giménez, Maria Rubini, Lopez-Ayala, Pedro, Ratmann, Paul David, Badertscher, Patrick, Wildi, Karin, Wussler, Desiree, Koechlin, Luca, Arslani, Ketina, Zimmermann, Tobias, Freese, Michael, Rinderknecht, Therese, Miró, Òscar, Martin-Sanchez, F Javier, Kawecki, Damian, Geigy, Nicolas, Keller, Dagmar, Twerenbold, Raphael, and Müller, Christian

Abstract

Adjudicated diagnosis of acute chest pain patients and levels of hs-cTnT/I at presentation in T1MI and T2MI. Adjudicated diagnosis of T1MI and T2MI in patients presenting with acute chest pain to the emergency department and levels of hs-cTnT/I at presentation in both groups. hs-cTn, high-sensitivity cardiac Troponin; T1MI, type 1 myocardial infarction; T2MI, type 2 myocardial infarction.

Published
2022
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219. Rhabdomyolysis

Author

du Fay de Lavallaz, Jeanne, primary, Zehntner, Tibor, additional, Puelacher, Christian, additional, Walter, Joan, additional, Strebel, Ivo, additional, Rentsch, Katharina, additional, Boeddinghaus, Jasper, additional, Nestelberger, Thomas, additional, Twerenbold, Raphael, additional, and Mueller, Christian, additional

Published
2018
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220. Influence of previous coronary artery bypass grafting in the difficulty of acute coronary syndrome diagnosis.

Author

Miró, Òscar, Martínez-Nadal, Gemma, Koechlin, Luca, Gil, Blanca Coll-Vinenta,Víctor, Aguiló, Sira, Galicia, Miguel, García-Martínez, Ana, Ortega, Mar, Strebel, Ivo, Ayala, Pedro López, Gualandro, Danielle M., Boeddinghaus, Jasper, Nestelberger, Thomas, Bragulat, Ernest, Sánchez, Miquel, Müller, Christian, and López-Barbeito, Beatriz

Published
2021
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226. Amyloid- (1-40) and Mortality in Patients With Non–ST-Segment Elevation Acute Coronary Syndrome A Cohort Study

Author

Stamatelopoulos, Kimon, Mueller-Hennessen, Matthias, Georgiopoulos, Georgios, Sachse, Marco, Boeddinghaus, Jasper, Sopova, Kateryna, Gatsiou, Aikaterini, Amrhein, Carolin, Biener, Moritz, Vafaie, Mehrshad, Athanasouli, Fani, Stakos, Dimitrios, Pateras, Konstantinos, Twerenbold, Raphael, Badertscher, Patrick, Nestelberger, Thomas, Dimmeler, Stefanie, Katus, Hugo A., Zeiher, Andreas M., Mueller, Christian, Giannitsis, Evangelos, Stellos, Konstantinos, Stamatelopoulos, Kimon, Mueller-Hennessen, Matthias, Georgiopoulos, Georgios, Sachse, Marco, Boeddinghaus, Jasper, Sopova, Kateryna, Gatsiou, Aikaterini, Amrhein, Carolin, Biener, Moritz, Vafaie, Mehrshad, Athanasouli, Fani, Stakos, Dimitrios, Pateras, Konstantinos, Twerenbold, Raphael, Badertscher, Patrick, Nestelberger, Thomas, Dimmeler, Stefanie, Katus, Hugo A., Zeiher, Andreas M., Mueller, Christian, Giannitsis, Evangelos, and Stellos, Konstantinos

Published
2018

227. Impact of age on the performance of the ESC 0/1h-algorithms for early diagnosis of myocardial infarction.

Author

UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service des urgences, Boeddinghaus, Jasper, Nestelberger, Thomas, Twerenbold, Raphael, Neumann, Johannes Tobias, Lindahl, Bertil, Giannitsis, Evangelos, Sörensen, Nils Arne, Badertscher, Patrick, Jann, Janina E, Wussler, Desiree, Puelacher, Christian, Rubini Giménez, Maria, Wildi, Karin, Strebel, Ivo, Du Fay de Lavallaz, Jeanne, Selman, Farah, Sabti, Zaid, Kozhuharov, Nikola, Potlukova, Eliska, Rentsch, Katharina, Miró, Òscar, Martin-Sanchez, F Javier, Morawiec, Beata, Parenica, Jiri, Lohrmann, Jens, Kloos, Wanda, Buser, Andreas, Geigy, Nicolas, Keller, Dagmar I, Osswald, Stefan, Reichlin, Tobias, Westermann, Dirk, Blankenberg, Stefan, Mueller, Christian, APACE, BACC, and TRAPID-AMI Investigators, Verschuren, Franck, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service des urgences, Boeddinghaus, Jasper, Nestelberger, Thomas, Twerenbold, Raphael, Neumann, Johannes Tobias, Lindahl, Bertil, Giannitsis, Evangelos, Sörensen, Nils Arne, Badertscher, Patrick, Jann, Janina E, Wussler, Desiree, Puelacher, Christian, Rubini Giménez, Maria, Wildi, Karin, Strebel, Ivo, Du Fay de Lavallaz, Jeanne, Selman, Farah, Sabti, Zaid, Kozhuharov, Nikola, Potlukova, Eliska, Rentsch, Katharina, Miró, Òscar, Martin-Sanchez, F Javier, Morawiec, Beata, Parenica, Jiri, Lohrmann, Jens, Kloos, Wanda, Buser, Andreas, Geigy, Nicolas, Keller, Dagmar I, Osswald, Stefan, Reichlin, Tobias, Westermann, Dirk, Blankenberg, Stefan, Mueller, Christian, APACE, BACC, and TRAPID-AMI Investigators, and Verschuren, Franck

Abstract

AIMS: We aimed to evaluate the impact of age on the performance of the European Society of Cardiology (ESC) 0/1h-algorithms and to derive and externally validate alternative cut-offs specific to older patients. METHODS AND RESULTS: We prospectively enrolled patients presenting to the emergency department (ED) with symptoms suggestive of acute myocardial infarction in three large diagnostic studies. Final diagnoses were adjudicated by two independent cardiologists. High-sensitivity cardiac troponin (hs-cTn) T and I concentrations were measured at presentation and after 1 h. Patients were stratified according to age [<55 years (young), ≥55 to <70 years (middle-age), ≥70 years (old)]. Rule-out safety of the ESC hs-cTnT 0/1h-algorithm was very high in all age-strata: sensitivity 100% [95% confidence interval (95% CI) 94.9-100] in young, 99.3% (95% CI 96.0-99.9) in middle-age, and 99.3% (95% CI 97.5-99.8) in old patients. Accuracy of rule-in decreased with age: specificity 97.0% (95% CI 95.8-97.9) in young, 96.1% (95% CI 94.5-97.2) in middle-age, and 92.7% (95% CI 90.7-94.3) in older patients. Triage efficacy decreased with increasing age (young 93%, middle-age 80%, old 55%, P < 0.001). Similar results were found for the ESC hs-cTnT 0/1h-algorithm. Alternative, slightly higher cut-off concentrations optimized for older patients maintained very high safety of rule-out, increased specificity of rule-in (P < 0.01), reduced overall efficacy for hs-cTnT (P < 0.01), while maintaining efficacy for hs-cTnI. Findings were confirmed in two validation cohorts (n = 2767). CONCLUSION: While safety of the ESC 0/1h-algorithms remained very high, increasing age significantly reduced overall efficacy and the accuracy of rule-in. Alternative slightly higher cut-off concentrations may be considered for older patients, particularly if using hs-cTnI. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT00470587, number NCT00470587 and NCT02355457 (BACC).

Published
2018

228. Combining High-Sensitivity Cardiac Troponin I and Cardiac Troponin T in the Early Diagnosis of Acute Myocardial Infarction

Author

van der Linden, Noreen, van der Linden, Noreen, Wildi, Karin, Twerenbold, Raphael, Pickering, John W., Than, Martin, Cullen, Louise, Greenslade, Jaimi, Parsonage, William, Nestelberger, Thomas, Boeddinghaus, Jasper, Badertscher, Patrick, Gimenez, Maria, Klinkenberg, Lieke J. J., Bekers, Otto, Schoni, Aline, Keller, Dagmar I., Sabti, Zaid, Puelacher, Christian, Cupa, Janosch, Schumacher, Lukas, Kozhuharov, Nikola, Grimm, Karin, Shrestha, Samyut, Flores, Dayana, Freese, Michael, Stelzig, Claudia, Strebel, Ivo, Miro, Oscar, Rentsch, Katharina, Morawiec, Beata, Kawecki, Damian, Kloos, Wanda, Lohrmann, Jens, Richards, A. Mark, Troughton, Richard, Pemberton, Christopher, Osswald, Stefan, van Dieijen-Visser, Marja P., Mingels, Alma M., Reichlin, Tobias, Meex, Steven J. R., Mueller, Christian, van der Linden, Noreen, van der Linden, Noreen, Wildi, Karin, Twerenbold, Raphael, Pickering, John W., Than, Martin, Cullen, Louise, Greenslade, Jaimi, Parsonage, William, Nestelberger, Thomas, Boeddinghaus, Jasper, Badertscher, Patrick, Gimenez, Maria, Klinkenberg, Lieke J. J., Bekers, Otto, Schoni, Aline, Keller, Dagmar I., Sabti, Zaid, Puelacher, Christian, Cupa, Janosch, Schumacher, Lukas, Kozhuharov, Nikola, Grimm, Karin, Shrestha, Samyut, Flores, Dayana, Freese, Michael, Stelzig, Claudia, Strebel, Ivo, Miro, Oscar, Rentsch, Katharina, Morawiec, Beata, Kawecki, Damian, Kloos, Wanda, Lohrmann, Jens, Richards, A. Mark, Troughton, Richard, Pemberton, Christopher, Osswald, Stefan, van Dieijen-Visser, Marja P., Mingels, Alma M., Reichlin, Tobias, Meex, Steven J. R., and Mueller, Christian

Abstract

Background: Combining 2 signals of cardiomyocyte injury, cardiac troponin I (cTnI) and T (cTnT), might overcome some individual pathophysiological and analytical limitations and thereby increase diagnostic accuracy for acute myocardial infarction with a single blood draw. We aimed to evaluate the diagnostic performance of combinations of high-sensitivity (hs) cTnI and hs-cTnT for the early diagnosis of acute myocardial infarction. Methods: The diagnostic performance of combining hs-cTnI (Architect, Abbott) and hs-cTnT (Elecsys, Roche) concentrations (sum, product, ratio, and a combination algorithm) obtained at the time of presentation was evaluated in a large multicenter diagnostic study of patients with suspected acute myocardial infarction. The optimal rule-out and rule-in thresholds were externally validated in a second large multicenter diagnostic study. The proportion of patients eligible for early rule-out was compared with the European Society of Cardiology 0/1 and 0/3 hour algorithms. Results: Combining hs-cTnI and hs-cTnT concentrations did not consistently increase overall diagnostic accuracy as compared with the individual isoforms. However, the combination improved the proportion of patients meeting criteria for very early rule-out. With the European Society of Cardiology 2015 guideline recommended algorithms and cut-offs, the proportion meeting rule-out criteria after the baseline blood sampling was limited (6% to 24%) and assay dependent. Application of optimized cut-off values using the sum (9 ng/L) and product (18 ng(2)/L-2) of hs-cTnI and hs-cTnT concentrations led to an increase in the proportion ruled-out after a single blood draw to 34% to 41% in the original (sum: negative predictive value [NPV] 100% [95% confidence interval (CI), 99.5% to 100%]; product: NPV 100% [95% CI, 99.5% to 100%]) and in the validation cohort (sum: NPV 99.6% [95% CI, 99.0-99.9%]; product: NPV 99.4% [95% CI, 98.8-99.8%]). The use of a combination algorithm (hs-cTnI <4

Published
2018

229. Prospective validation of prognostic and diagnostic syncope scores in the emergency department

Author

du Fay de Lavallaz, Jeanne, Badertscher, Patrick, Nestelberger, Thomas, Isenrich, Rahel, Miró, Òscar, Salgado, Emilio, Geigy, Nicolas, Christ, Michael, Cullen, Louise, Than, Martin, Martin-Sanchez, F. Javier, Bustamante Mandrión, José, Di Somma, Salvatore, Peacock, W. Frank, Kawecki, Damian, Boeddinghaus, Jasper, Twerenbold, Raphael, Puelacher, Christian, Wussler, Desiree, Strebel, Ivo, Keller, Dagmar I., Poepping, Imke, Kühne, Michael, Mueller, Christian, Reichlin, Tobias, Giménez, Maria Rubini, Walter, Joan, Kozhuharov, Nikola, Shrestha, Samyut, Mueller, Deborah, Sazgary, Lorraine, Morawiec, Beata, Muzyk, Piotr, Nowalany-Kozielska, Ewa, Freese, Michael, Stelzig, Claudia, Meissner, Kathrin, Kulangara, Caroline, Hartmann, Beate, Ferel, Ina, Sabti, Zaid, Greenslade, Jaimi, Hawkins, Tracey, Rentsch, Katharina, von Eckardstein, Arnold, Buser, Andreas, Kloos, Wanda, Lohrmann, Jens, Osswald, Stefan, du Fay de Lavallaz, Jeanne, Badertscher, Patrick, Nestelberger, Thomas, Isenrich, Rahel, Miró, Òscar, Salgado, Emilio, Geigy, Nicolas, Christ, Michael, Cullen, Louise, Than, Martin, Martin-Sanchez, F. Javier, Bustamante Mandrión, José, Di Somma, Salvatore, Peacock, W. Frank, Kawecki, Damian, Boeddinghaus, Jasper, Twerenbold, Raphael, Puelacher, Christian, Wussler, Desiree, Strebel, Ivo, Keller, Dagmar I., Poepping, Imke, Kühne, Michael, Mueller, Christian, Reichlin, Tobias, Giménez, Maria Rubini, Walter, Joan, Kozhuharov, Nikola, Shrestha, Samyut, Mueller, Deborah, Sazgary, Lorraine, Morawiec, Beata, Muzyk, Piotr, Nowalany-Kozielska, Ewa, Freese, Michael, Stelzig, Claudia, Meissner, Kathrin, Kulangara, Caroline, Hartmann, Beate, Ferel, Ina, Sabti, Zaid, Greenslade, Jaimi, Hawkins, Tracey, Rentsch, Katharina, von Eckardstein, Arnold, Buser, Andreas, Kloos, Wanda, Lohrmann, Jens, and Osswald, Stefan

Abstract

Background: Various scores have been derived for the assessment of syncope patients in the emergency department (ED) but stay inconsistently validated. We aim to compare their performance to the one of a common, easy-to-use CHADS 2 score. Methods: We prospectively enrolled patients ≥ 40 years old presenting with syncope to the ED in a multicenter study. Early clinical judgment (ECJ) of the treating ED-physician regarding the probability of cardiac syncope was quantified. Two independent physicians adjudicated the final diagnosis after 1-year follow-up. Major cardiovascular events (MACE) and death were recorded during 2 years of follow-up. Nine scores were compared by their area under the receiver-operator characteristics curve (AUC) for death, MACE or the diagnosis of cardiac syncope. Results: 1490 patients were available for score validation. The CHADS 2 -score presented a higher or equally high accuracy for death in the long- and short-term follow-up than other syncope-specific risk scores. This score also performed well for the prediction of MACE in the long- and short-term evaluation and stratified patients with accuracy comparative to OESIL, one of the best performing syncope-specific risk score. All scores performed poorly for diagnosing cardiac syncope when compared to the ECJ. Conclusions: The CHADS 2 -score performed comparably to more complicated syncope-specific risk scores in the prediction of death and MACE in ED syncope patients. While better tools incorporating biochemical and electrocardiographic markers are needed, this study suggests that the CHADS 2 -score is currently a good option to stratify risk in syncope patients in the ED. Trial registration: NCT01548352

Published
2018

230. Characteristics and occurrence of type 2 myocardial infarction in emergency department patients: A prospective study

Author

Greenslade, Jaimi H., Adikari, Thushani, Mueller, Christian, Sandoval, Yader, Nestelberger, Thomas, Parsonage, William, Hawkins, Tracey, Cullen, Louise, Greenslade, Jaimi H., Adikari, Thushani, Mueller, Christian, Sandoval, Yader, Nestelberger, Thomas, Parsonage, William, Hawkins, Tracey, and Cullen, Louise

Abstract

Objective To identify differences in prevalence, demographics, clinical features and outcomes for type 1 myocardial infarction (T1MI) and type 2 myocardial infarction (T2MI) in a cohort of patients presenting to the Emergency Department (ED) with chest pain. Methods This was a post hoc analysis of data collected from two prospective studies. Data were collected between November 2008 and February 2011 for the first study, and between February 2011 and March 2014 for the second. Participants were patients presenting to the ED with symptoms suggestive of acute coronary syndrome (ACS). The outcome was 30-day diagnosis; classified into T1MI, T2MI or non-MI. Descriptive statistics were used to compare the demographics, clinical history and presenting symptoms across diagnoses (T1MI, T2MI and non-MI). Cumulative mortality over 1 year was compared for T1MI and T2MI. Results 147 patients (6.3%; 95% CI 5.3% to 7.3%) were classified as T1MI and 52 (2.2%; 95% CI 1.7% to 2.9%) were classified as T2MI. T2MIs were more likely to be female (OR 4.71, 95% CI 2.28 to 9.76), have an abnormal but non-ischaemic ECG (OR 2.95, 95% CI 1.45 to 6.00), report prior hypertension (OR 2.83, 95% CI 1.35 to 6.12), have tachycardia (OR 9.26, 95% CI 3.08 to 30.77) and pain at rest (OR 3.04, 95% CI 1.28 to 8.02) compared with T1MI. One-year mortality was similar between T1MI and T2MI (9% and 14.6%, respectively, p=0.37). Conclusions T2MIs comprised one quarter of all MIs diagnosed in the ED. Among patients presenting to the ED with symptoms of ACS, symptoms do not allow clinicians to reliably differentiate patients with T1MI and T2MI. Prior hypertension, tachycardia and abnormal non-ischaemic ECGs are seen more often in T2MI compared with T1MI. One-year mortality was substantial in patients with T1MI and T2MI, but low power precludes conclusions about mortality differences between groups.

Published
2018

231. Amyloid- (1-40) and Mortality in Patients With Non–ST-Segment Elevation Acute Coronary Syndrome A Cohort Study

Author

Data Science & Biostatistiek, Stamatelopoulos, Kimon, Mueller-Hennessen, Matthias, Georgiopoulos, Georgios, Sachse, Marco, Boeddinghaus, Jasper, Sopova, Kateryna, Gatsiou, Aikaterini, Amrhein, Carolin, Biener, Moritz, Vafaie, Mehrshad, Athanasouli, Fani, Stakos, Dimitrios, Pateras, Konstantinos, Twerenbold, Raphael, Badertscher, Patrick, Nestelberger, Thomas, Dimmeler, Stefanie, Katus, Hugo A., Zeiher, Andreas M., Mueller, Christian, Giannitsis, Evangelos, Stellos, Konstantinos, Data Science & Biostatistiek, Stamatelopoulos, Kimon, Mueller-Hennessen, Matthias, Georgiopoulos, Georgios, Sachse, Marco, Boeddinghaus, Jasper, Sopova, Kateryna, Gatsiou, Aikaterini, Amrhein, Carolin, Biener, Moritz, Vafaie, Mehrshad, Athanasouli, Fani, Stakos, Dimitrios, Pateras, Konstantinos, Twerenbold, Raphael, Badertscher, Patrick, Nestelberger, Thomas, Dimmeler, Stefanie, Katus, Hugo A., Zeiher, Andreas M., Mueller, Christian, Giannitsis, Evangelos, and Stellos, Konstantinos

Published
2018

232. 0/1-Hour Triage Algorithm for Myocardial Infarction in Patients With Renal Dysfunction

Author

Twerenbold, Raphael, Badertscher, Patrick, Boeddinghaus, Jasper, Nestelberger, Thomas, Wildi, Karin, Puelacher, Christian, Sabti, Zaid, Rubini Gimenez, Maria, Tschirky, Sandra, du Fay de Lavallaz, Jeanne, Kozhuharov, Nikola, Sazgary, Lorraine, Mueller, Deborah, Breidthardt, Tobias, Strebel, Ivo, Flores Widmer, Dayana, Shrestha, Samyut, Miró, Òscar, Martín-Sánchez, F Javier, Morawiec, Beata, Parenica, Jiri, Geigy, Nicolas, Keller, Dagmar I, Rentsch, Katharina, von Eckardstein, Arnold, Osswald, Stefan, Reichlin, Tobias, Mueller, Christian, Twerenbold, Raphael, Badertscher, Patrick, Boeddinghaus, Jasper, Nestelberger, Thomas, Wildi, Karin, Puelacher, Christian, Sabti, Zaid, Rubini Gimenez, Maria, Tschirky, Sandra, du Fay de Lavallaz, Jeanne, Kozhuharov, Nikola, Sazgary, Lorraine, Mueller, Deborah, Breidthardt, Tobias, Strebel, Ivo, Flores Widmer, Dayana, Shrestha, Samyut, Miró, Òscar, Martín-Sánchez, F Javier, Morawiec, Beata, Parenica, Jiri, Geigy, Nicolas, Keller, Dagmar I, Rentsch, Katharina, von Eckardstein, Arnold, Osswald, Stefan, Reichlin, Tobias, and Mueller, Christian

Abstract

BACKGROUND The European Society of Cardiology recommends a 0/1-hour algorithm for rapid rule-out and rule-in of non-ST-segment elevation myocardial infarction using high-sensitivity cardiac troponin (hs-cTn) concentrations irrespective of renal function. Because patients with renal dysfunction (RD) frequently present with increased hs-cTn concentrations even in the absence of non-ST-segment elevation myocardial infarction, concern has been raised regarding the performance of the 0/1-hour algorithm in RD. METHODS In a prospective multicenter diagnostic study enrolling unselected patients presenting with suspected non-ST-segment elevation myocardial infarction to the emergency department, we assessed the diagnostic performance of the European Society of Cardiology 0/1-hour algorithm using hs-cTnT and hs-cTnI in patients with RD, defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2, and compared it to patients with normal renal function. The final diagnosis was centrally adjudicated by 2 independent cardiologists using all available information, including cardiac imaging. Safety was quantified as sensitivity in the rule-out zone, accuracy as the specificity in the rule-in zone, and efficacy as the proportion of the overall cohort assigned to either rule-out or rule-in based on the 0- and 1-hour sample. RESULTS Among 3254 patients, RD was present in 487 patients (15%). The prevalence of non-ST-segment elevation myocardial infarction was substantially higher in patients with RD compared with patients with normal renal function (31% versus 13%, P<0.001). Using hs-cTnT, patients with RD had comparable sensitivity of rule-out (100.0% [95% confidence interval {CI}, 97.6-100.0] versus 99.2% [95% CI, 97.6-99.8]; P=0.559), lower specificity of rule-in (88.7% [95% CI, 84.8-91.9] versus 96.5% [95% CI, 95.7-97.2]; P<0.001), and lower overall efficacy (51% versus 81%, P<0.001), mainly driven by a much lower percentage of patients eligible for rule-out (18% versus 6

Published
2018

235. How accurate is clinical assessment of neck veins in the estimation of central venous pressure in acute heart failure? Insights from a prospective study

Author

Breidthardt, Tobias, Moreno-Weidmann, Zoraida, Uthoff, Heiko, Sabti, Zaid, Aeppli, Sven, Puelacher, Christian, Stallone, Fabio, Twerenbold, Raphael, Wildi, Karin, Kozhuharov, Nikola, Wussler, Desiree, Flores, Dayana, Shrestha, Samyut, Badertscher, Patrick, Boeddinghaus, Jasper, Nestelberger, Thomas, Gimenez, Maria Rubini, Staub, Daniel, Aschwanden, Markus, Lohrmann, Jens, Pfister, Otmar, Osswald, Stefan, and Mueller, Christian

Subjects
Heart Failure, Male, Central Venous Pressure, Acute Disease, Humans, Reproducibility of Results, Blood Pressure Determination, Female, Jugular Veins
Published
2017

236. Direct Comparison of Cardiac Myosin-Binding Protein C With Cardiac Troponins for the Early Diagnosis of Acute Myocardial Infarction

Author

Kaier, Thomas E., Twerenbold, Raphael, Puelacher, Christian, Marjot, Jack, Imambaccus, Nazia, Boeddinghaus, Jasper, Nestelberger, Thomas, Badertscher, Patrick, Sabti, Zaid, Giménez, Maria Rubini, Wildi, Karin, Hillinger, Petra, Grimm, Karin, Loeffel, Sarah, Shrestha, Samyut, Widmer, Dayana Flores, Cupa, Janosch, Kozhuharov, Nikola, Miró, Òscar, Martín-Sánchez, F. Javier, Morawiec, Beata, Rentsch, Katharina, Lohrmann, Jens, Kloos, Wanda, Osswald, Stefan, Reichlin, Tobias, Weber, Ekkehard, Marber, Michael, and Mueller, Christian

Subjects
Male, Time Factors, health care facilities, manpower, and services, Myocardial Infarction, cardiac myosin-binding protein C, macromolecular substances, myocardial infarction, APACE, Troponin T, Predictive Value of Tests, Original Research Articles, troponin I, Humans, cardiovascular diseases, health care economics and organizations, Aged, Aged, 80 and over, troponin T, Reproducibility of Results, Middle Aged, Prognosis, Up-Regulation, Europe, Early Diagnosis, ROC Curve, Area Under Curve, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, cardiovascular system, Female, Triage, Carrier Proteins, Emergency Service, Hospital, cMyC, Biomarkers
Abstract

Supplemental Digital Content is available in the text., Background: Cardiac myosin-binding protein C (cMyC) is a cardiac-restricted protein that is more abundant than cardiac troponins (cTn) and is released more rapidly after acute myocardial infarction (AMI). We evaluated cMyC as an adjunct or alternative to cTn in the early diagnosis of AMI. Methods: Unselected patients (N=1954) presenting to the emergency department with symptoms suggestive of AMI, concentrations of cMyC, and high-sensitivity (hs) and standard-sensitivity cTn were measured at presentation. The final diagnosis of AMI was independently adjudicated using all available clinical and biochemical information without knowledge of cMyC. The prognostic end point was long-term mortality. Results: Final diagnosis was AMI in 340 patients (17%). Concentrations of cMyC at presentation were significantly higher in those with versus without AMI (median, 237 ng/L versus 13 ng/L, P

Published
2017

237. Cardiovascular Biomarkers in the Early Discrimination of Type 2 Myocardial Infarction

Author

Nestelberger, Thomas, Boeddinghaus, Jasper, Lopez-Ayala, Pedro, Kaier, Thomas E., Marber, Michael, Gysin, Vincent, Koechlin, Luca, Sanchez, Ana Yufera, Giménez, Maria Rubini, Wussler, Desiree, Walter, Joan Elias, Strebel, Ivo, Zimmermann, Tobias, Glarner, Noemi, Miró, Òscar, Martin-Sanchez, F. Javier, Zehnder, Tatjana, Twerenbold, Raphael, Keller, Dagmar I., and Mueller, Christian

Abstract

IMPORTANCE: Rapid and accurate noninvasive discrimination of type 2 myocardial infarction (T2MI), which is because of a supply-demand mismatch, from type 1 myocardial infarction (T1MI), which arises via plaque rupture, is essential, because treatment differs substantially. Unfortunately, this is a major unmet clinical need, because even high-sensitivity cardiac troponin (hs-cTn) measurement provides only modest accuracy. OBJECTIVE: To test the hypothesis that novel cardiovascular biomarkers quantifying different pathophysiological pathways involved in T2MI and/or T1MI may aid physicians in the rapid discrimination of T2MI vs T1MI. DESIGN, SETTING, AND PARTICIPANTS: This international, multicenter prospective diagnostic study was conducted in 12 emergency departments in 5 countries (Switzerland, Spain, Italy, Poland, and the Czech Republic) with patients presenting with acute chest discomfort to the emergency departments. The study quantified the discrimination of hs-cTn T, hs-cTn I, and 17 novel cardiovascular biomarkers measured in subsets of consecutively enrolled patients against a reference standard (final diagnosis), centrally adjudicated by 2 independent cardiologists according to the fourth universal definition of MI, using all information, including cardiac imaging and serial measurements of hs-cTnT or hs-cTnI. RESULTS: Among 5887 patients, 1106 (18.8%) had an adjudicated final diagnosis of MI; of these, 860 patients (77.8%) had T1MI, and 246 patients (22.2%) had T2MI. Patients with T2MI vs those with T1MI had lower concentrations of biomarkers quantifying cardiomyocyte injury hs-cTnT (median [interquartile range (IQR)], 30 (17-55) ng/L vs 58 (28-150) ng/L), hs-cTnI (median [IQR], 23 [10-83] ng/L vs 115 [28-576] ng/L; P &lt; .001), and cardiac myosin-binding protein C (at presentation: median [IQR], 76 [38-189] ng/L vs 257 [75-876] ng/L; P &lt; .001) but higher concentrations of biomarkers quantifying endothelial dysfunction, microvascular dysfunction, and/or hemodynamic stress (median [IQR] values: C-terminal proendothelin 1, 97 [75-134] pmol/L vs 68 [55-91] pmol/L; midregional proadrenomedullin, 0.97 [0.67-1.51] pmol/L vs 0.72 [0.53-0.99] pmol/L; midregional pro–A-type natriuretic peptide, 378 [207-491] pmol/L vs 152 [90-247] pmol/L; and growth differentiation factor 15, 2.26 [1.44-4.35] vs 1.56 [1.02-2.19] ng/L; all P &lt; .001). Discrimination for these biomarkers, as quantified by the area under the receiver operating characteristics curve, was modest (hs-cTnT, 0.67 [95% CI, 0.64-0.71]; hs-cTn I, 0.71 [95% CI, 0.67-0.74]; cardiac myosin-binding protein C, 0.67 [95% CI, 0.61-0.73]; C-terminal proendothelin 1, 0.73 [95% CI, 0.63-0.83]; midregional proadrenomedullin, 0.66 [95% CI, 0.60-0.73]; midregional pro–A-type natriuretic peptide, 0.77 [95% CI, 0.68-0.87]; and growth differentiation factor 15, 0.68 [95% CI, 0.58-0.79]). CONCLUSIONS AND RELEVANCE: In this study, biomarkers quantifying myocardial injury, endothelial dysfunction, microvascular dysfunction, and/or hemodynamic stress provided modest discrimination in early, noninvasive diagnosis of T2MI.

Published
2021
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238. Cinética temprana de troponina en pacientes con sospecha de infarto agudo de miocardio

Author

Rubini Giménez, María, Wildi, Karin, Wussler, Desiree, Koechlin, Luca, Boeddinghaus, Jasper, Nestelberger, Thomas, Badertscher, Patrick, Sedlmayer, Raphael, Puelacher, Christian, Zimmermann, Tobias, du Fay de Lavallaz, Jeanne, Lopez-Ayala, Pedro, Leu, Kathrin, Rentsch, Katharina, Miró, Òscar, López, Beatriz, Martín-Sánchez, F. Javier, Bustamante, José, Kawecki, Damian, Parenica, Jiri, Lohrmann, Jens, Kloos, Wanda, Buser, Andreas, Keller, Dagmar I., Reichlin, Tobias, Twerenbold, Raphael, and Mueller, Christian

Abstract

La cinética de liberación de troponinas cardiacas ultrasensibles (Tnc-us) T e I en pacientes con sospecha de infarto agudo de miocardio (IAM) se desconoce completamente a día de hoy. Nuestro objetivo fue evaluar si la liberación de Tnc-us T/I en las fases iniciales del IAM sigue un patrón linear.

Published
2021
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239. Obesity paradox and perioperative myocardial infarction/injury in non-cardiac surgery.

Author

Hidvegi, Reka, Puelacher, Christian, Gualandro, Danielle M., Lampart, Andreas, Lurati Buse, Giovanna, Hammerer-Lerchner, Angelika, Walter, Joan, Liffert, Marcel, Bolliger, Daniel, Steiner, Luzius, Kindler, Christoph, Espinola, Jaqueline, Strebel, Ivo, Gueckel, Johanna, Marbot, Stella, Arslani, Ketina, Boeddinghaus, Jasper, Nestelberger, Thomas, Zimmermann, Tobias, and Freese, Michael

Abstract

Background: The impact of obesity on the incidence of perioperative myocardial infarction/injury (PMI) and mortality following non-cardiac surgery is not well understood. Methods: We performed a prospective diagnostic study enrolling consecutive patients undergoing non-cardiac surgery, who were considered at increased cardiovascular risk. All patients were screened for PMI, defined as an absolute increase from preoperative to postoperative sensitive/high-sensitivity cardiac troponin T (hs-cTnT) concentrations. The body mass index (BMI) was classified according to the WHO classification (underweight< 18 kg/m2, normal weight 18–24.9 kg/m2, overweight 25–29.9 kg/m2, obesity class I 30–34.9 kg/m2, obesity class II 35–39.9 kg/m2, obesity class III > 40 kg/m2). The incidence of PMI and all-cause mortality at 365 days, both stratified according to BMI. Results: We enrolled 4277 patients who had undergone 5413 surgeries. The median BMI was 26 kg/m2 (interquartile range 23–30 kg/m2). Incidence of PMI showed a non-linear relationship with BMI and ranged from 12% (95% CI 9–14%) in obesity class I to 19% (95% CI 17–42%) in the underweight group. This was confirmed in multivariable analysis with obesity class I. showing the lowest risk (adjusted OR 0.64; 95% CI 0.49–0.83) for developing PMI. Mortality at 365 days was lower in all obesity groups compared to patients with normal body weight (e.g., unadjusted OR 0.54 (95% CI 0.39–0.73) and adjusted OR 0.52 (95% CI 0.38–0.71) in obesity class I). Conclusion: Obesity class I was associated with a lower incidence of PMI, and obesity in general was associated with a lower all-cause mortality at 365 days. [ABSTRACT FROM AUTHOR]

Published
2020
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240. Performance of the ESC 0/1-h and 0/3-h Algorithm for the Rapid Identification of Myocardial Infarction Without ST-Elevation in Patients With Diabetes.

Author

Haller, Paul M., Boeddinghaus, Jasper, Neumann, Johannes T., Sörensen, Nils A., Hartikainen, Tau S., Goßling, Alina, Nestelberger, Thomas, Twerenbold, Raphael, Lehmacher, Jonas, Keller, Till, Zeller, Tanja, Blankenberg, Stefan, Mueller, Christian, and Westermann, Dirk

Subjects
MYOCARDIAL infarction, PEOPLE with diabetes, ALGORITHMS, DIABETES, IDENTIFICATION, MYOCARDIAL infarction complications, MYOCARDIAL infarction diagnosis, DIAGNOSIS of diabetes, ARRHYTHMIA diagnosis, CARDIOLOGY, TROPONIN, RESEARCH, PREDICTIVE tests, TIME, RESEARCH methodology, EVALUATION research, MEDICAL cooperation, COMPARATIVE studies, ARRHYTHMIA, DIABETIC angiopathies, MEDICAL societies, LONGITUDINAL method, DISEASE complications
Abstract

Objective: Patients with diabetes mellitus (DM) have elevated levels of high-sensitivity cardiac troponin (hs-cTn). We investigated the diagnostic performance of the European Society of Cardiology (ESC) algorithms to rule out or rule in acute myocardial infarction (AMI) without ST-elevation in patients with DM.Research Design and Methods: We prospectively enrolled 3,681 patients with suspected AMI and stratified those by the presence of DM. The ESC 0/1-h and 0/3-h algorithms were used to calculate negative and positive predictive values (NPV, PPV). In addition, alternative cutoffs were calculated and externally validated in 2,895 patients.Results: In total, 563 patients (15.3%) had DM, and 137 (24.3%) of these had AMI. When the ESC 0/1-h algorithm was used, the NPV was comparable in patients with and without DM (absolute difference [AD] -1.50 [95% CI -5.95, 2.96]). In contrast, the ESC 0/3-h algorithm resulted in a significantly lower NPV in patients with DM (AD -2.27 [95% CI -4.47, -0.07]). The diagnostic performance for rule-in of AMI (PPV) was comparable in both groups: 0/1-h (AD 6.59 [95% CI -19.53, 6.35]) and 0/3-h (AD 1.03 [95% CI -7.63, 9.7]). Alternative cutoffs increased the PPV in both algorithms significantly, while improvements in NPV were only subtle.Conclusions: Application of the ESC 0/1-h algorithm revealed comparable safety to rule out AMI comparing patients with and without DM, while this was not observed with the ESC 0/3-h algorithm. Although alternative cutoffs might be helpful, patients with DM remain a high-risk population in whom identification of AMI is challenging and who require careful clinical evaluation. [ABSTRACT FROM AUTHOR]

Published
2020
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241. Direct Comparison of Cardiac Troponin T and I Using a Uniform and a Sex-Specific Approach in the Detection of Functionally Relevant Coronary Artery Disease

Author

Mueller, Deborah, primary, Puelacher, Christian, primary, Honegger, Ursina, primary, Walter, Joan E, primary, Badertscher, Patrick, primary, Schaerli, Nicolas, primary, Strebel, Ivo, primary, Twerenbold, Raphael, primary, Boeddinghaus, Jasper, primary, Nestelberger, Thomas, primary, Hollenstein, Christina, primary, du Fay de Lavallaz, Jeanne, primary, Jeger, Raban, primary, Kaiser, Christoph, primary, Wild, Damian, primary, Rentsch, Katharina, primary, Buser, Andreas, primary, Zellweger, Michael, primary, Reichlin, Tobias, primary, and Mueller, Christian, primary

Published
2018
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242. Diagnostic and prognostic value of QRS duration and QTc interval in patients with suspected myocardial infarction

Author

Cupa, Janosch, primary, Strebel, Ivo, additional, Badertscher, Patrick, additional, Abächerli, Roger, additional, Twerenbold, Raphael, additional, Schumacher, Lukas, additional, Boeddinghaus, Jasper, additional, Nestelberger, Thomas, additional, Maechler, Patrick, additional, Kozhuharov, Nikola, additional, Giménez, Maria Rubini, additional, Wildi, Karin, additional, Du Fay de Lavallaz, Jeanne, additional, Sabti, Zaid, additional, Sazgary, Lorraine, additional, Puelacher, Christian, additional, Mueller, Deborah, additional, Bianci, Chiara, additional, Miró, Òscar, additional, Fuenzalida, Carolina, additional, Calderón, Sofia, additional, Martín-Sánchez, F. Javier, additional, Iglesias, Sergio Lopez, additional, Morawiec, Beata, additional, Kawecki, Damian, additional, Parenica, Jiri, additional, Keller, Dagmar I., additional, Geigy, Nicolas, additional, Osswald, Stefan, additional, Mueller, Christian, additional, and Reichlin, Tobias, additional

Published
2018
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243. Prospective validation of prognostic and diagnostic syncope scores in the emergency department

Author

du Fay de Lavallaz, Jeanne, primary, Badertscher, Patrick, additional, Nestelberger, Thomas, additional, Isenrich, Rahel, additional, Miró, Òscar, additional, Salgado, Emilio, additional, Geigy, Nicolas, additional, Christ, Michael, additional, Cullen, Louise, additional, Than, Martin, additional, Martin-Sanchez, F. Javier, additional, Bustamante Mandrión, José, additional, Di Somma, Salvatore, additional, Peacock, W. Frank, additional, Kawecki, Damian, additional, Boeddinghaus, Jasper, additional, Twerenbold, Raphael, additional, Puelacher, Christian, additional, Wussler, Desiree, additional, Strebel, Ivo, additional, Keller, Dagmar I., additional, Poepping, Imke, additional, Kühne, Michael, additional, Mueller, Christian, additional, Reichlin, Tobias, additional, Giménez, Maria Rubini, additional, Walter, Joan, additional, Kozhuharov, Nikola, additional, Shrestha, Samyut, additional, Mueller, Deborah, additional, Sazgary, Lorraine, additional, Morawiec, Beata, additional, Muzyk, Piotr, additional, Nowalany-Kozielska, Ewa, additional, Freese, Michael, additional, Stelzig, Claudia, additional, Meissner, Kathrin, additional, Kulangara, Caroline, additional, Hartmann, Beate, additional, Ferel, Ina, additional, Sabti, Zaid, additional, Greenslade, Jaimi, additional, Hawkins, Tracey, additional, Rentsch, Katharina, additional, von Eckardstein, Arnold, additional, Buser, Andreas, additional, Kloos, Wanda, additional, Lohrmann, Jens, additional, and Osswald, Stefan, additional

Published
2018
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245. Combining High-Sensitivity Cardiac Troponin I and Cardiac Troponin T in the Early Diagnosis of Acute Myocardial Infarction

Author

van der Linden, Noreen, primary, Wildi, Karin, additional, Twerenbold, Raphael, additional, Pickering, John W., additional, Than, Martin, additional, Cullen, Louise, additional, Greenslade, Jaimi, additional, Parsonage, William, additional, Nestelberger, Thomas, additional, Boeddinghaus, Jasper, additional, Badertscher, Patrick, additional, Rubini Giménez, Maria, additional, Klinkenberg, Lieke J.J., additional, Bekers, Otto, additional, Schöni, Aline, additional, Keller, Dagmar I., additional, Sabti, Zaid, additional, Puelacher, Christian, additional, Cupa, Janosch, additional, Schumacher, Lukas, additional, Kozhuharov, Nikola, additional, Grimm, Karin, additional, Shrestha, Samyut, additional, Flores, Dayana, additional, Freese, Michael, additional, Stelzig, Claudia, additional, Strebel, Ivo, additional, Miró, Òscar, additional, Rentsch, Katharina, additional, Morawiec, Beata, additional, Kawecki, Damian, additional, Kloos, Wanda, additional, Lohrmann, Jens, additional, Richards, A. Mark, additional, Troughton, Richard, additional, Pemberton, Christopher, additional, Osswald, Stefan, additional, van Dieijen-Visser, Marja P., additional, Mingels, Alma M., additional, Reichlin, Tobias, additional, Meex, Steven J.R., additional, and Mueller, Christian, additional

Published
2018
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246. Proenkephalin for the early detection of acute kidney injury in hospitalized patients with chronic kidney disease

Author

Breidthardt, Tobias, primary, Jaeger, Cedric, additional, Christ, Andreas, additional, Klima, Theresia, additional, Mosimann, Tamina, additional, Twerenbold, Raphael, additional, Boeddinghaus, Jasper, additional, Nestelberger, Thomas, additional, Badertscher, Patrick, additional, Struck, Joachim, additional, Bergmann, Andreas, additional, Hartmann, Oliver, additional, Kalbermatter, Stefan, additional, Marenzi, Giancarlo, additional, and Mueller, Christian, additional

Published
2018
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247. Prospective Validation of the 0/1-h Algorithm for Early Diagnosis of Myocardial Infarction

Author

Twerenbold, Raphael, primary, Neumann, Johannes Tobias, additional, Sörensen, Nils Arne, additional, Ojeda, Francisco, additional, Karakas, Mahir, additional, Boeddinghaus, Jasper, additional, Nestelberger, Thomas, additional, Badertscher, Patrick, additional, Rubini Giménez, Maria, additional, Puelacher, Christian, additional, Wildi, Karin, additional, Kozhuharov, Nikola, additional, Breitenbuecher, Dominik, additional, Biskup, Ewelina, additional, du Fay de Lavallaz, Jeanne, additional, Flores, Dayana, additional, Wussler, Desiree, additional, Miró, Òscar, additional, Martín Sánchez, F. Javier, additional, Morawiec, Beata, additional, Parenica, Jiri, additional, Geigy, Nicolas, additional, Keller, Dagmar I., additional, Zeller, Tanja, additional, Reichlin, Tobias, additional, Blankenberg, Stefan, additional, Westermann, Dirk, additional, and Mueller, Christian, additional

Published
2018
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248. Response by Kaier et al to Letter Regarding Article, “Direct Comparison of Cardiac Myosin-Binding Protein C With Cardiac Troponins for the Early Diagnosis of Acute Myocardial Infarction”

Author

Kaier, Thomas E., primary, Twerenbold, Raphael, additional, Puelacher, Christian, additional, Marjot, Jack, additional, Imambaccus, Nazia, additional, Boeddinghaus, Jasper, additional, Nestelberger, Thomas, additional, Badertscher, Patrick, additional, Sabti, Zaid, additional, Rubini Giménez, Maria, additional, Wildi, Karin, additional, Hillinger, Petra, additional, Grimm, Karin, additional, Loeffel, Sarah, additional, Shrestha, Samyut, additional, Flores Widmer, Dayana, additional, Cupa, Janosch, additional, Kozhuharov, Nikola, additional, Miró, Òscar, additional, Martín-Sánchez, F. Javier, additional, Morawiec, Beata, additional, Rentsch, Katharina, additional, Lohrmann, Jens, additional, Kloos, Wanda, additional, Osswald, Stefan, additional, Reichlin, Tobias, additional, Weber, Ekkehard, additional, Marber, Michael, additional, and Mueller, Christian, additional

Published
2018
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249. Direct Comparison of the 0/1h and 0/3h Algorithms for Early Rule-Out of Acute Myocardial Infarction

Author

Badertscher, Patrick, primary, Boeddinghaus, Jasper, additional, Twerenbold, Raphael, additional, Nestelberger, Thomas, additional, Wildi, Karin, additional, Wussler, Desiree, additional, Schwarz, Jonas, additional, Puelacher, Christian, additional, Rubini Giménez, Maria, additional, Kozhuharov, Nikola, additional, du Fay de Lavallaz, Jeanne, additional, Cerminara, Sara Elisa, additional, Potlukova, Eliska, additional, Rentsch, Katharina, additional, Miró, Òscar, additional, López, Beatriz, additional, Martin-Sanchez, F. Javier, additional, Morawiec, Beata, additional, Muzyk, Piotr, additional, Keller, Dagmar I., additional, Reichlin, Tobias, additional, Mueller, Christian, additional, Sabti, Zaid, additional, Strebel, Ivo, additional, Shrestha, Samyut, additional, Flores, Dayana, additional, Freese, Michael, additional, Stelzig, Claudia, additional, Kulangara, Caroline, additional, Meissner, Kathrin, additional, Schaerli, Nicolas, additional, Mueller, Deborah, additional, Yufera Sanchez, Ana, additional, Sazgary, Lorraine, additional, Marbot, Stella, additional, Fuenzalida, Carolina, additional, Calderón, Sofia, additional, Rodriguez Adrada, Esther, additional, Kawecki, Damian, additional, Nowalany-Kozielska, Ewa, additional, Parenica, Jiri, additional, Ganovská, Eva, additional, von Eckardstein, Arnold, additional, Lohrmann, Jens, additional, Kloos, Wanda, additional, Osswald, Stefan, additional, Buser, Andreas, additional, Bingisser, Roland, additional, and Geigy, Nicolas, additional

Published
2018
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250. Amyloid-β (1-40) and Mortality in Patients With Non–ST-Segment Elevation Acute Coronary Syndrome

Author

Stamatelopoulos, Kimon, primary, Mueller-Hennessen, Matthias, additional, Georgiopoulos, Georgios, additional, Sachse, Marco, additional, Boeddinghaus, Jasper, additional, Sopova, Kateryna, additional, Gatsiou, Aikaterini, additional, Amrhein, Carolin, additional, Biener, Moritz, additional, Vafaie, Mehrshad, additional, Athanasouli, Fani, additional, Stakos, Dimitrios, additional, Pateras, Konstantinos, additional, Twerenbold, Raphael, additional, Badertscher, Patrick, additional, Nestelberger, Thomas, additional, Dimmeler, Stefanie, additional, Katus, Hugo A., additional, Zeiher, Andreas M., additional, Mueller, Christian, additional, Giannitsis, Evangelos, additional, and Stellos, Konstantinos, additional

Published
2018
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